BACKGROUND: In August 2020, the Centers for Disease Control and Prevention (CDC) released guidance to prevent transmission of coronavirus disease 2019 (COVID-19) in K-12 education settings. Schools varied in the degree to which they were able to implement COVID-19 prevention strategies during the height of the pandemic. METHODS: An evaluation team conducted interviews with state education staff and focus groups with district and school staff over 2 years to explore contextual factors that influenced the implementation of CDC's recommended COVID-19 prevention strategies. RESULTS: Eight implementation drivers influenced COVID-19 response efforts in school settings, including COVID-19 guidance, political climate, communication challenges, state health and education agency support, partnerships, physical and financial resources, staffing, and student needs. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Evaluation results offer insights for future guidance and support for schools and educators as they continue efforts to prevent the spread of COVID-19 and other infectious diseases for safe in-person learning. CONCLUSIONS: The authors describe key drivers and conditions that influenced, facilitated, and/or impeded schools' implementation of COVID-19 prevention strategies. Federal, state, district, and school leadership can use the results to bolster future emergency preparedness and response efforts to protect student and school employee health.

CONTEXT: Schools vary in their capacity to implement recommended strategies to prevent infectious diseases, such as COVID-19. Professional development (PD) and technical assistance (TA) are well-established tools used to strengthen school capacity and infrastructure for healthier school environments. OBJECTIVE: The authors examined the relationship between PD and TA received by districts and schools and their implementation of COVID-19 prevention strategies during the 2020-2021 school year. DESIGN AND SETTING: We conducted a descriptive analysis of survey responses collected during Spring 2021 from selected districts and schools in 9 participating states. The survey assessed the implementation of 10 COVID-19 prevention strategies recommended by the Centers for Disease Control and Prevention and whether district or school staff received PD and/or TA on topics related to COVID-19 during the same year. PARTICIPANTS: Survey responses were received from designated contacts in 310 districts and 931 schools across 9 states. MAIN OUTCOME MEASURES: The dependent variable was the number of COVID-19 prevention strategies that were reported as "in place" by each district and school ranging from 0 to 10. RESULTS: On average, districts and schools reported implementing 7 of 10 recommended COVID-19 prevention strategies during the 2020-2021 school year. Schools that received PD on at least 1 of 12 topics reported implementing 7.61 COVID-19 prevention strategies, whereas schools that did not receive PD reported implementing 6.34 strategies. Similarly, schools that received TA on at least 1 topic reported higher COVID-19 implementation scores (7.51) than schools that did not receive any TA (7.20). CONCLUSIONS: Findings reveal a positive relationship between receiving PD and/or TA and implementation of COVID-19 prevention strategies in school settings.

BACKGROUND: School-based health education can provide students with learning experiences that improve knowledge, attitudes, and perceptions (KAP) and behaviors regarding physical activity and nutrition. METHODS: We conducted a 2-phase systematic review. Phase 1 was a review of reviews (ie, systematic reviews or meta-analyses) that were published 2010-2018. Phase 2 was a search for individual articles published 2010-2020 addressing topics relevant to our review; we searched for articles that had not been part of a sufficiently relevant or recent review or that had been part of a review that concluded that too few articles were available to assert sufficient evidence. RESULTS: Forty-three studies were assessed: 20 randomized controlled trials and 23 quasi-experimental designs. Collectively, interventions had a favorable impact on students' PA and nutrition KAP, but behavioral and secondary outcome results (eg, body mass index) were mixed. CONCLUSIONS: Using the evidence-based health education strategies identified in this review can help contribute to improvements in students' KAP and behaviors.

Mask wearing is a critical mitigation strategy in preventing the introduction and spread of SARS-CoV-2, the virus that causes coronavirus 2019 (COVID-19), within school settings. In October 2020, a sample of 3,953 middle and high school students aged 13–21 years who were attending in-person classes were asked about mask use by fellow students in several settings. Approximately 65% of students reported that fellow students wore a mask “all the time” in the classroom and in hallways or stairwells. However, reported use of masks all the time was lower in other indoor locations, including school buses (42%), restrooms (40%), and the cafeteria (when not eating) (36%). Reported observed mask use all the time was lowest during sports or extracurricular activities (28%) and outside on school property (25%).