Physical education and physical activity: results from the School Health Policies and Programs Study 2006

School physical activity environment related to student obesity and activity: a national study of schools and students

PURPOSE

To explore whether characteristics of the U.S. secondary school physical activity environment are associated with student body mass index (BMI) and physical activity.

METHODS

This report uses data from two studies: Monitoring the Future (MTF; an annual nationally representative survey of 8th-, 10th-, and 12th-grade public and private school students) and Youth, Education, and Society (a survey of administrators in schools that have completed their 2-year participation in the MTF study). School policies and programs related to various health issues, including physical education (PE) and sports activity, were examined for relationships with student self-reported height, weight, being active in sports, exercising vigorously, and participating in school athletics.

RESULTS

The results show that in 2004-2007, the percentage of students who attended schools that required PE in their grade differed sharply by grade level: 88% of 8th graders, 48% of 10th graders, and 20% of 12th graders. There were few statistically significant associations between school PE requirements and student BMI. The average percentage of students who participated in interscholastic or varsity sports was associated at the bivariate level with a lower percentage of students being overweight in all three grades. Other measures of PE and sports activity showed varying associations with BMI and physical activity measures.

CONCLUSIONS

Relationships between the school physical activity environment and student BMI and physical activity were not uniformly strong. We conclude that, as currently practiced in schools, existing variations in physical activity policies may not be sufficient to produce discernible school-wide differences; thus, there is a need for more vigorous PE programming than is typically provided.

Physical education class injuries treated in emergency departments in the US in 1997-2007

OBJECTIVE

The goal was to describe the epidemiological features of physical education (PE)-related injuries treated in US emergency departments.

METHODS

A retrospective analysis was conducted with data for children and adolescents (5-18 years of age) from the National Electronic Injury Surveillance Study of the US Consumer Product Safety Commission, from 1997 through 2007. Sample weights provided by the National Electronic Injury Surveillance System were used to calculate national estimates of PE-related injuries. Trend significance of the number of PE-related injuries over time was analyzed by using linear regression analysis.

RESULTS

An estimated 405305 children and adolescents were treated in emergency departments for PE-related injuries. The annual number of cases increased 150% during the study period (P = .001). Nearly 70% of PE-related injuries occurred during 6 activities, that is, running, basketball, football, volleyball, soccer, and gymnastics. Boys' injuries were more likely to involve the head, to be diagnosed as a laceration or fracture, to be attributable to contact with a person or structure, and to occur during group activities. Girls' injuries were more likely to involve the lower extremities, to be strains and sprains, to be acute noncontact injuries, and to occur during individual activities.

CONCLUSION

More research is needed to identify the cause of the increase in PE-related injuries, to examine the gender difference in PE-related injuries, and to determine appropriate injury prevention solutions and policies.

Associations of various family characteristics and time use with children's body mass index

This study used multiple regression models to estimate associations of various family characteristics and time use with the body mass index (BMI) z-scores of 734 boys and 725 girls aged 5-18y from the Panel Study of Income Dynamics Child Development Supplement 2003. The strongest relationship in the data was between the BMI of the head of household and a child's BMI z-score (p < 0.001). Time spent sleeping, performing sedentary behaviors, and participating in physical activities was not associated with a child's BMI z-score. This suggests that a family-oriented approach to prevent and treat childhood and adolescent overweight is required.

An adapted version of Intervention Mapping (AIM) is a tool for conducting community-based participatory research

The field of public health is increasingly using community-based participatory research (CBPR) to address complex health problems such as childhood obesity. Despite the growing momentum and funding base for doing CBPR, little is known about how to undertake intervention planning and implementation in a community-academic partnership. An adapted version of Intervention Mapping (AIM) was created as a tool for university and elementary school partners to create school-level environment and policy changes aimed at increasing student physical activity and healthy eating. After AIM was completed, interviews were conducted with school partners. Findings indicate AIM is closely aligned to 7 of 9 CBPR principles. Examples include equitable involvement of all partners, co-learning, and balancing knowledge generation and community improvement. Shortcomings, lessons learned, and suggestions for strengthening the AIM process are described.

Associations between school recreational environments and physical activity

BACKGROUND

School environments may promote or hinder physical activity in young people. The purpose of this research was to examine relationships between school recreational environments and adolescent physical activity.

METHODS

Using multilevel logistic regression, data from 7638 grade 6 to 10 students from 154 schools who participated in the 2005/06 Canadian Health Behaviour in School-Aged Children Survey were analyzed. Individual and cumulative effects of school policies, varsity and intramural athletics, presence and condition of fields, and condition of gymnasiums on students' self-reported physical activity (>or=2 h/wk vs <2 h/wk) were examined.

RESULTS

Moderate gradients in physical activity were observed according to number of recreational features and opportunities. Overall, students at schools with more recreational features and opportunities reported higher rates of class-time and free-time physical activity; this was strongest among high school students. Boys' rates of class-time physical activity were 1.53 (95% confidence interval (CI) = 1.12-1.80) times as high at high schools with the most recreational features as at schools with the fewest. Similarly, girls' rates of free-time physical activity at school were 1.62 (95% CI: 0.96-2.21) times as high at high schools with the most opportunities and facilities as compared to schools with the fewest. Modest associations were observed between individual school characteristics and class-time and free-time physical activity.

CONCLUSIONS

Taken together, the cumulative effect of school recreational features may be more important than any one characteristic individually.

Implementation of a school-based state policy to increase physical activity*

BACKGROUND

In 2005, the North Carolina State Board of Education updated the Healthy Active Children Policy to include a requirement that all kindergarten through eighth-grade children receive at least 30 minutes of moderate-to-vigorous physical activity each school day through physical education, recess, and other creative approaches. This study describes how districts are meeting the physical activity-related portion of this policy and explores the policy implementation successes and challenges.

METHODS

An online survey was conducted in summer 2007 in all school districts in the state (response rate 106/111; 95.5%). Respondents were asked to describe the implementation successes and challenges associated with including 30 minutes of physical activity in the school day. Answers were double coded, checked, and grouped into themes.

RESULTS

The physical activity requirement was most often met through recess, physical education, classroom Energizers, and intramural sports. School districts reported numerous positive effects of the policy in elementary and middle schools. Benefits included increased student focus on studies, physical activity participation, awareness of healthy habits, alertness and enjoyment, and higher staff involvement. Implementation challenges to the policy included lack of time in the school day, teacher participation, and concerns about academics.

CONCLUSIONS

School districts reported that implementation of the policy produced many positive results for students and staff. Addressing several implementation challenges common across school districts would strengthen the ongoing success of the policy.

Schools and obesity prevention: creating school environments and policies to promote healthy eating and physical activity

CONTEXT

Research consistently shows that the majority of American children do not consume diets that meet the recommendations of the Dietary Guidelines for Americans, nor do they achieve adequate levels of daily physical activity. As a result, more children are overweight today than at any other time in U.S. history. Schools offer many opportunities to develop strategies to prevent obesity by creating environments in which children eat healthfully and engage regularly in physical activity.

METHODS

This article discusses the role of schools in obesity prevention efforts. Current issues in schools' food and physical activity environments are examined, as well as federal, state, and local policies related to food and physical activity standards in schools. The article is organized around four key areas: (1) school food environments and policies, (2) school physical activity environments and policies, (3) school body mass index measurements, and (4) school wellness policies. Recommendations for accelerating change also are addressed.

FINDINGS

The article found that (1) competitive foods (foods sold outside of federally reimbursed school meals) are widely available in schools, especially secondary schools. Studies have related the availability of snacks and drinks sold in schools to students' high intake of total calories, soft drinks, total fat and saturated fat, and lower intake of fruits and vegetables; (2) physical activity can be added to the school curriculum without academic consequences and also can offer physical, emotional, and social benefits. Policy leadership has come predominantly from the districts, then the states, and, to a much lesser extent, the federal government; (3) few studies have examined the effectiveness or impact of school-based BMI measurement programs; and (4) early comparative analyses of local school wellness policies suggest that the strongest policies are found in larger school districts and districts with a greater number of students eligible for a free or reduced-price lunch.

CONCLUSIONS

Studies show that schools have been making some progress in improving the school food and physical activity environments but that much more work is needed. Stronger policies are needed to provide healthier meals to students at schools; limit their access to low-nutrient, energy-dense foods during the school day; and increase the frequency, intensity, and duration of physical activity at school.

School Physical Education: The Pill Not Taken

Physical education programs in schools have the potential to promote healthy, active lifestyles by providing children with some of their recommended physical activity, increasing their physical fitness levels, and teaching them generalizable movement and behavioral skills. If “exercise is medicine,” physical education is the pill not taken. Numerous barriers, including limited curriculum time allocations, low subject status, and inadequate resources hinder physical education from playing a major role in providing and promoting physical activity. This article profiles physical education as it relates to physical activity, describes its current status from both historical and contextual standpoints, and concludes with recommendations for improving it.

A national snapshot of local school wellness policies

BACKGROUND

The federal mandate for local wellness policies (LWP) provides an unprecedented opportunity to improve schools' practices that support student health, which, in turn, supports academic achievement. With a full agenda and budget challenges, districts need resources and support to turn policies into sustainable practices. The purpose of this study was to assess district policy goals and compare them to the federal mandate and benchmarks of best practices. It is hoped that this information will lead to development of specific assistance in the areas of policy implementation, evaluation, and revision.

METHODS

Action for Healthy Kids (AFHK) collected a convenience sample of 256 approved LWP. The sample included districts with small, medium, and large student enrollment from every state (except Hawaii). Policies were compared to federal requirements and the AFHK Wellness Policy Fundamentals, a tool which documents best practices for nutrition and physical activity in schools.

RESULTS

Sixty-eight percent of policies sampled were consistent with the mandates set forth in the law. Thirty-two percent did not address 1 or more goal areas set by the federal mandate with 15% not addressing goals for evaluation and monitoring. None of the policies addressed all components of AFHK's Fundamentals. Less than 1% addressed all 4 of the evaluation components. Teacher requirements and training for nutrition and physical education were addressed by 43% and 45% of policies, respectively.

CONCLUSIONS

This study's findings indicate schools will need assistance to meet each of the mandates provided by the federal mandate. Areas lacking attention in policies, yet essential for sustaining wellness practices, include assurances of qualified staff, opportunities for staff development, and implementation, evaluation, and revision of the policy.