Texas statewide assessment of youth fitness

Development of a Fitness Surveillance System to Track and Evaluate Obesity in North Idaho

BACKGROUND

Internationally 18% of youth are obese. Fitness testing can be used to establish fitness surveillance, which can inform policy and targeted interventions aimed at addressing obesity. The purpose of this study was to estimate the prevalence of overweight, obesity, and low fitness in Idaho school-aged youth through a pilot study.

METHODS

A convenience sample of 13 teachers from 11 north Idaho rural schools collected FitnessGram fitness data: body composition (body mass index [BMI]), aerobic capacity (Progressive Aerobic Cardiovascular Endurance Run [PACER] test), muscular endurance (curl up), strength (pushup), and flexibility (sit and reach).

RESULTS

A total of 761 students (aged 9-18 years) from grades 3&5, 7, and 9 to 12 participated in the study. Approximately 24% of 3&5 and 22% of 7th, and 12% of 9 to 12th-grade students were categorized as Needs Improvement/Health Risk by FitnessGram standards for BMI. Similarly, approximately 25% of 3&5, and 22% of 7 and 9 to 12th-grade students were considered Needs Improvement/Health Risk for PACER.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Results from fitness testing can provide school and public health representatives with a "needs assessment" of student health that can be used to help develop policies and practices to improve student health and wellbeing.

CONCLUSIONS

This study provides a model for statewide annual fitness testing surveillance and reporting within K-12 public school physical education classrooms.

NYC FITNESSGRAM: Population-Level Physical Fitness Surveillance for New York City Youth

NYC FITNESSGRAM, monitored by the New York City (NYC) Department of Education and the NYC Department of Health and Mental Hygiene, functions as the NYC Department of Education's citywide youth fitness surveillance program. Here we present the methods, characteristics, and data used in this surveillance system to monitor physical fitness in public school students (grades kindergarten through 12; initiated in 2006; n = 6,748,265 observations; mean sample of 519,097 observations per year to date) in New York, New York. Youth physical fitness prevalence estimates, longitudinal trends, and spatial analyses may be investigated using continuous fitness composite percentile scores and Cooper Institute for Aerobic Research-defined sex- and age-specific Healthy Fitness Zones. Healthy Fitness Zones are based on individual-child fitness test performance, with standard errors clustered at the school and student levels and adjusted for sociodemographic characteristics. Results may be used to show trends in youth fitness attainment over time and highlight disparities in the fitness prevalence of NYC students. In sum, continuous fitness composite percentile scores offer the opportunity for prospective tracking of shifts in youth physical fitness on a population scale and across subpopulations. NYC FITNESSGRAM can accompany a growing body of surveillance tools demonstrating the potential for population-level surveillance tools to promote global public health.

The History of Aerobics (50 Years and Still Counting)

Looking back over the 50 years since Aerobics was published, I could never have expected for there to have been a major change in physicians' attitudes toward the value of exercise in the practice of medicine. In my lifetime, I never thought I would see a stress test be considered a mandatory component of a complete examination, inactivity classified as importantly as high blood pressure and high cholesterol, and cigarette smoking considered a coronary risk factor. I have tried in this Research Quarterly for Exercise and Sport (RQES) Lecture presentation to document how this slow but gradual transition took place due to my work and the work of many of my colleagues in this field, along with the important work of The Cooper Institute. In June 1970, I chartered the institute 6 months before I saw my first patient at the Cooper Clinic, but now with the Cooper Center Longitudinal Study being the largest database in the world comparing measured levels of fitness, instead of relying only on questionnaires and correlating fitness and health in our more than 700 published peer-review articles, we have proven and can safely say that "exercise is medicine." In greater detail, I want this lecture to present what we and others have done in this scientific endeavor, and even the harshest critics are now saying that "these results are too impressive to be ignored."

Value of primordial and primary prevention for cardiovascular disease: a policy statement from the American Heart Association

The process of atherosclerosis may begin in youth and continue for decades, leading to both nonfatal and fatal cardiovascular events, including myocardial infarction, stroke, and sudden death. With primordial and primary prevention, cardiovascular disease is largely preventable. Clinical trial evidence has shown convincingly that pharmacological treatment of risk factors can prevent events. The data are less definitive but also highly suggestive that appropriate public policy and lifestyle interventions aimed at eliminating tobacco use, limiting salt consumption, encouraging physical exercise, and improving diet can prevent events. There has been concern about whether efforts aimed at primordial and primary prevention provide value (ie, whether such interventions are worth what we pay for them). Although questions about the value of therapeutics for acute disease may be addressed by cost-effectiveness analysis, the long time frames involved in evaluating preventive interventions make cost-effectiveness analysis difficult and necessarily flawed. Nonetheless, cost-effectiveness analyses reviewed in this policy statement largely suggest that public policy, community efforts, and pharmacological intervention are all likely to be cost-effective and often cost saving compared with common benchmarks. The high direct medical care and indirect costs of cardiovascular disease-approaching $450 billion a year in 2010 and projected to rise to over $1 trillion a year by 2030-make this a critical medical and societal issue. Prevention of cardiovascular disease will also provide great value in developing a healthier, more productive society.

Texas Youth Fitness Study: a commentary

When institutional testing is done well, there are many potential benefits; however, it is not without its negatives. The TYEP is an example of large scale institutional testing that yielded more than a few benefits as described in this supplement. However, results reported some problems as well. We have learned much from the TYEP, including what works and what does not when conducting large-scale fitness testing projects. Questions that need answers include: (a) How often must similar testing be done to achieve the intended goals? (b) Can alternative forms of testing be used to meet our goals? (c) How can we improve the next institutional testing to accentuate the positives and diminish the negatives? (d) How do we acquire the necessary funding and adequate teacher support for future institutional testing? and (e) How can we best obtain the necessary funding and support for quality physical education, including already approved but unfunded mandates? Support for quality physical education is necessary if we are to increase youth activity levels, improve youth fitness, and help reduce the risk for childhood obesity-all important goals of the TYEP.