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Affiliation(s)
- Ruopeng An
- Brown School, Washington University, St. Louis, MO 63130, USA.
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Woods CB, Volf K, Kelly L, Casey B, Gelius P, Messing S, Forberger S, Lakerveld J, Zukowska J, Bengoechea EG. The evidence for the impact of policy on physical activity outcomes within the school setting: A systematic review. J Sport Health Sci 2021; 10:263-276. [PMID: 33482424 PMCID: PMC8167338 DOI: 10.1016/j.jshs.2021.01.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/24/2020] [Accepted: 11/13/2020] [Indexed: 05/06/2023]
Abstract
BACKGROUND Despite the well-established health benefits of physical activity (PA) for young people (aged 4-19 years), most do not meet PA guidelines. Policies that support PA in schools may be promising, but their impact on PA behavior is poorly understood. The aim of this systematic review was to ascertain the level and type of evidence reported in the international scientific literature for policies within the school setting that contribute directly or indirectly to increasing PA. METHODS This systematic review is compliant with Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Six databases were searched using key concepts of policy, school, evaluation, and PA. Following title and abstract screening of 2323 studies, 25 progressed to data synthesis. Methodological quality was assessed using standardized tools, and the strength of the evidence of policy impact was described based on pre-determined codes: positive, negative, inconclusive, or untested statistically. RESULTS Evidence emerged for 9 policy areas that had a direct or indirect effect on PA within the school setting. These were whole school PA policy, physical education, sport/extracurricular PA, classroom-based PA, active breaks/recess, physical environment, shared use agreements, active school transport, and surveillance. The bulk of the evidence was significantly positive (54%), 27% was inconclusive, 9% was significantly negative, and 11% was untested (due to rounding, some numbers add to 99% or 101%). Frequency of evidence was highest in the primary setting (41%), 34% in the secondary setting, and 24% in primary/secondary combined school settings. By policy area, frequency of evidence was highest for sport/extracurricular PA (35%), 17% for physical education, and 12% for whole school PA policy, with evidence for shared use agreements between schools and local communities rarely reported (2%). Comparing relative strength of evidence, the evidence for shared use agreements, though sparse, was 100% positive, while 60% of the evidence for whole school PA policy, 59% of the evidence for sport/extracurricular PA, 57% of the evidence for physical education, 50% of the evidence for PA in classroom, and 50% of the evidence for active breaks/recess were positive. CONCLUSION The current evidence base supports the effectiveness of PA policy actions within the school setting but cautions against a "one-size-fits-all" approach and emphasizes the need to examine policy implementation to maximize translation into practice. Greater clarity regarding terminology, measurement, and methods for evaluation of policy interventions is needed.
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Affiliation(s)
- Catherine B Woods
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland.
| | - Kevin Volf
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Bláthín Casey
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
| | - Peter Gelius
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91058, Germany
| | - Sven Messing
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen 91058, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen 28359, Germany
| | - Jeroen Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research institute, Amsterdam UMC, VU University Amsterdam, Amsterdam 1081 HV, the Netherlands; Upstream Team, Amsterdam UMC, VU University Amsterdam, Amsterdam 1081 HV, the Netherlands
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk 80-213, Poland
| | - Enrique García Bengoechea
- Department of Physical Education and Sport Sciences, Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland
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An R, Liu J, Liu R. State laws governing school physical education in relation to attendance and physical activity among students in the USA: A systematic review and meta-analysis. J Sport Health Sci 2021; 10:277-287. [PMID: 32961302 PMCID: PMC8167326 DOI: 10.1016/j.jshs.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/13/2020] [Accepted: 08/21/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND This study systematically synthesized and quantified the relationship linking state laws governing school physical education (PE) to PE attendance and physical activity (PA) in class and throughout the day and week among students in the USA. METHODS A keyword search was performed in PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Academic Search Complete, and EconLit. Meta-analyses were performed to estimate the effects of state PE laws. RESULTS A total of 17 studies were included in the review, and five contributed to the meta-analyses. A total of 8 studies used nationally representative school- or student-level data, three focused on multiple states, and the remaining six examined the PE laws of a single state. The presence and strength of state PE laws were positively associated with PE attendance and the frequency and duration of PA during PE classes and throughout the school day. Compared to those residing in states with weak or no PE laws, students in states with strong PE laws had an additional 0.2 days (95% confidence interval (95%CI): 0.1-0.4) of PE attendance per week and spent an additional 33.9 min (95%CI: 22.7-45.0) participating PE classes per week. State PE laws affected girls' PA more than boys'. Different aspects of state PE laws tended to affect students' PE attendance differently. Disparities in the implementation of state PE laws existed across schools. CONCLUSION Future studies should adopt objective measures on PE and PA participation and examine the roles schools and districts play in mediating the effect of state PE laws on students' PE attendance and PA.
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Affiliation(s)
- Ruopeng An
- Brown School, Washington University, St. Louis, MO 63130, USA
| | - Jianxiu Liu
- Department of Physical Education, Tsinghua University, Beijing 100084, China.
| | - Ruidong Liu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
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Kahan D, McKenzie TL. California Districts and Schools Underutilize Websites to Demonstrate Compliance to a Physical Education Lawsuit. Res Q Exerc Sport 2019; 90:712-719. [PMID: 31282787 DOI: 10.1080/02701367.2019.1623855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/21/2019] [Indexed: 06/09/2023]
Abstract
Purpose: Quality physical education (PE) reaches many objectives (e.g., knowledge, physical fitness, and physical skills) and could provide at least half the dose of recommended daily physical activity for youths if their opportunity to learn is provided according to national professional recommendations (min/week) and related state mandates. A 2015 California class-action lawsuit required affected schools to post data indicating they scheduled PE time meeting the state mandate of 200 min per 10-day period. The extent to which schools posted PE schedules on their websites and demographic factors related to their compliance was investigated in this study. Method: We performed a quantitative, cross-sectional content analysis of the websites of 37 school districts plus a random sample of 860 elementary schools in them. Z tests were used to analyze frequencies/proportions and associations among demographic (e.g., Hispanic enrollment, PE specialist) and PE schedule variables (e.g., schools meeting state-mandated PE time). Results: Twenty-two districts (59.4%) had websites with ≥1 page/document related to PE opportunities. Only 11% of schools posted PE schedules, an event that was associated with employing a PE specialist (p = .01). Of schools posting schedules, 68% specified a PE volume that met the state mandate. Meeting the mandate was independently associated with enrolling a minority of Hispanic students (p = .02). Conclusion: Websites can provide information about the importance/occurrence of PE; however, schools in the lawsuit did not use the potential of their websites to inform constituents either about the lawsuit or their PE programs. Non-compliant schools should adjust PE schedules to meet statutory requirements.
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Gamble A, Chatfield SL, Cormack ML, Hallam JS. Not Enough Time in the Day: A Qualitative Assessment of In-School Physical Activity Policy as Viewed by Administrators, Teachers, and Students. J Sch Health 2017; 87:21-28. [PMID: 27917482 DOI: 10.1111/josh.12464] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/06/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND In recent decades, the alignment of health and education has been at the forefront of school reform. Whereas the establishment of national in-school physical activity (ISPA) recommendations and state-level mandates demonstrates success, there has been less achievement in areas that address health disparities. The purpose of this investigation was to explore barriers and facilitators to implementing state-mandated ISPA policies in the Mississippi Delta. METHODS Focus groups or interviews were conducted with district administrators, school principals, teachers, and students. A total of 2 semistructured moderator guides were developed to focus on (1) student ISPA practices and preferences and (2) facilitators and barriers to implementing ISPA policies and practices. RESULTS A total of 6 themes were developed. In that, 2 themes addressed participant-described barriers (primary challenges and interferences and excuses). Three themes highlighted participant-described facilitators (compromises, things that work, and being active at school). Finally, 1 theme encompassed the participant-described need to address educating the whole child. CONCLUSIONS There is a critical need for meaningful and relevant solutions to circumvent challenges to implementing ISPA policies and practices in the Mississippi Delta. The Whole School, Whole Community, Whole Child model offers a broad means of visualizing rural, low-income, racially concentrated schools to circumvent challenges and foster ISPA policies and practices.
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Affiliation(s)
- Abigail Gamble
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216
| | | | - Michael L Cormack
- Barksdale Reading Institute, 1003 Jefferson Avenue, Oxford, MS 38655
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Cooper KH, Greenberg JD, Castelli DM, Barton M, Martin SB, Morrow JR. Implementing Policies to Enhance Physical Education and Physical Activity in Schools. Res Q Exerc Sport 2016; 87:133-140. [PMID: 27100264 DOI: 10.1080/02701367.2016.1164009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this commentary is to provide an overview of national physical activity recommendations and policies (e.g., from the Institute of Medicine, National Physical Activity Plan, and Centers for Disease Control and Prevention) and to discuss how these important initiatives can be implemented in local schools. Successful policies are illustrated. Specific strategies and ideas are shared regarding how physical educators can assert themselves and impart their knowledge in an effort to build support for policy implementations that enhance the delivery of physical education and physical activity in their schools and communities.
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O'Dowd A. Experts seek ban on tackling in school rugby to prevent child injuries. BMJ 2016; 352:i1289. [PMID: 26940525 DOI: 10.1136/bmj.i1289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND Strategies to improve physical activity prevalence often include policy and environmental changes. State-level policies can be influential in supporting access and opportunities for physical activity in schools and communities. The purpose of this study was to explore the prevalence of state legislation related to physical activity and identify the correlates of enactment of this legislation. METHODS An online legislative database was used to collect bills from 50 states in the U.S. from 2006 to 2012 for 1010 topics related to physical activity. Bills were coded for content and compiled into a database with state-level variables (eg, obesity prevalence). With enactment status as the outcome, bivariate and multivariate analyses were conducted. RESULTS Of the 1,542 bills related to physical activity introduced, 30% (N = 460) were enacted. Bills on public transportation and trails were more likely to be enacted than those without these topics. Primary sponsorship by the Republican Party, bipartisan sponsorship, and mention of specific funding amounts were also correlates of enactment. CONCLUSION Policy surveillance of bills and correlates of enactment are important for understanding patterns in legislative support for physical activity. This information can be used to prioritize advocacy efforts and identify ways for research to better inform policy.
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Affiliation(s)
- Amy A. Eyler
- Prevention Research Center in St. Louis, Brown School, Washington University, St. Louis, MO
| | - Elizabeth Budd
- Prevention Research Center in St. Louis, Brown School, Washington University, St. Louis, MO
| | - Gabriela J. Camberos
- Prevention Research Center in St. Louis, Brown School, Washington University, St. Louis, MO
| | - Yan Yan
- Washington University School of Medicine, St. Louis, MO
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University, St. Louis, MO
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Brissette I, Wales K, O'Connell M. Evaluating the Wellness School Assessment Tool for use in public health practice to improve school nutrition and physical education policies in New York. J Sch Health 2013; 83:757-762. [PMID: 24138345 DOI: 10.1111/josh.12091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 08/14/2012] [Indexed: 06/02/2023]
Abstract
BACKGROUND Addressing the limitations of existing Local Wellness Policies (LWPs) and promoting their implementation remain priorities for health and education agencies. One gap has been the absence of a standard assessment to support LWP revision. During planning for an initiative to improve school nutrition and physical education policy, the Wellness School Assessment Tool (WellSAT) was evaluated. METHODS Five public health practitioners used WellSAT to assess 50 LWPs. A randomized, counterbalanced design ensured each LWP was coded twice by separate raters. Models evaluated the extent to which WellSAT ratings reflected differences in the LWPs and order, familiarity and rater effects. During field testing, 18 public health practitioners used WellSAT as part of a statewide public health initiative. RESULTS In pilot testing the majority of the variability in WellSAT scores (median = 88%; range = 76% to 100%) was attributable to differences between policies. Correlations between independent raters' strength and comprehensiveness scores were strong, r = .88 and r = .77, respectively. During field testing, WellSAT was well accepted by public health practitioners and members of the school community. CONCLUSIONS WellSAT represents a reliable and feasible tool for health and education agencies to use in improving LWPs and aligning them with recognized standards.
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Affiliation(s)
- Ian Brissette
- Research Scientist, , New York State Department of Health, 1084 Corning Tower Empire State Plaza, Albany, NY 12237
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Shuler FD, Lycans D, Gill T, Oliashirazi A. Physical education in West Virginia schools: are we doing enough to generate peak bone mass and promote skeletal health? W V Med J 2013; 109:66-70. [PMID: 23930566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Peak bone mass (PBM) is attained at 25-35 years of age, followed by a lifelong decline in bone strength. The most rapid increase in bone mass occurs between the ages of 12-17. Daily school physical education (PE) programs have been shown to produce measurable increases in PBM, but are not federally mandated. Increases in PBM can decrease the lifelong risk of osteoporosis and fractures; critical for West Virginia prevention programs. Nationally only 1 in 6 schools require PE three days per week, with 4% of elementary schools, 8% of middle schools and 2% of high schools providing daily PE. In 2005, West Virginia passed the Healthy Lifestyles Act that returned physical education to the K-12 curriculum. This law requires only one credit of PE from grades 9-12 and provides only 35% of the recommended PE for grades K-12. This article highlights the relationship of PE to PBM and discusses the potential impact on West Virginia skeletal health.
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Affiliation(s)
- Franklin D Shuler
- Marshall University, Dept. of Orthopaedic Surgery, 1600 Medical Center Dr., Ste. G-500, Huntington, WV 25701, USA.
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Consiglieri G, Leon-Chi L, Newfield RS. Policy challenges in the fight against childhood obesity: low adherence in San Diego area schools to the California Education Code regulating physical education. J Obes 2013; 2013:483017. [PMID: 23762537 PMCID: PMC3666203 DOI: 10.1155/2013/483017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 04/14/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Assess the adherence to the Physical Education (PE) requirements per California Education Code in San Diego area schools. METHODS Surveys were administered anonymously to children and adolescents capable of physical activity, visiting a specialty clinic at Rady Children's Hospital San Diego. The main questions asked were their gender, grade, PE classes per week, and time spent doing PE. RESULTS 324 surveys were filled, with 36 charter-school students not having to abide by state code excluded. We report on 288 students (59% females), mostly Hispanic (43%) or Caucasian (34%). In grades 1-6, 66.7% reported under the 200 min per 10 school days required by the PE code. Only 20.7% had daily PE. Average PE days/week was 2.6. In grades 7-12, 42.2% had reported under the 400 min per 10 school days required. Daily PE was noted in 47.8%. Average PE days/week was 3.4. Almost 17% had no PE, more so in the final two grades of high school (45.7%). CONCLUSIONS There is low adherence to the California Physical Education mandate in the San Diego area, contributing to poor fitness and obesity. Lack of adequate PE is most evident in grades 1-6 and grades 11-12. Better resources, awareness, and enforcement are crucial.
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Affiliation(s)
- G. Consiglieri
- Division of Pediatric Endocrinology, Department of Pediatrics, Rady Children's Hospital San Diego, 3020 Children's Way MC 5103, San Diego, CA 92123, USA
| | - L. Leon-Chi
- Department of Pediatrics, University of California San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA
| | - R. S. Newfield
- Division of Pediatric Endocrinology, Department of Pediatrics, Rady Children's Hospital San Diego, 3020 Children's Way MC 5103, San Diego, CA 92123, USA
- Department of Pediatrics, University of California San Diego, 200 W Arbor Drive, San Diego, CA 92103, USA
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Carlson JA, Sallis JF, Chriqui JF, Schneider L, McDermid LC, Agron P. State policies about physical activity minutes in physical education or during school. J Sch Health 2013; 83:150-156. [PMID: 23343315 DOI: 10.1111/josh.12010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 04/03/2012] [Accepted: 04/15/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND School policies can change practices on a relatively permanent basis. This study investigated adoption and implementation of state-level policies specifying minutes (or percent) of physical activity in physical education (PE) or during school. METHODS Policies were identified from existing databases and rated as having weak, moderate, or strong wording. Interviews with state-level PE coordinators were conducted to investigate the level of implementation, monitoring, and enforcement of the identified policies. RESULTS Sixteen states had a policy that met inclusion criteria (19 policies total); 11 states had a policy addressing minutes of physical activity during school, 2 had a policy addressing percent of PE time to be spent in physical activity, and 3 had policies addressing both. None of the 19 policies were rated as having strong wording and 5 were rated as having moderate wording. The range in minutes of physical activity per week addressed in the policies was 60 to 300. Four of the 5 (elementary) and 5 of 5 (middle) policies addressing percent of PE spent physically active specified 50%. The only monitoring efforts reported consisted of schools self-reporting progress to the state. CONCLUSIONS More states need to adopt school physical activity policies and policy language needs to be more specific to prevent potential loopholes. Monitoring and evaluation strategies, beyond school self-report, are likely needed for these policies to lead to increases in physical activity.
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Affiliation(s)
- Jordan A Carlson
- Joint Doctoral Program in Public Health, San Diego State University & University of California, San Diego, PO Box 3900, Fifth Avenue, Suite 310, San Diego, CA 92103, USA.
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Eyler AA, Nguyen L, Kong J, Yan Y, Brownson R. Patterns and predictors of enactment of state childhood obesity legislation in the United States: 2006-2009. Am J Public Health 2012; 102:2294-302. [PMID: 23078482 PMCID: PMC3519321 DOI: 10.2105/ajph.2012.300763] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2012] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We developed a content review for state policies related to childhood obesity, and we have quantitatively described the predictors of enactment. METHODS We collected an inventory of 2006 through 2009 state legislation on 27 childhood obesity topics from legislative databases. We coded each bill for general information, topic content, and other appropriate components. We conducted a general descriptive analysis and 3 multilevel analyses using bill- and state-level characteristics to predict bill enactment. RESULTS Common topics in the 27% of the bills that were enacted were community physical activity access, physical education, and school food policy. Committee and bipartisan sponsorship and having term limits significantly predicted enactment in at least 1 model. Bills with safe routes to school or health and nutrition content were twice as likely to be enacted. Bills containing product and menu labeling or soda and snack taxes were significantly less likely to be enacted. CONCLUSIONS Bipartisan and committee support and term limits are important in bill enactment. Advocacy efforts can be tailored to increase awareness and sense of priority among policymakers.
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Affiliation(s)
- Amy A Eyler
- George Warren Brown School of Social Work, Washington University, St. Louis, MO 63110, USA.
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Abstract
PURPOSE OF REVIEW Obesity is well recognized as a major public health crisis throughout the USA. In recent years, governmental bodies at the federal, state and local levels have enacted policies intended to prevent the transition to obesity. Researchers have had the opportunity to study these policies and evaluate their impact on prevention of obesity. RECENT FINDINGS Most public policies have been directed principally, but not exclusively, to the prevention of obesity in school-age children. Interventions have been directed to encouraging breast-feeding, to changing school lunches, limiting access to sugar-sweetened beverages, encouraging physical activity, changing the composition of competitive foods and affecting food advertising directed at children as well as collecting BMI information. Efforts more directed at adults include encouraging workplace wellness programs and improving the nutrition label on packaged foods with front-of-package labels and caloric information on restaurant menus. SUMMARY For the most part, evaluations of the interventions reveal weak or modest benefits. The actual picture might be less positive due to the poor quality of research and publication bias. Push back by industry and others will require higher quality experimental and real world studies. All interventions fail to accommodate the multifactorial aspects of obesity.
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Affiliation(s)
- Morgan Downey
- Downey Obesity Report, Washington, District of Columbia, USA.
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Southward LH, Ragsdale K, McKee C, Buffington A, Baggett D, Blanchard T, Edwards J. Public school parents' perspectives of the Mississippi Healthy Students Act of 2007: findings from 2009-2011. J Miss State Med Assoc 2012; 53:247-252. [PMID: 23094384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Annual evaluations of the Mississippi Healthy Students Act of 2007 (MHSA) were conducted from 2009-2011 among four stakeholder groups: (1) parents of public school students; (2) adolescents; (3) school officials (e.g., superintendents); (4) state-level policymakers (e.g., legislators). We examine results from the first state-wide study among a randomized sample of parents (N>3,600 per year) on childhood obesity as it related to MHSA. Parents were surveyed to determine: (1) knowledge/attitudes towards MHSA; (2) knowledge/attitudes/behaviors (KAB) that influence children's health; and (3) perceived overweight/obesity of self and child versus BMI-determined overweight/obesity. Across all three years, parents were very supportive of MHSA across a number of variables, while parents greatly underestimated obesity among self and child when compared to their BMI data. Results highlight complexities of parents' KAB that potentially influence children's health, including the MHSA. Policy implications are discussed.
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Affiliation(s)
- Linda H Southward
- Social Science Research Center, Mississippi State University, MS 39762-0868, USA
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Sacheck J, Glynn A. Overweight and obesity in Massachusetts: a focus on physical activity. Issue Brief (Mass Health Policy Forum) 2012:1-35. [PMID: 22629597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Hong M, Valerio MA, Spencer M. Let's get moving: the need for more effective state-level physical education policies. Fam Community Health 2011; 34:51-60. [PMID: 21135628 DOI: 10.1097/fch.0b013e3181fdecda] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This study reviews obesity trends and physical education policies of 13 states with the highest and lowest youth obesity rates. A review of state policies for physical education was compared and analyzed. Although a majority of the states had physical education policies, they were typically not mandated and varied in time and grade-level requirements. However, little distinction in policies between states with higher and lower prevalence of obese youth was found. Financial and infrastructure support for the implementation and evaluation of physical education policies are needed, as well as innovative strategies including socioecological models to better address the obesity epidemic.
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Affiliation(s)
- Mina Hong
- School of Social Work, School of Public Health (Dr Valerio), University of Michigan, Ann Arbor, MI 48109, USA.
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Abstract
The passage of Senate Bill 530 in June 2007 increased visibility about the importance of health-related fitness in Texas. As a result of the mandate, more than 2.6 million 3rd- through 12th-grade students from all Texas counties were evaluated between January 1, 2008, and June 1, 2008, using a standardized test of health-related physical fitness (FITNESSGRAM). This number represented 84.8% of all public school districts in Texas. In the subsequent 2 years, 2.8 and 2.9 million children were tested, which represents more than 90% of all public school districts in Texas. This summary provides reflections on the test results and implications for future school-based fitness initiatives, both in Texas and in other states.
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Abstract
This paper summarizes the historical and legislative backgrounds leading to statewide testing of health-related physical fitness in Texas children grades 3-12 as mandated by Texas Senate Bill 530. The rationale and goals for an associated research project (the Texas Youth Fitness Study, funded by the Robert Wood Johnson Foundation) to evaluate data collected from the statewide initiative are provided. The study investigated the relations between health-related physical fitness and educational variables, including academic achievement, absenteeism, and negative school incidents. It also provides unique insights into the quality (both reliability and validity) of collected data and implications of large-scale school-based physical fitness testing. Teacher commentary and experiences add to the description of the data collection processes. Last, the relations between psychosocial variables and health-related fitness in middle school students are described.
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Affiliation(s)
- James R Morrow
- Department of Kinesiology, Health Promotion and Recreation, University of North Texas, Denton, 76205-5017, USA.
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Eyler AA, Brownson RC, Aytur SA, Cradock AL, Doescher M, Evenson KR, Kerr J, Maddock J, Pluto DL, Steinman L, Tompkins NO, Troped P, Schmid TL. Examination of trends and evidence-based elements in state physical education legislation: a content analysis. J Sch Health 2010; 80:326-332. [PMID: 20591097 DOI: 10.1111/j.1746-1561.2010.00509.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES To develop a comprehensive inventory of state physical education (PE) legislation, examine trends in bill introduction, and compare bill factors. METHODS State PE legislation from January 2001 to July 2007 was identified using a legislative database. Analysis included components of evidence-based school PE from the Community Guide and other authoritative sources: minutes in PE, PE activity, teacher certification, and an environmental element, including facilities and equipment. Researchers abstracted information from each bill and a composite list was developed. RESULTS In total, 781 bills were analyzed with 162 enacted. Of the 272 bills that contained at least 1 evidence-based element, 43 were enacted. Only 4 bills included all 4 evidence-based elements. Of these 4, 1 was enacted. Funding was mentioned in 175 of the bills introduced (37 enacted) and an evaluation component was present in 172 of the bills (49 enacted). CONCLUSIONS Based on this analysis, we showed that PE is frequently introduced, yet the proportion of bills with evidence-based elements is low. Future research is needed to provide the types of evidence required for development of quality PE legislation.
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Affiliation(s)
- Amy A Eyler
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO 63110, USA.
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Barroso CS, Kelder SH, Springer AE, Smith CL, Ranjit N, Ledingham C, Hoelscher DM. Senate Bill 42: implementation and impact on physical activity in middle schools. J Adolesc Health 2009; 45:S82-90. [PMID: 19699442 PMCID: PMC2903960 DOI: 10.1016/j.jadohealth.2009.06.017] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 06/16/2009] [Accepted: 06/18/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE In 2005, the Texas State Legislature passed Senate Bill 42 (SB42), which required public middle school students (grades 6-8) to participate in 30 minutes of daily structured physical activity. The purpose of this study was to assess awareness of and adherence to SB42 in Texas middle schools, and to assess the impact of SB42 on the frequency and quality of structured physical activity. METHODS Key informant (school principals, physical education [PE] instructors, nurses, or designated personnel) telephone interviews on the implementation of SB42 were conducted from a statewide representative sample of public middle schools (n=112). Direct observation, key informant, and student report of physical activity in PE classes at 17 Texas-Mexico border middle schools assessed the frequency and quality of structured physical activity. RESULTS State level (94% +/- 4.5%) and border district (94% +/- 13.5%) key informants reported a high level of overall awareness of SB42. Postimplementation of SB42 border districts reported a minimum of 4 days per week of PE instruction and more than 58 minutes per PE class, exceeding the 30-minute minimum of structured physical activity per day or 135 minutes per week as required by SB42 (range: 58.2-61.4 minutes). A significant increase in the number of days of PE class was observed in the border sample between 2004 and 2005 and 2006 and 2008, with eighth grade students reporting an average of 2.0 days and 3.7 days of PE per week, respectively (p < .001). Additionally, border districts met the Healthy People 2010 objective of 50% time in moderate-to-vigorous physical activity (mean 54.9% +/- 5.1%) during PE class. CONCLUSIONS Implementation of SB42 appears to have impacted the frequency of school PE in Texas and the prevalence of child self-reported physical activity behaviors along the Texas-Mexico border. General awareness of and adherence to SB42 was high in both statewide and among the border districts. Our mixed findings on adherence to specific components of the legislation suggest the need for further investigation of the factors that both facilitate and inhibit local leadership around school policy and the mechanisms to ensure the school policy is being implemented.
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Affiliation(s)
- Cristina S Barroso
- Hispanic Health Research Center, Michael & Susan Dell Center for Advancement of Healthy Living, University of Texas School of Public Health, Brownsville Regional Campus, Brownsville, Texas 78520, USA.
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CDC reviews school laws, policies on child/adolescent health. School Nurse News 2008; 25:4-6. [PMID: 19149007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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McGuire DK, Wyne KL. Combating childhood type 2 diabetes mellitus: it will take a village. Diab Vasc Dis Res 2007; 4:283-4. [PMID: 18158697 DOI: 10.3132/dvdr.2007.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Cawley J, Meyerhoefer C, Newhouse D. The impact of state physical education requirements on youth physical activity and overweight. Health Econ 2007; 16:1287-301. [PMID: 17328052 DOI: 10.1002/hec.1218] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
To combat childhood overweight in the US, which has risen dramatically in the past three decades, many medical and public health organizations have called for students to spend more time in physical education (PE) classes. This paper is the first to examine the impact of state PE requirements on student PE exercise time. It also exploits variation in state laws as quasi-natural experiments in order to estimate the causal impact of PE on overall student physical activity and weight. We study nationwide data from the Youth Risk Behavior Surveillance System for 1999, 2001, and 2003 merged with data on state minimum PE requirements from the 2001 Shape of the Nation Report. We find that high school students with a binding PE requirement report an average of 31 additional minutes per week spent physically active in PE class. Our results also indicate that additional PE time raises the number of days per week that girls report having exercised vigorously or having engaged in strength-building activity. We find no evidence that PE lowers BMI or the probability that a student is overweight. We conclude that raising PE credit requirements may make girls more physically active overall but there is not yet the scientific base to declare raising PE requirements an anti-obesity initiative for either boys or girls.
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Affiliation(s)
- John Cawley
- Department of Policy Analysis and Management, Cornell University, Ithaca, New York 14853, USA.
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Winterfeld A. School wellness policies. NCSL Legisbrief 2006; 14:1-2. [PMID: 17121205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Winterfeld A. Physical education activity for children and teens. NCSL Legisbrief 2006; 14:1-2. [PMID: 16479689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Abstract
Mary Story, Karen Kaphingst, and Simone French argue that U.S. schools offer many opportunities for developing obesity-prevention strategies by providing more nutritious food, offering greater opportunities for physical activity, and providing obesity-related health services. Meals at school are available both through the U.S. Department of Agriculture's school breakfast and lunch programs and through "competitive foods" sold a la carte in cafeterias, vending machines, and snack bars. School breakfasts and school lunches must meet federal nutrition standards, but competitive foods are exempt from such requirements. And budget pressures force schools to sell the popular but nutritionally poor foods a la carte. Public discomfort with the school food environment is growing. But can schools provide more healthful food options without losing money? Limited evidence shows that they can. Although federal nutrition regulations are inadequate, they permit state and local authorities to impose additional restrictions. And many are doing so. Some states limit sales of nonnutritious foods, and many large school districts restrict competitive foods. Several interventions have changed school food environments, for example, by reducing fat content of food in vending machines and making more fruits and vegetables available. Interventions are just beginning to target the availability of competitive foods. Other pressures can also compromise schools' efforts to encourage physical activity. As states use standardized tests to hold schools and students academically accountable, physical education and recess have become a lower priority. But some states are now mandating and promoting more physical activity in schools. School health services can also help address obesity by providing screening, health information, and referrals to students, especially low-income students, who are at high risk of obesity, tend to be underinsured, and may not receive health services elsewhere.
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Affiliation(s)
- Mary Story
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, USA
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Winterfeld A. What's for lunch? When's recess? The fight against obesity makes its way into schools. State Legis 2005; 31:32-3. [PMID: 16397979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Henze C, Plaza CI. Public health issue brief: physical education: year end report-2004. Issue Brief Health Policy Track Serv 2004:1-16. [PMID: 15765575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
In the past 30 years, the prevalence of overweight and obesity among children and adolescents has increased alarmingly. Because overweight and obesity increase the risk for chronic illnesses and associated health care cost, reducing and preventing obesity has become a top health priority among lawmakers. During the past three years, the media, the food and beverage industry, public health advocates and both federal and state policymakers have devoted significant attention to this escalating health problem and its associated risk factors. This issue brief outlines the role of state physical education policy to address childhood obesity. This report will provide information on the issues surrounding childhood obesity and physical education, physical education guidelines, related legislative history, 2004 physical education legislative actions and state physical education statutes.
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Dempsey T, Miller A, Boyattia T. Let's get physical: a policy on increasing physical activity in school-aged children. J Okla State Med Assoc 2004; 97:119-21; quiz 122-3. [PMID: 15088815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Childhood obesity has reached epidemic proportions. One of the major reasons is the lack of physical activity due to time spent watching television or using computers. This lack coupled with poor dietary habits has led to significant increases in the number of children with Type II diabetes and predisposition to hypertension, coronary artery disease and others. Physicians can help reduce this trend.
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Affiliation(s)
- Tiece Dempsey
- Department of Health Administration and Policy, University of Oklahoma Health Sciences Center, PO Box 26901, Oklahoma City, OK 73190, USA
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32
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Byrne D. Providers issue brief: nutrition and obesity: year end report-2003. Issue Brief Health Policy Track Serv 2003:1-23. [PMID: 14870738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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Byrne D. Providers issue brief: physical education: year end report-2003. Issue Brief Health Policy Track Serv 2003:1-21. [PMID: 14969255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
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Abstract
The purpose was to survey adapted physical educators, teaching in the public schools, concerning the nature of their work and the percentage of time spent weekly in 14 specific job roles or responsibilities. Of 102 respondents solicited from national conferences, 66 teachers representing 20 states provided usable data. Most respondents worked in urban settings (77%), served an average of 8 schools per week, had an average caseload of 76 students, and saw each student an average of two times a week. Percentages of time spent each week were greatest in direct instruction (43%), traveling (9%), planning instruction (9%), and assessing students (7%). Findings were similar to those reported previously and discussed in relation to job competencies taught in university classes designed to prepare specialists in adapted physical education.
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Levine HG. Medical concerns in the female athlete. Pediatrics 2002; 109:350-1. [PMID: 11826226 DOI: 10.1542/peds.109.2.350-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Clark WR. Physical Education Bill. Alaska Med 2002; 44:21. [PMID: 11969138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
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Augustin JP. [Sports in black Africa: developing research into sports institutions, practices, and facilities]. Historiens Geogr 2002; 93:197-203. [PMID: 20043362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Gounot A. Sport or political organization? Structures and characteristics of the Red Sport International, 1921-1937. J Sport Hist 2002; 28:23-9. [PMID: 17500127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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Abstract
American impact on modern sports in Latin America overlaps geographically and chronologically with the European, especially British, impact. Principally baseball in the Caribbean basin, more recently basketball and volleyball across the hemisphere and occasionally American football in more limited areas illustrate a north-to-south movement executed by businessmen, educators, missionaries, military personnel, returning travelers (often students), sports entrepreneurs and television. Often initially supported by promoters of development within Latin America, this transfer has altered local recreational patterns and attracted Latin athletes to pursue careers in North America, provoking accusations of cultural imperialism and exploitation.
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40
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Guttmann A, Thompson L. Educators, imitators, modernizers: the arrival and spread of modern sport in Japan. Eur Sport Hist Rev 2001; 3:23-48. [PMID: 21046848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Arnaud P. [The conscriptive society and French athletes during the Third Republic]. Stadion (Koln) 2001; 27:23-31. [PMID: 18572484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Bloomfield A. The quickening of the national spirit: Cecil Sharp and the pioneers of folk-dance revival in English state schools (1900-26). Hist Educ 2001; 30:59-75. [PMID: 18283748 DOI: 10.1080/00467600010002103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Bonde H. The white man's body: Danish gymnasts in South Africa, 1939. S Afr Hist J 2001; 44:143-162. [PMID: 19202641 DOI: 10.1080/02582470108671391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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DaCosta LP. Hegemony, emancipation and mythology. Int J Hist Sport 2001; 18:181-196. [PMID: 18592682 DOI: 10.1080/714001589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This epilogue offers a critical overview of some current interpretations of modern sport's origins and evolution in Latin America by certain European and North American commentators. These analyses still adhere to the tradition of the New World's creation. They seldom refer to primary sources. Conclusions are often born out of patronizing compassion and exotic impression. Latin American sources, if any, are mostly quoted when they serve a pessimistic historical bias cultivated by outsiders. In fact, Latin American sport represents a mirror image of more developed areas and indeed a reinvention of sport in specific cases of community isolation and self-development.
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45
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Chappell R. Sport in Latin America from past to present: a European perspective. Int J Hist Sport 2001; 18:158-180. [PMID: 18592683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This chapter examines sport in Latin America in its social, cultural, and political contexts. An analysis of the development of sport in Latin America suggests that there have been a number of distinct phases influenced by the cultures of the Spanish, British and French. More recently, the games and pastimes of the United States have made a significant impact. It is suggested that the further development of sport in Latin America is hindered by a number of significant problems. It concludes that the problems faced by some countries are immense and that governments and international organizations in the developed world should offer help where appropriate.
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Torres CR. Tribulations and achievements: the early history of Olympism in Argentina. Int J Hist Sport 2001; 18:59-92. [PMID: 18286739 DOI: 10.1080/714001592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
By the end of the nineteenth century, modern sport had enchanted the people of Argentina. At that time the nation enjoyed a remarkable degree of economic prosperity and embarked on increasing political democratization. These circumstances, along with the fact that the nation was represented from the beginning, in 1894, on the International Olympic Committee seemed to favour Argentina as the spearhead of the diffusion of Olympism throughout South America. However, the country only enjoyed its first official Olympic participation in the Paris Games of 1924 - a few months after the establishment of the Argentine Olympic Committee. This essay explores the reception and diffusion of Olympism in Argentina. It reveals a process of gradual adoption including conflicting views on the relationship between the state and sport, several attempts at institutionalization, international misunderstandings and the role of politics and class.
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Johnson J, Deshpande C. Health education and physical education: disciplines preparing students as productive, healthy citizens for the challenges of the 21st century. J Sch Health 2000; 70:66-68. [PMID: 10715828 DOI: 10.1111/j.1746-1561.2000.tb07246.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- J Johnson
- Office of Elementary and Secondary Education, U.S. Department of Education, Washington, DC 20202-6100, USA
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48
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Gori G. Women's physical and sporting education at school and university in the years of fascism. Stadion (Koln) 2000; 26:69-98. [PMID: 19334339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Davis DL. Athletic training's regulatory history. Rehab Manag 1999; 12:40. [PMID: 10724670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- D L Davis
- Bellin Sports Medicine, Green Bay, Wis., USA
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50
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Gerbod P. [The state and physical and sports activities from the 1780's to the 1930's]. Rev Hist (Paris) 1999; 301:307-331. [PMID: 22232824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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