The Superintendent’s office was first contacted to recruit elementary principals/schools for participation. Two school principals volunteered to participate and initial meetings were organized between the principals, teachers, nursing faculty, study investigators, and public health representatives. The initial meeting took place in Spring 2008. Subsequent meetings were held to develop the project protocol so that the study investigators took into consideration specific concerns about lesson plans, school day disruptions,and parent involvement. Parents and students were invited to attend informational meetings about the project presented by the study investigators.