This study explores factors associated with implementation of the physical education and physical activity standards of the South Carolina Students Health and Fitness Act of 2005 in Title I elementary schools. The study was framed using selected components of the diffusion of innovations theory, which looked at characteristics of the law and their influence on level of implementation of the law. Additionally, factors of the school organization (size, school culture, system support, system openness) were studied for possible association with implementation. Methods: Electronic surveys were designed and administered through Survey Monkey, one targeting principals and another targeting physical activity directors. SAS statistical software was used to analyze collected data. Multiple regression analysis was used to determine associations of independent and dependent variables. Results: A total of 37 principals and 36 physical activity directors from 55 school districts participated in this cross-sectional study. The only factor found to be statistically significant to level of implementation was compatibility as perceived by principals. Of a possible maximum index score of 12, the mean score for implementation of requirements as reported by the 36 physical activity directors was 8.29. Conclusion: Like with any research study, this study has several limitations including a small sample size, missing and incomplete responses, self-reporting by respondents. However, despite the limitations, this study is important to the field of school health promotion because it 1) provides insight on physical education and physical activity policy implementation in school organizations and 2) provides insight on what is required and the relationship between school level practices compared to state level policy. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]