Residents of rural and urban areas of North Dakota were surveyed regarding chronic pain. Participants (N = 188) responded to questions pertaining to the prevalence and characteristics of chronic pain, quality of life, and social support. Overall, 58% of the participants reported chronic pain, with arthritis as the leading cause, the lower back as the main location, and oral medication as the most common treatment. Individuals from rural and urban locations differed significantly in the rate of chronic pain reported. Participants with chronic pain reported a significantly lower quality of life than individuals without chronic pain.

Weight-related outcomes were examined among high school students in Minnesota public school districts according to the quality of district wellness policies. Wellness policy strength and comprehensiveness were scored using the Wellness School Assessment Tool (WellSAT) for 325 Minnesota public school districts in 2013. The associations between WellSAT scores and district-level means of high school student responses to a statewide survey of health behaviors were examined in this ecologic study. WellSAT Total Strength and Total Comprehensiveness scores were positively associated with both student mean Body Mass Index (BMI) percentile (Strength: P = 0.018, Comprehensiveness: P = 0.031) and mean percent overweight or obese (Strength: P = 0.008, Comprehensiveness: P = 0.026), but only in districts with > 50% of students eligible for Free or Reduced-Price Lunches (FRPLs), or 'high FRPL districts'. WellSAT Physical Education and Physical Activity subscale scores were also positively associated with the mean days per week students engaged in physical activity for ≥ 60 min in high FRPL districts (Strength: P = 0.008, Comprehensiveness: P = 0.003) and in low FRPL districts (< 35% eligible) for Strength score: (P = 0.027). In medium FRPL districts (35-50% eligible), Nutrition Education and Wellness Promotion Strength and Comprehensiveness subscale scores were positively associated with, respectively, daily servings of vegetables (P = 0.037) and fruit (P = 0.027); and WellSAT Total scores were positively associated with daily vegetable servings (Strength: P = 0.037, Comprehensiveness: P = 0.012). Administrators of economically disadvantaged school districts with a higher percentage of overweight students may be recognizing the need for stronger wellness policies and the specific importance of implementing policies pertaining to physical activity as a means to improve student health.

Residents of rural and urban areas of North Dakota were surveyed regarding chronic pain. Participants (N = 188) responded to questions pertaining to the prevalence and characteristics of chronic pain, quality of life, and social support. Overall, 58% of the participants reported chronic pain, with arthritis as the leading cause, the lower back as the main location, and oral medication as the most common treatment. Individuals from rural and urban locations differed significantly in the rate of chronic pain reported. Participants with chronic pain reported a significantly lower quality of life than individuals without chronic pain.

Objective To compare the strength of district wellness policies with corresponding school-level practices reported by principals and teachers. Design District-level wellness policy data was collected from school district websites and, if not available online, by requests made to district administrators in the fall of 2013. The strength of district policies was scored using the Wellness School Assessment Tool. School-level data were drawn from the 2012 Minnesota School Health Profiles principal and teacher surveys and National Center for Education Statistics Common Core Data. Generalized estimating equations which accounted for school-level demographics and the nesting of up to two schools within some districts were used to examine 10 district policy items and 14 school-level practices of relevance to nutrition standards, nutrition education and wellness promotion, and physical activity promotion. Setting/Subjects Statewide sample of 180 districts and 212 public schools in Minnesota. Results The mean number of energy-dense, nutrient-poor snack foods and beverages available for students to purchase at school was inversely related to the strength of district wellness policies regulating vending machines and school stores (p=0.01). The proportion of schools having a joint use agreement for shared use of physical activity facilities was inversely related to the strength of district policies addressing community use of school facilities (p=0.03). No associations were found between the strength of other district policies and school-level practices. Conclusions Nutrition educators and other health professionals should assist schools in periodically assessing their wellness practices to ensure compliance with district wellness policies and environments supportive of healthy behaviors.

In 2006, the Anchorage School District implemented a school wellness policy to address the problem of obesity among its elementary-aged students. We assessed whether the addition of this policy is effective in protecting or preventing students from becoming overweight/obese over time. The methods involved following two cohorts of students for 5 years, a cohort not exposed and a cohort exposed to the policy. The results show that exposure to the policy does not significantly protect or prevent students from becoming overweight/obese. However, we found that regardless of being exposed to the policy, boys (odds ratio [OR] = 1.12), ethnic minorities, (OR = 1.18), and students from low socioeconomic backgrounds (OR = 1.44) were more likely to remain or become overweight/obese. Our findings suggest that factors outside the school may be impacting students' overweight/obese status. Efforts to curb the problem of childhood obesity should extend to the children's communities and homes.