In 1999 the American Cancer Society (ACS) launched the National School Health Coordinator Leadership Institute, a groundbreaking initiative designed to enhance and invigorate school health in the nation's schools by training individual school health coordinators to act as change agents. The Institute consisted of three, week-long summer training sessions, and three, shorter midyear "booster" sessions, with the various sessions designed to assist one cohort of participants (n = 50) to build leadership capacities to coordinate school health. This evaluation examined the effects of the Institute as measured through a panel survey of participants - school health coordinators or their equivalents - over an 18-month period. Findings suggest that substantial progress was made in institutionalizing the school health coordination function in the target school districts. Specifically, in contrast to when the training began, clear, written position descriptions are common among program participants, most have functioning school health councils in their school districts, and program trainees appear to be moving aggressively to enhance the infrastructure for school health coordination through planning, setting priorities, and assessing needs. Program trainees report spending increased time on school health coordination, and they are active in spreading the word about coordinated school health programs. Trainees viewed the Institute as relevant to their needs, though not all aspects of the program are viewed as equally useful. As possible shortcomings, the training needed more emphasis on funding for school health coordination, and a low level of evaluation skills existed among coordinators.