Using Diffusion of Innovations (DOI) in Organizations as a theoretical framework, this dissertation analyzed the diffusion process of the federally mandated School Wellness Policy (SWP) in three separate studies. Beginning with a content analysis of the SWP mandate's legislative history using the constant comparative method, the first manuscript evaluated the policy Initiation process to provide context for the creation of the original mandate. Next, the researcher conducted a systematic literature review to organize and analyze the current literature on SWP implementation. The third manuscript presented a qualitative case study of one local school district's experience implementing the School Wellness Policy. Interviewing school personnel such as teachers, school nurses, PE teachers, and cafeteria mangers provided key insight to processes involved in policy implementation at the local level. Three key findings emerged from the study: 1) a lack of research on the clarifying stage of the policy diffusion process, 2) the limitation of policy alone in addressing child obesity, and 3) an opportunity for health promotion researchers to engage in policy research. This study is unique because it analyzed the complete diffusion process of the SWP policy, beginning with policy decision making by legislators on the federal level and ending with policy implementation efforts by school district personnel on the local level. Public attention to the child obesity epidemic has grown significantly in the last decade. However, increased awareness is not necessarily indicative of change or improvement of the problem. In the case of the School Wellness Policy (SWP), the federal government attempted to mandate change in the school environment as a way of combating the child obesity epidemic. Although public policy can be effectively used to facilitate change, policy alone is incapable of solving problems as vast and complex as the child obesity epidemic. The SWP has resulted in changes to the school environment; but, this study showed that a societal shift (change across all private and public sectors) is necessary for long term success in combating child obesity.

This study determined attitudes of kindergarten through fifth grade teachers about school nutrition environments, their perceived influence on school nutrition environments, and self-reported classroom behaviors. Specific objectives were to: (a) identify perceived factors that influence the school nutrition environment, according to teachers surveyed; (b) examine relationships between elementary school teacher attitudes about school nutrition environments and perceived influence on the environment; (c) examine relationships between elementary school teachers’ attitudes about school nutrition environments, and self-reported classroom behaviors; (d) examine relationships between perceived influence over the school nutrition environment and self-reported classroom behaviors; and, (e) examine relationships between teachers’ demographic characteristics and attitudes and perceived influence on school nutrition environments, and self-reported classroom behaviors. Research was conducted in a mid-size Florida school district including 501 participants from 23 elementary schools. The Teacher Survey on School Nutrition Environments instrument was developed and validated by the researcher. Teachers identified the Food and Nutrition Services department as having the greatest impact on school nutrition environments, followed by student lunches and snacks sent from home. Responses to open-ended questions identified parents as part of the problem in developing healthy school nutrition environments. The Food and Nutrition Services department and parents were identified as having primary responsibility for encouraging healthy food choices at school, followed by administration, then teachers. Teachers did not perceive opportunities to provide input or to impact the school nutrition environment beyond their classrooms. The greater self-efficacy the teachers possessed, the more they felt they influenced the nutrition environment, and the more likely they were to offer menu suggestions, to sit or eat with students, to discuss food-related topics, and to integrate nutrition into lessons. Similar results were noted for teachers with college coursework in nutrition and those who were more experienced teachers. Classroom teachers should be encouraged to become involved and to recognize their role in developing and maintaining a healthy school nutrition environment. Increased communication should occur between school nutrition programs and teachers. Local wellness policy development and implementation should emphasize teachers’ influence.