Implementing Statewide Health Surveillance in Schools: Processes and Lessons Learned from the Texas SPAN Project

Objective: Prevalence of obesity among youth has increased in the last several decades. Using schools as a place to collect data on childhood obesity is considered by many researchers to be an important component to combating the disease. In this paper, we present process data from the Texas School Physical Activity and Nutrition (SPAN) project, a statewide surveillance system to monitor the prevalence of Texas school-aged children who have overweight/obesity. Methods: We selected 3 Public Health Regions (PHRs), including 30 districts and 140 schools, to represent geographic variability of processes of conducting this surveillance system. We tracked and analyzed administrative and communicative processes to conduct the Texas SPAN in those districts/schools. Results: The results demonstrate significant procedural variability across and within PHRs in implementing Texas SPAN. These variations occurred and are presented at both the district and school levels and relate to parental consent, communication processes, and time lags involved in approval and measurement. Conclusions: Due to the variability in the process data observed across and within PHRs, we recommend researchers interested in establishing obesity surveillance systems work to create statewide and local partnerships, cultivate strong communication, and develop mechanisms for data management.