Background
The prevalence of overweight among US children and adolescents has increased substantially since 1980. As a result, overweight in childhood and adolescence has become a substantial health problem that requires effective health promotion programs and interventions.

Context
Coinciding with the 2002 Winter Olympic Games in Salt Lake City, the Utah Department of Health (UDOH) developed a pilot program called Gold Medal Schools (GMS) to promote healthy lifestyles among school-aged children.

Methods
The GMS program was designed to help schools develop policies and create healthy school environments to meet specific criteria at 5 levels: bronze, silver, gold, platinum, and platinum focus. Participating schools, mentored by the UDOH, earn incentives to create a healthy school environment.

Consequences
A total of 316 schools and approximately 166,600 students in 37 Utah school districts have participated in the GMS program. As a result, 1,029 medals have been awarded, 2,205 policies have been developed, and 2,121 environmental changes have been reported since program inception (2001-2002 school year).

Interpretation
Because of their participation in the GMS program, schools have developed and implemented a wide range of school-based policies and environmental changes. To improve the program, we recommend enhanced efforts in impact and outcome evaluation and increased participation in vigorous-intensity physical activity during the school day.