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Schools are a key venue for childhood obesity prevention policies. The objective of this study was to examine factors associated with elementary school teacher awareness and implementation of their schools' food and physical activity policies. Methods We collected data through an online survey of teachers at Utah elementary schools with food and physical activity policies. We used bivariate analysis and logistic regression to assess association of variables with teacher awareness and implementation. Results Of 1,243 teacher respondents, 546 (44%) were aware of the food policy and 550 (44%) were aware of the physical activity policy. Food policy awareness was associated with knowing where written policies were located (odds ratio [OR], 2.7; 95% confidence interval [CI], 2.0-3.5), knowing the school health program coordinator (OR, 1.9; 95% CI, 1.4-2.7), and being reminded of policies at least once per semester (OR, 2.3; 95% CI, 1.7-2.9). Policy awareness was associated with both food (OR, 4.6; 95% CI, 3.6-6.0) and physical activity (OR, 1.6, 95% CI, 1.2-2.3) policy implementation. Helping develop the physical activity policy was associated with its implementation (OR, 2.4; 95% CI, 1.2-4.7). Thinking that students were more overweight than in the past was associated with food policy implementation (OR, 1.6; 95% CI, 1.1-2.5). Conclusion Establishing food and physical activity policies at schools does not ensure teacher awareness or implementation. To promote policy awareness and implementation, school leaders should involve teachers in policy development, remind teachers of policies at least once per semester, and continue to educate teachers about childhood obesity.

Teacher Awareness and Implementation of Food and Physical Activity Policies in Utah Elementary Schools, 2010