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Objective: To explore factors influencing the adoption of direct education programs and policy, systems, and environmental (PSE) change initiatives focused on physical activity for Supplemental Nutrition Assistance Program-eligible audiences by Virginia Expanded Food and Nutrition Education Program and Supplemental Nutrition Assistance Program-Education (SNAP-Ed) staff., Methods: Online survey with Expanded Food and Nutrition Education Program and SNAP-Ed peer (paraprofessional) educators (n = 28) and SNAP-Ed agents (master of science level) (n = 9) in Virginia. Descriptive statistics were computed for sociodemographic characteristics and responses to questions on the basis of Likert-type scales. Exploratory factor analyses were run to identify the underlying structures of the different variables., Results: The main factors for peer educators were related to substituting nutrition programs or content for physical activity programs. Other factors included staff qualifications and expectations about leading vs teaching physical activities. For PSEs, the top factors were the capacity to reach many community members, attract new partners and stakeholders, and personal interest in the PSE., Conclusions and Implications: The results provide insight into potential barriers and motivators for adopting physical activity education and PSEs within community-based initiatives and can be used to inform program planning and staff training. Additional research is warranted to examine other factors influencing the adoption and implementation of physical activity programs and PSEs., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: The aims of this systematic review were 2-fold: (1) evaluate the effect of vitamin D educational interventions on serum 25-hydroxyvitamin D (25-OHD) concentration in adolescents (aged 10-19 years) and adults, and (2) assess the association between serum 25-OHD concentration and vitamin D knowledge, awareness of vitamin D deficiency risk, and attitudes toward behaviors associated with acquiring vitamin D., Methods: Medline, CINAHL, Embase, and SPORTDiscus were systematically searched for studies reporting associations between serum 25-OHD concentration and vitamin D knowledge, awareness, and attitudes. Results were summarized narratively. Effect sizes were calculated when data were available., Results: Eight studies reported experimental effects (2 randomized controlled trials, 1 cluster randomized trial, 4 quasi-experiments, 1 clinical audit), and 14 reported cross-sectional associations. Seven of 8 interventions reported no effect of educational interventions on serum 25-OHD concentration. A slight majority (53%; κ = 19) of studies reported statistically significant associations between serum 25-OHD concentration and vitamin D knowledge and attitudes., Implications for Research and Practice: The few educational interventions employed to increase serum 25-OHD concentration lack effectiveness. Future studies may use randomized controlled trial designs, enroll those at risk for vitamin D insufficiency and underrepresented in the literature, increase the salience of the information to the target population, and include safe sun exposure recommendations., (Copyright © 2023 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Although healthy food retail strategies are widely used, there appears to be a limited understanding of the processes and determinants for successful adoption, implementation, and sustainment. To fill this gap, we recommend the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to be used to advance the science and practice of healthy food retail. In this perspective, we: (1) introduce EPIS and describe why it was chosen as a recommended implementation science framework for healthy food retail, (2) highlight healthy food retail evidence supporting EPIS, and (3) discuss research and practice needs moving forward., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To assess the validity of the Market Basket Analysis Tool (MBAT) for food environment quality within various retail environments compared to the Nutrition Environment Measures Survey in Stores (NEMS-S)., Methods: In-store assessments using the MBAT and the NEMS-S on the same day in a given store were conducted in grocery stores, corner stores, pharmacies, and dollar stores in a metropolis, and urban and rural counties across 4 states: Louisiana, Mississippi, North Carolina, and Virginia. Descriptive statistics, correlations, and ANOVAs were used to assess store location, store type differences, and MBAT and NEMS-S scores., Results: Market Basket Analysis Tool and NEMS-S data were collected from 114 stores. Market Basket Analysis Tool and NEMS-S total and all individual component scores were significantly correlated (r = 0.84, P ≤ 0.0001; r range, 0.51-0.88; P ≤ 0.0001)., Conclusions and Implications: The MBAT offers a methodology to measure the food retail environment focusing on the availability of healthful food items with a reduced training time and streamlined data collection compared with the NEMS-S. Future work can assess the completion time of the MBAT compared with the NEMS-S and the ability of the MBAT to detect changes in food environment quality post healthy food retail interventions., (Copyright © 2022 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: Supplemental Nutrition Assistance Program (SNAP)-authorized retailers' healthy perceptions and store availability of healthy products were explored to plan a healthy food retail program., Methods: Cognitive anthropology (free list) and quantitative (food environment measure) methods were used to assess retailers' healthy product perceptions and the availability of store products aligned with dietary guidance. Cultural domain analysis techniques and descriptive and inferential statistics were used to interpret data., Results: SNAP-authorized retailers (n = 29) of rural grocery (17%), dollar (14%), convenience (66%), and specialty (3%) stores participated. There was low salience for what constituted healthy and misalignments with dietary guidance and inventory. Dried beans, nuts, and seeds were widely available products across all stores and were listed less frequently by retailers., Conclusions and Implications: Engagement with SNAP-authorized retailers to develop retailer-focused nutrition education and/or training protocols is warranted to improve the capacity for retailers to market store products aligned with dietary guidance., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

This report summarizes the available evidence for strategies used in large-scale, branded marketing campaigns to promote healthy dietary behaviors to Americans between 1990 and 2016. An adapted health-branding framework guided the 3-step mixed-methods approach to identify evidence for campaigns using a scoping review, comprehensive literature review, and key-informant interviews (n = 11). Results show that industry, government, and nongovernmental organizations supported 13 campaigns that used various health-branding strategies. The authors suggest opportunities that may inform the design and evaluation of diet-related campaigns to improve understanding and application of health-branding strategies to promote a healthy diet and to advance consumer health and well-being., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

The national Cooperative Extension System delivers a number of nutrition and physical activity interventions, but it is unknown how an intervention may translate from 1 state within the system to another. Using the reach, effectiveness, adoption, implementation, maintenance framework for program evaluation can improve intervention scale-out. Adoption is a key dimension of reach, effectiveness, adoption, implementation, maintenance: if delivery personnel do not deliver an intervention, it can have no impacts on health. Here, differences are discussed regarding adoption rates between state Extension systems when scaling out a 4-H healthy meeting intervention. This experience provides suggestions for improved scale-out of Extension programs, including state-specific adaptation and pragmatic data collection., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To determine barriers, motivators, and perspectives regarding plate waste reduction of early adolescents., Design: Trained interviewers conducted audio-recorded individual interviews with adolescents., Setting: Elementary schools implementing the National School Lunch Program in Hawai'i, Montana, and Virginia., Participants: Early adolescents (n = 47, aged 9-13 years) from families receiving or eligible to receive Supplemental Nutrition Assistance Program benefits were recruited to participate., Phenomenon of Interest: Factors influencing plate waste among adolescents and potential plate waste reduction strategies., Analysis: Coders analyzed content and thematic data to identify code categories and themes., Results: Main barriers to reducing school lunch plate waste were unsupportive school policy, undesirable food quality, satiation, and social influences. Key motivators to reducing school lunch plate waste were supportive school policy, including allowing students to share food with peers and save food to eat later; and social influences. Participants found it acceptable to throw away disliked food and unacceptable to throw away wanted food; they perceived that their peers did not care whether food was thrown away; and they thought their parents disliked wasting food., Conclusion and Implications: Results suggest that several factors might allow for minimization of school lunch plate waste in the National School Lunch Program, including improvements in food quality, food policy, and social influences. Under these important themes, strategies to employ may include improving food preparation and taste, allocating more time for students to finish lunch, allowing students to self-select food lunch items, and permitting them to share and save their leftover food., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To investigate differences in school breakfast participation and food waste in 1 school district before and after the adoption of Breakfast in the Classroom., Methods: Using a pretest-posttest design, participation and food waste were measured from 7 elementary schools in a rural area of southwest Virginia during the 2014-2015 school year. Participation and waste were measured on 4 days in each school (twice before and twice after Breakfast in the Classroom implementation) using the quarter-waste method., Results: Across all schools, food waste decreased from 43.0% to 38.5% with Breakfast in the Classroom, with significant decreases for entrée items, juice, and savory snack foods (P < .01). Fruit and cheese items generated the greatest amount of food waste at 58.2% and 49.0%, respectively., Conclusions and Implications: Breakfast in the Classroom may be an effective tool to decrease food waste while improving dietary intake. Future research is needed among more diverse populations., (Copyright © 2019 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Evidence-based walking programs exist and some have been tailored specifically for the national Cooperative Extension System; however, program outcomes and translational challenges and successes are underreported. This has presented a challenge to scaling the best-fit intervention for walking promotion within this national system. Here, we describe existing open-access walking programs as well as implications for improving the fit and sustainability of this intervention type within the system. Our experience provides suggestions for pragmatic data collection, infrastructure to support pragmatic data collection, and novel ways to disseminate best practices, as well as considerations for de-implementing what is not working., (Published by Elsevier Inc.)

Objective: To examine dietary intake differences resulting from a sugar-sweetened beverage reduction intervention by 3 Supplemental Nutrition Assistance Program (SNAP) participation groups: SNAP participants (n = 56), income-eligible nonparticipants (n = 30), and income-ineligible nonparticipants (n = 60)., Methods: Adults in southwest Virginia were enrolled in a 6-month behavioral trial. The researchers collected SNAP enrollment status and 3 24-hour dietary recalls at baseline and 6 months. Repeated-measures ANOVAs were used to assess differences in dietary intake among SNAP participation groups., Results: No significant group × time differences were found for energy density, Healthy Eating Index scores, Healthy Beverage Index scores, or intake of total calories, added sugars, and sugar-sweetened beverages. However, several within-group improvements were noted: income-ineligible nonparticipants and SNAP participants improved in more areas compared with income-eligible nonparticipants, including intake of total calories, added sugars, and sugar-sweetened beverages., Conclusions and Implications: This exploratory analysis suggests that the overall effectiveness of a sugar-sweetened beverage intake reduction intervention was not influenced by SNAP eligibility and participation status, because there were no significant group by time differences over the intervention. It is important to recognize for future programs that different approaches to improving dietary intake may be needed to match the characteristics of this audience better. This may be accomplished by attempting to decrease the disparity gap between income-eligible nonparticipants and those receiving SNAP or who are income ineligible through the use of programs such as SIPsmartER., (Copyright © 2018. Published by Elsevier Inc.)

Objective: To evaluate the reliability of the Market Basket Assessment Tool (MBAT) for assessing the availability of fruits and vegetables, low-fat or nonfat dairy and eggs, lean meats, whole-grain products, and seeds, beans, and nuts in Supplemental Nutrition Assistance Program-authorized retail environments., Methods: Different trained raters used the MBAT simultaneously at 14 retail environments to measure interrater reliability. Raters returned to 12 retail environments (85.7%) 1 week later to measure test-retest reliability. Data were analyzed using paired-sample t tests and correlations., Results: No significant differences were found for interrater reliability or test-retest reliability for individual categories (mean differences, 0.0 to 0.3 ± 0.2 points) or total score (mean difference, 0.5 ± 0.4 points and (mean differences, 0.0 to 0.3 ± 0.3 points) or total score (mean difference, 0.8 ± 0.4 points), respectively., Conclusions and Implications: Future steps include validation of the MBAT. A low-burden tool can facilitate evaluation of efforts to promote healthful foods in retail environments., (Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To assess the effects of the national Smart Snacks in School standards, which include nutrient and ingredient limitations for school competitive foods and beverages effective July, 2014, on student intake in low-income rural Appalachian middle schools., Methods: Food-frequency questionnaires were administered to students before and after implementation. Multiple ordinal logistic regression models were conducted to examine effects from year of data collection, grade, and free or reduced price lunch participation rates., Results: No significant changes were observed after implementation except a decrease in consumption of 1% or nonfat flavored milk at school., Conclusions and Implications: Smart Snacks in School standards did not result in significant dietary changes in this study. Longitudinal studies could evaluate long-term impacts of nutrition standards., (Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To assess differences, by health literacy status and behavioral condition, in participants' abilities to self-monitor behaviors accurately and recall key behavioral messages using data from a teach-back call., Design: Cross-sectional., Setting: Rural, southwestern Virginia., Participants: Adults (n = 301). The majority were female (81.1%), 31.9% had a high school education or less, 66.1% earned < $25,000/y, and 32.9% were low health literate., Intervention: First class session of 2 community-based behavioral interventions: SIPsmartER (reduce sugar-sweetened beverage intake) or MoveMore (increase physical activity)., Main Outcome Measures: Reported accuracy of behavioral diary completion, proportion of behavioral messages recalled during the first round of teach-back, and rounds of teach-back., Analysis: Descriptive statistics and generalized linear model., Results: Low health literate participants were significantly less accurate in diary completion (P < .001), recalled fewer behavioral messages correctly (P < .001), and needed more rounds of teach-back (P < .001) than high health literate participants. Compared with SIPsmartER participants, MoveMore participants more accurately completed diaries (P = .001) but recalled a lower proportion of behavioral messages correctly (P < .001) and required more rounds of teach-back (P < .001)., Conclusions and Implications: Health literacy status and behavioral target affect the ability to self-monitor and recall key concepts. Researchers should consider using teach-back early in the intervention to assess and reinforce participants' ability to self-monitor., (Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To determine whether sociodemographic characteristics, food security status, participation in federal nutrition programs (Supplemental Nutrition Assistance Program [SNAP] or Special Supplemental Nutrition Program for Women, Infants, and Children [WIC]), and chronic disease status were associated with adherence to water and sugar-sweetened beverage (SSB) intake recommendations., Design: Cross-sectional, random-digit phone survey with questions from the Behavioral Risk Factor Surveillance System and beverage intake questionnaire., Participants: Residents of a medically underserved, rural area., Main Outcome Measures: Water and SSB intake., Analysis: Descriptive statistics, chi-square and 1-way ANOVA, and linear and logistic regression., Results: The sample consisted of 930 respondents (aged 56 ± 17 years; 35% non-white); reported food insecurity and SNAP and WIC participation were 37%, 29%, and 8%, respectively. Prevalent health conditions included overweight/obesity (69%), diabetes (19%), and hypertension (45%). Water recommendations were more likely to be met (72%; mean intake, 31 ± 19 fluid oz) than SSB (41%; mean intake, 246 ± 297 kcal). Food insecurity and SNAP/WIC participation were not associated with meeting recommendations, but those reporting ≥ 1 chronic disease were more likely to meet SSB recommendations (odds ratio, 2.42; P = .02)., Conclusions and Implications: Odds of achieving SSB but not water recommendations were greater among individuals with a chronic disease. Efforts to communicate beverage recommendations to at-risk groups are needed., (Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: Approximately 40% of children bring a packed lunch to school. Little is known about the quality of these lunches. This study examined the nutritional quality of packed lunches compared with school lunches for pre-kindergarten and kindergarten children after the implementation of 2012-2013 National School Lunch Program standards., Methods: The researchers collected observational data for packed and school lunches from 3 schools in rural Virginia for 5 consecutive school days and analyzed them for macro and micro nutrients., Results: Of the 1,314 observations collected; 42.8% were packed lunches (n = 562) and 57.2% were school lunches (n = 752). Energy, fat, saturated fat, sugar, vitamin C, and iron were significantly higher whereas protein, sodium, fiber, vitamin A, and calcium were significantly lower for packed lunches than school lunches., Conclusions and Implications: Packed lunches were of less nutritional quality than school lunches. Additional research is needed to explore factors related to choosing packed over school lunches., (Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To explore Family Nutrition Program assistants' perception of farmers' markets and alternative agricultural practices for themselves and their clients., Methods: Cross-section design, survey of Virginia Expanded Food and Nutrition Education Program (NEP) and Supplemental Nutrition Assistance Program-Education Family Nutrition Program assistants (n = 52) working with limited-resource populations., Results: Twenty-one percent to 55% of FNP assistants valued alternative agricultural practices, and only 5% to 8% of FNP assistants perceived that their clients did so. Benefits to shopping at farmers' markets included supporting local economies, and food price, quality, and safety. Barriers included lack of transportation, location/convenience, hours, and food prices. Assistants rated the benefits to shopping at farmers' markets similarly for themselves and their clients, but rated many of the barriers to shopping at farmers' markets as significantly lower (P < .05) for themselves than for their clients., Conclusions and Implications: Future assistant trainings should address the connection between agriculture and health, and how to overcome barriers to shopping at farmers' markets for their clients., (Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To assess the amount of food waste by meal components according to the new National School Lunch Program guidelines among pre-kindergarten and kindergarten students., Methods: For 5 consecutive school days in 1 elementary school, the research team collected school lunch trays and separated meal components into bins relative to each food or beverage appearing on the school's daily menu. Bins were weighed in grams and converted to ounces and cups at the end of each lunch period., Results: The researchers examined 304 meals from 1 pre-kindergarten class and 5 kindergarten classes. Of 4,988 oz of food and beverages served, 2,261 oz (45.3%) were wasted during 1 full school week, totaling 141 lb. The greatest amount of food waste was generated from vegetables, the main entree, and milk, respectively., Conclusions and Implications: Strategies to reduce food waste in school lunch should be researched and implemented., (Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: Identification of prominent themes to be considered when planning a nutrition intervention using the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework., Design: Qualitative formative research., Setting: Women's social and civic organizations in the Lower Mississippi Delta., Participants: Thirty-seven (5 white and 32 black) women with a college degree or higher., Phenomenon of Interest: Impact of dietary and contextual factors related to the Lower Mississippi Delta culture on intervention planning., Analysis: Case analysis strategy using question-by-question coding., Results: Major themes that emerged were "healthy eating focus" and "promoting a healthy lifestyle" when recruiting organizations (Reach); "positive health changes" as a result of the intervention (Effectiveness); "logistics: time commitment, location, and schedule" to initiate a program (Adoption); "expense of healthy foods" and "cooking and meal planning" as barriers to participation (Implementation); and "resources and training" and "motivation" as necessary for program continuation (Maintenance). The "health of the Delta" theme was found across all dimensions, which reflected participants' compassion for their community., Conclusions and Implications: Results were used to develop an implementation plan promoting optimal reach, effectiveness, adoption, implementation, and maintenance of a nutrition intervention. This research emphasizes the benefits of formative research using a systematic process at organizational and individual levels., (Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Objective: To describe sugar-sweetened beverage (SSB) consumption and to establish psychometric properties and utility of a Theory of Planned Behavior (TPB) instrument for SSB consumption., Methods: This cross-sectional survey included 119 southwest Virginia participants. Most of the respondents were female (66%), white (89%), and had at least a high school education (79%), and their average age was 41.4 ± 13.5 years. A validated beverage questionnaire was used to measure SSB. Eleven TPB constructs were assessed with a 56-item instrument. Analyses included descriptive statistics, 1-way ANOVA, Cronbach α, and multiple regression., Results: Sugar-sweetened beverage intake averaged 457 ± 430 kcal/d. The TPB model provided a moderate explanation of SSB intake (R(2) = 0.38; F = 13.10, P < .01). Behavioral intentions had the strongest relationships with SSB consumption, followed by attitudes, perceived behavioral control, and subjective norms. The 6 belief constructs did not predict significant variance in the models., Conclusions and Implications: Future efforts to comprehensively develop and implement interventions guided by the TPB hold promise for reducing SSB intake., (Copyright © 2012 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

The Youth Expanded Food and Nutrition Education Program (EFNEP) is one of the United States Department of Agriculture's hallmark nutrition education programs for limited-resource youth. The objective of this study was to gather opinions from experts in EFNEP and related content areas to identify costs, effects (impacts), and related instruments to develop a cost-effectiveness model (instrument) for youth EFNEP, which does not exist. A cost-effectiveness model determines the economic or financial cost of producing an impact. The findings highlight several challenges in identifying inputs through consensus and provide a roadmap for the creation of a model that can be adopted by state EFNEP coordinators., (Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.)

Objective: To develop and assess reliability and validity of the Nutrition, Food Safety, and Physical Activity Checklist to measure nutrition, food safety, and physical activity practices among adult Expanded Food and Nutrition Education Program (EFNEP) and Food Stamp Nutrition Education program (FSNE) participants., Methods: Test-retest reliability (Cronbach alpha), internal consistency (Pearson Correlation), criterion-related validity (Spearman Correlation Coefficients), and sensitivity-to-change, were calculated for dietary quality, food safety, and physical activity, based on data collected from 73 EFNEP and FSNE participants., Results: Nutrition and physical activity domains achieved reliability coefficients of 0.70. The instrument scored Spearman correlation coefficients of 0.20 for nutrition, 0.34 for food safety, and 0.28 for physical activity., Conclusions and Implications: The instrument consistently measured dietary and physical activity practices, but not food safety. All domains obtained low correlation coefficients, although consistent with other studies' validity results., (Published by Elsevier Inc.)

Objective: Compare the macronutrient content of children's meals sold by fast-food restaurants (FFR) and non-fast-food restaurants (NFF)., Design: All restaurants within the designated city limits were surveyed. Non-fast-food children's meals were purchased, weighed, and analyzed using nutrition software. All fast-food children's meals were recorded, with nutrient content information obtained from their respective commercial Web sites., Setting: Community in southeastern United States., Participants: 33 restaurants, 10 FFR and 23 NFF., Main Outcome Measure(s): Total weight, total calories, fat, saturated fat, protein, carbohydrates, and fiber., Analysis: Paired t tests, 1-way analysis of variance, and general linear model analyses., Results: Overall mean percentage of calories from fat for children's meals at FFR was 37.5%, and 40.5% at NFF. Significant differences (P < .01) existed between FFR and NFF, with FFR providing smaller servings, fewer calories, and less total fat, saturated fat, protein, carbohydrates, and fiber. When analyzing only with the highest calorie option side, controlling for portion size, no differences remained except saturated fat., Conclusions and Implications: Fast-food restaurants offered smaller children's portion sizes and lower-fat options. These results have implications for restaurants, parents, children, and nutrition educators.

Objective: To measure whole-grain intake in college students and determine the association with body mass index (BMI)., Design: Cross-sectional convenience sample of college students enrolled in an introductory nutrition course., Setting: Large state university., Participants: 159 college students, mean age: 19.9., Main Outcome Measures: Intake of whole grains, refined grains, calories, and fiber from food records; BMI determined from height and weight measurements., Analysis: Analysis of variance with linear contrasts; participants grouped by BMI category (P<.05)., Results: Average intake of cereal grains was 5.4 servings per day, of which whole-grain intake accounted for an average of 0.7 servings per day. Whole-grain intake was significantly higher in normal weight students than in overweight and obese students (based on BMI)., Conclusions and Implications: The low intake of whole grains in this population of college students indicates the need for interventions aiming to increase whole-grain intake to the recommended minimum of 3 servings per day. College students who are concerned about their body weight may be motivated to increase their intake of whole-grain foods; however, their intake of whole grains is likely to be influenced by the availability of these food items in campus dining halls and other locations around the college campus.

By fall 2006 each school division participating in the National School Lunch Program was mandated to establish a local wellness policy. The study objective was to assess schools' plans for the policy, including goals for food, nutrition education, and physical activity and evaluation. Surveys were administered to 132 School Health Advisory Board coordinators in Virginia in early 2006; 92 (69.7%) responded. The findings highlight gaps toward meeting minimum requirements for the policy and give guidance on how nutrition educators and researchers can provide expertise to optimize the policy and document progress and impacts on children's health related to the policy.