North Carolina

Improving Healthy Eating and Physical Activity Opportunities in North Carolina Public Schools
Initiatives to improve nutrition and physical activity benefit 8,000 students and over 440 teachers and staff in 22 schools.


Water bottle refilling station

The North Carolina Division of Public Health, working with the North Carolina Department of Public Instruction, identified five school districts in the state to implement a program to improve healthy eating and physical activity in North Carolina Public Schools. The districts were selected on the basis of the prevalence of chronic disease, students receiving free and reduced lunch, and other socioeconomic markers. The districts were also diverse in terms of population density and size, (i.e., rural vs. urban districts).

The selected districts, with input from the Division of Public Health, hired five Healthy Eating and Active Living (HEAL) liaisons to implement strategies that improve healthy eating and physical activity in targeted schools in their respective districts.


The HEAL liaisons identified a minimum of three schools within their districts for intervention. The liaisons worked with the schools to complete the Alliance for a Healthier Generation’s assessment each year, write action plans that included at least one healthy eating or nutrition-related support as an objective, and implement the Comprehensive School Physical Activity Program (CSPAP) approach to support physical activity and physical education. For healthy eating and nutrition support, liaisons selected from a list of 10 CDC-recommended, evidence-based strategies for supporting healthy food and nutrition in schools.

For the physical activity support, each of the liaisons were required to use the CSPAP model to identify a physical activity leader and establish a wellness team to promote physical activity and physical education in their classes. These efforts have taken various shapes across the districts. Some liaisons have focused on increased physical activity within the classroom, while others have put more emphasis on professional development for teachers on techniques for promoting active recess, creating walking clubs, and using school walking trails.

This program was supported by CDC’s State Public Health Actions to Prevent and Control Diabetes, Heart Disease, Obesity, and Associated Risk Factors and Promote School Health cooperative agreement (DP13-1305).