Elementary School Personnel and Cultural Factors Affecting Health Education Implementation in the High-Stakes Testing Era.

Background: Despite proven health and learning benefits, health education implementation in elementary schools is not optimal. This study investigated learning environment, leadership, and training factors that may influence elementary-level health education implementation in the current standardized testing-saturated environment.

Methods: Survey data were collected from principals of 8 Michigan elementary schools and, via focus groups, 30 teachers in their schools.