This study is a retrospective evaluation of the Coordinated Approach To Child Health (CATCH) coordinated school health program. An abundant amount of research has been conducted concerning CATCH, but no data exist that represents the characteristics and attitudes of individuals implementing the program. This study looked to examine organizational readiness, commitment to change, leadership, implementation barriers, innovation perceptions and their influence on the diffusion of CATCH. The primary purpose of this study is to describe and explain why schools in the same area that receive the same CATCH training result in different implementation practices. This study included a retrospective evaluation that evaluated school employees' motivation of CATCH implementation over the 2011-2012 school year. A survey of 284 school employees and health department partners consisting of 33 school administers, 197 classroom teachers, 27 physical education teachers, 21 cafeteria supervisors, and 6 health department partners at elementary school located in the southernmost counties of southern Illinois was conducted. Particular attention was focused upon the differences between classroom teachers, physical education teachers, cafeteria supervisors, and health department partners. Degree of CATCH implementation was the best among cafeteria supervisors and physical education teachers while classroom teachers implemented roughly 50% of the CATCH classroom curriculum. Organizational readiness was a significant predictor of classroom teacher degree of implementation while school leadership served as a significant predictor of degree of implementation by physical education teachers. The study utilizes CATCH; however, this study could be helpful concerning other school health programs to enhance program implementation practices and delivery. The significance of these data provide health educators with evidence of why schools have different implementation practices, what constructs influence degree of implementation, and how addressed constructs that influence implementation can be rectified through school preparation and training protocols to enhance degree of implementation. Additional variables are also discussed that could account for further variation in school employee degree of implementation.

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School-aged children’s health needs have changed over the last several decades to the present day population of many overweight and obese children with health complications (Centers for Disease Control & Prevention, 2015). Tennessee has implemented the Centers for Disease Control and Prevention’s (CDC) model for Coordinated School Health (CSH) in all public schools. Leading each school district’s program is a CSH Coordinator. The role of CSH Coordinators is to provide leadership to district and school administrators while effectively and efficiently implementing the CSH program (Wechsler, 2012). The purpose of this quantitative study was to explore the self-perceived leadership styles and practices of Tennessee CSH Coordinators. The focus of many public health initiatives in America is childhood health. Research conducted by the CDC has shown that school health interventions have been effective in improving physical activity, comprehensive health education, and nutrition. Good health is essential for academic success (McKenzie & Richmond, 1998). CSH Coordinators are the leaders of health for school systems (Wechsler, 2012). How these individuals implement the CDC model for CSH varies based on leadership style and practices. Many studies exist on the topic of CSH but few consider the people leading the program (Strickland, 2012). By obtaining information regarding the leadership style of current CSH Coordinators, this research provides insight into best practices and continuing education for current and future leaders. The study population consisted of all 137 Tennessee CSH Coordinators. Seventy (51.1%) CSH Coordinators participated in the demographic, best practices, and Multifactor Leadership Questionnaire (Appendix A). Findings indicated that all of the CSH Coordinators self-reported leadership style was transformational. There were no significant differences reported between the degree to which CSH Coordinator identified as transformational leaders compared by years of experience, gender, school district size, education level, and number of best practices implemented.

Abstract Dawn Arlotta (The Effects of HealthMPowers on the Levels of Physical Activity among Students in 13 Georgia Public Schools) (Under the direction of Dr. Marshall Kreuter and Dr. Derek Shendell) Objectives. This study evaluated a school based health and physical education program conducted in nine elementary and four middle schools in seven Metro-Atlanta school districts in Georgia. HealthMPowers served 5,644 students last year and approximately 15,000 students over the 3 year intervention. Methods. Quantitative programmatic data were collected by HealthMPowers before the intervention started (pre, 2004) and again three years later (post, 2007). HealthMPowers worked with these schools for the entire three year period and collected post Program Design and post-intervention fitness data in spring 2007. Results. The nine participating elementary schools each demonstrated an increase in student fitness levels for the fourth and fifth grades. The four middle schools demonstrated an increase in student fitness levels in at least one grade, which varied by school. Conclusion. Our findings suggested school programs can be effective in increasing physical activity and fitness scores and supports broader implementation of known successful programs. INDEX WORDS: Physical Activity, Youth, School Health Index, Coordinated School Health Program, Obesity, FITNESSGRAM, Physical Fitness Testing, Physical Education.

ABSTRACT Lifestyle factors related to overweight, obesity, and Type 2 diabetes are currently in the forefront of health issues affecting children and adolescents. Schools have been considered important venues for disseminating health education and promotion programs. Some investigators, however, contend that school-based programs have only seen modest success over the last two decades. Typically short-term, school-based interventions do not address program sustainability or larger social issues such as socioeconomic status (SES). A growing body of literature suggests there is value in collaborative efforts between university researchers and communities as these relationships can help build the capacity of the school and community. The Coordinated School Health Program (CSHP) model was developed as a mechanism to build the organizational capacity of schools to facilitate, integrate and sustain health education and promotion efforts to improve the health of youth in our nation. The purpose of the current study was to assess a mid-western middle school's capacity to sustain a previously implemented Type 2 diabetes prevention program. An instrumental case study design was utilized. A total of 19 interviews were conducted. Additionally, observations and documents related to school policies and procedures were reviewed. The four infrastructures of the CSHP framework were used as predetermined categories into which data were coded. This study found that there was potential for the school to sustain the Type 2 diabetes program within the framework of the CSHP Model. The school already had in place five of the eight CSHP components. The three remaining components could be implemented if several issues were addressed. First, there were many myths and misconceptions regarding the purpose and costs of a CSHP. Education for district administrators, school faculty and staff, as well as the community, would be vital. Concerns regarding personnel to implement a CSHP were expressed. A dedicated health course would also need to be implemented. When planning health related interventions that will be implemented in school-based settings researchers should seriously consider implementing a CSHP prior to employing their short-term programs. If programs can be planned with sustainability in mind, there is potential for greater health outcomes for school-aged children and adolescents.

Childhood obesity rates have increased nationwide, but rates of childhood obesity are higher in Tennessee (TN). The Coordinated School Health (CSH) Program is a multicomponent approach designed to improve academics and health in children in Tennessee; however, researchers have not evaluated the 8 components of the plan and the impact it has on weight in children. The purpose of the study was to determine if a relationship existed between the Coordinated School Health Program and obesity in children. The conceptual framework for this study was Bandura's social cognitive theory. One hundred forty CSH coordinators in TN were surveyed and the results were analyzed using multiple regression to determine the relationship between the 8 components of the CSH program and obesity rates in children in TN. Nutrition service was the only component that was statistically significant. According to study results, many districts had been exposed to the coordinated school health program and had some components in place, but the program was not seen as a priority by school administration, which affected the successful implementation of the program. The findings from this research can be used to help school officials determine how to better integrate the components of the Coordinated School Health program into the existing curriculum, allot time and resources for implementation strategies, hire the appropriate staff, and/or determine which component needs more focus. Determining which component(s) should have more emphasis creates potential for social change by reducing obesity in children, which will likely reduce the chance of those children becoming obese adults.