The purpose of this project was to describe state, district, and school level policy regarding physical activity and the built environment of elementary schools in the Mississippi Delta; examine the relationship between the built environment, physical activity and weight status in children aged 6-11; and describe physical activity during structured physical education and unstructured recess. Physical activity levels and built environment characteristics were assessed using validated measurement tools. Qualitative data was collected via in-depth interviews with state, district, and school personnel to understand the facilitators and barriers related to implementation of statewide physical activity policy.