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health services, mental health or social services, and food staff in this area.” Responses were coded 1 (yes) or 0
service staff. Seven additional items assessed (no/no state level staff/no answer) due to the supposition
collaboration in the last 12 months among selected that a lack of staff precluded collaboration and no answer
organizations including state-level American Alliance for indicated the respondent was unsure or unaware of
Health, Physical Education, Recreation, and Dance collaboration. The number of states collaborating with
(AAHPERD); state school health association; state-level organization types for 2000, 2006, and 2012 were totaled
health organizations (such as American Heart Association and changes were calculated from 2000 to 2006 and from
or American Cancer Society); state health agency; state 2006 to 2012. Only comparable items from consecutive
mental health or social services agency; colleges or iterations of the SHPPS were included in analyses.
universities; and businesses. Collaboration breadth in each state was defined as of the
number of organization types collaborating with HE staff
In 2006 two items were added (working with staff or on school HE activities. We examined average
members of a state-level school nurses’ association or collaboration breadth for distribution of organizations
physicians’ organization such as the American Academy working with state staff in 2012.
of Pediatrics) and further revision in 2012 resulted in four
additional items (working with staff or members of a state-
level parents’ organization, juvenile justice department,
foundations, or the Action for Healthy Kids). RESULTS
Additionally in 2012, AAHPERD was removed as an From 2000 to 2006, the number of states in which HE
organization from the questionnaire. staff collaborated with other state-level staff was mixed
All questions were developed and tested by CDC staff (Table 1). In 2000, HE staff in 37 states reported
as well as evaluated by external reviewers before collaborating with state-level nutrition and food service
inclusion (CDC, 2013). Response options for state staff, which increased to 48 states (+11 states) by 2006
collaboration items were “yes,” “no,” or “no state-level with a smaller increase in collaboration between HE staff
and PE staff (+5 states). Decreases in collaboration were

THE HEALTH EDUCATION MONOGRAPH SERIES, Volume 34, Number 1, 2017 9