Background: The National Federation of State High School Associations provides recommendations regarding health and safety policies; however, policy development is governed at the state level. Given interstate differences in governance, the primary purpose was to describe processes that State High School Athletic Associations (SHSAAs) utilize to…

Background: Children residing in households with very low food sufficiency (VLFS), where there is "often" not enough to eat, are more likely to experience academic, health, and psychological challenges. During the COVID-19 pandemic, a temporary universal free school meals (UFSM) policy was implemented, improving food access for children…

Background: Children with asthma should have immediate access to rescue medication. Yet, <15% of children have access to this life-saving drug while at school. Methods: A search was conducted in the all states database of Westlaw to identify which the US states, territories, and the District of Columbia have a law for K-12 schools. Terms…

Background: State-level leadership and conditions are instrumental to local and regional comprehensive school mental health system (CSMHS) quality, sustainability, and growth. However, systematic documentation of state-level school mental health (SMH) policy, infrastructure, funding, and practice is limited. Methods: Using a multi-phase,…

Background: State recess laws are recommended to encourage adequate and equitable access to recess and its benefits, but the downstream effects of state recess laws are unknown. We examined the association of state recess laws with district-level policy and school recess provision. Methods: This is cross-sectional analysis of the School Health…

Background: The most recent Farm to School (FTS) Census reported that of the 42% of US schools that participate in FTS, 77% procure food locally. In 2019, Colorado joined many other states in passing legislation that provides per-meal incentives for purchasing local foods. However, little is known about how these incentives impact procurement…

Background: Asthma reliever medication access is critical, especially in schools. Policies that "stock" reliever inhalers in schools provide failsafe medication access. This research aims to understand barriers and facilitators to Illinois stock inhaler policy implementation. Methods: We conducted 18 semi-structured interviews in…

Background: The weight-normative approach to nutrition education dominates health education programming across the United States, despite evidence that this paradigm contributes to negative outcomes including weight cycling, bias and stigma, the development of disordered eating behaviors, and weight-based bullying. Methods: This study investigates…

Background: This study explored the cardiac emergency preparedness of school employees in Illinois, as well as their attitudes toward cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) training. Methods: One thousand two hundred seventy-six school employees completed an online survey regarding their school's cardiac…

Background: Anaphylaxis is a life-threatening allergic reaction with significant risk for children with allergies. Access to potentially life-saving medication is critical for these children. This review aims to describe state laws and policies guiding stock epinephrine in schools for allergic or anaphylactic events and detail recommendations for…

Background: The National School Lunch and School Breakfast programs reduce food insecurity and improve dietary intake. During the COVID-19 pandemic, school meals were provided to all children at no cost, regardless of income. This policy is known as Healthy School Meals For All (HSMFA). The purpose of the study was to examine the feasibility of a…

Background: As attention to the potential negative outcomes of childhood trauma has grown, so have calls for schools to take an active role in supporting students experiencing trauma. These calls extend beyond efforts initiated by individual schools to include those mandated by state law, which largely focus on teacher training and on screening…

Background: Under "Smart Snacks," state agencies can adopt a policy regulating infrequent school-sponsored fundraisers. Fundraiser exemptions allow noncompliant foods and beverages to be sold during the school day. This article examines fundraiser exemption policies in each state as of September 1, 2017. Methods: Laws were collected for…

Background: State policies influence the quantity and quality of educational programs delivered in schools. This study examined state physical education policy changes from 2001 to 2016 by analyzing data reported in "The Shape of the Nation Report." Methods: Policies related to state mandates for physical education, time/credit…

Background: Many youth engage in risky sexual behaviors that are associated with adverse sexual health outcomes. Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ) youth are disproportionately affected. Comprehensive sex education is instrumental to minimize these outcomes; however, each state varies in the topics taught. Methods:…