Heather Erwin

After-School Program Impact on Physical Activity and Fitness: A Meta-Analysis

CONTEXT The majority of children do not participate in sufficient amounts of daily, health-enhancing physical activity. One strategy to increase activity is to promote it within the after-school setting. Although promising, the effectiveness of this strategy is unclear. A systematic review was performed summarizing the research conducted to date regarding the effectiveness of after-school programs in increasing physical activity. EVIDENCE ACQUISITION Databases, journals, and review articles were searched for articles published between 1980 and February 2008. Meta-analysis was conducted during July of 2008. Included articles had the following characteristics: findings specific to an after-school intervention in the school setting; subjects aged <or=18 years; an intervention component designed to promote physical activity; outcome measures of physical activity, related constructs, and/or physical fitness. Study outcomes were distilled into six domains: physical activity, physical fitness, body composition, blood lipids, psychosocial constructs, and sedentary activities. Effect sizes (Hedges g) were calculated within and across studies for each domain, separately. EVIDENCE SYNTHESIS Of the 797 articles found, 13 unique articles describing findings from 11 after-school interventions were reviewed. Although physical activity was a primary component of all the tested interventions, only eight studies measured physical activity. From the six domains, positive effect sizes were demonstrated for physical activity (0.44 [95% CI=0.28-0.60]); physical fitness (0.16 [95% CI=0.01-0.30]); body composition (0.07 [95% CI=0.03-0.12]); and blood lipids (0.20 [95% CI=0.06-0.33]). CONCLUSIONS The limited evidence suggests that after-school programs can improve physical activity levels and other health-related aspects. Additional studies are required that provide greater attention to theoretical rationale, levels of implementation, and measures of physical activity within and outside the intervention.

Physical Education's Role in Public Health: Steps Forward and Backward over 20 Years and HOPE for the Future.

The 1991 paper, “Physical Educations Role in Public Health” described the importance of physical education in addressing public health problems. On its 20th anniversary, this article reviews accomplishments in improving the health impact of physical education and identifies areas lacking progress. Major accomplishments include development of evidence-based programs, documentation of health and academic benefits of physical education, and acceptance of physical education as a public health resource. Additional work is needed to evaluate the uptake of evidence-based programs, improve national surveillance of physical education quantity and quality, establish stronger policies supporting active physical education, and achieve wide acceptance of public health goals within the physical education field. These opportunities constitute an agenda for actualizing the promise of Health-Optimizing Physical Education before the next 20-year anniversary.

Review and special articleAfter-School Program Impact on Physical Activity and Fitness: A Meta-Analysis

CONTEXT The majority of children do not participate in sufficient amounts of daily, health-enhancing physical activity. One strategy to increase activity is to promote it within the after-school setting. Although promising, the effectiveness of this strategy is unclear. A systematic review was performed summarizing the research conducted to date regarding the effectiveness of after-school programs in increasing physical activity. EVIDENCE ACQUISITION Databases, journals, and review articles were searched for articles published between 1980 and February 2008. Meta-analysis was conducted during July of 2008. Included articles had the following characteristics: findings specific to an after-school intervention in the school setting; subjects aged <or=18 years; an intervention component designed to promote physical activity; outcome measures of physical activity, related constructs, and/or physical fitness. Study outcomes were distilled into six domains: physical activity, physical fitness, body composition, blood lipids, psychosocial constructs, and sedentary activities. Effect sizes (Hedges g) were calculated within and across studies for each domain, separately. EVIDENCE SYNTHESIS Of the 797 articles found, 13 unique articles describing findings from 11 after-school interventions were reviewed. Although physical activity was a primary component of all the tested interventions, only eight studies measured physical activity. From the six domains, positive effect sizes were demonstrated for physical activity (0.44 [95% CI=0.28-0.60]); physical fitness (0.16 [95% CI=0.01-0.30]); body composition (0.07 [95% CI=0.03-0.12]); and blood lipids (0.20 [95% CI=0.06-0.33]). CONCLUSIONS The limited evidence suggests that after-school programs can improve physical activity levels and other health-related aspects. Additional studies are required that provide greater attention to theoretical rationale, levels of implementation, and measures of physical activity within and outside the intervention.

School day segmented physical activity patterns of high and low active children

BackgroundVariability exists in children’s activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.MethodsTwo hundred and twenty-three children (mean age: 10.7 ± 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or low active (LOW) depending on the percentage of week days they accumulated at least 60 minutes of MVPA. Minutes spent in MPA and VPA were calculated for school time and non-school time and for five discrete school day segments (before-school, class time, recess, lunchtime, and after-school). Data were analysed using multi-level modelling.ResultsThe HIGH group spent significantly longer in MPA and/or VPA before-school, during class time, lunchtime, and after-school (P < .05), independent of child and school level factors. The greatest differences occurred after-school (MPA = 5.5 minutes, VPA = 3.8 minutes, P < 0.001). MPA and VPA were also associated with gender, BMI z-score, number of enrolled children, playground area per student, and temperature, depending on the segment analysed.The additive effect of the segment differences was that the HIGH group accumulated 12.5 minutes per day more MVPA than the LOW group.ConclusionsHIGH active children achieved significantly more MPA and VPA than LOW active during four of the five segments of the school day when analyses were adjusted for potential correlates. Physical activity promotion strategies targeting low active children during discretionary physical activity segments of the day, and particularly via structured afterschool physical activity programs may be beneficial.

Effect of a Low-Cost, Teacher-Directed Classroom Intervention on Elementary Students' Physical Activity.

BACKGROUND Effective physical activity (PA) interventions are warranted for youth, and schools have been identified as logical locations for such involvement. Experts and professionals in the field promote comprehensive school PA programs, including classroom PA. The purpose of this study was to determine the effect of a low-cost, teacher-directed classroom-based intervention on the school PA of elementary children. METHODS Nine classroom teachers were provided inexpensive curricula and trained to implement and instruct PA breaks (2 × 30 minute training sessions). The teachers were encouraged to lead 1 activity break per day after the training. One hundred and six elementary students wore pedometers up to 12 days over 3 monitoring periods during the school year (baseline, follow-up, post follow-up) to assess the effectiveness and the sustainability of the intervention. The teachers self-reported the frequency of activity breaks instructed. RESULTS The teachers (n = 5) who complied with the recommended 1 activity break per day had students who accrued ∼33% more mean school steps/day at follow-up (∼1100) and post follow-up (∼1350) compared to controls. Teachers (n = 4) in the intervention who did not comply with the 1 activity break per day recommendation had students accrue similar mean school steps/day as controls. CONCLUSION Inexpensive, teacher-directed classroom-based PA interventions can be effective in improving childrens PA levels if teachers implement 1 activity break per school day. We recommend promoting the notion of 1 activity break per day in the classroom as part of a comprehensive school PA program that includes quality physical education, recess, and before/after school programs.

Integrating movement in academic classrooms: understanding, applying and advancing the knowledge base

In the context of comprehensive and coordinated approaches to school health, academic classrooms have gained attention as a promising setting for increasing physical activity and reducing sedentary time among children. The aims of this paper are to review the rationale and knowledge base related to movement integration in academic classrooms, consider the practical applications of current knowledge to interventions and teacher education, and suggest directions for future research. Specifically, this paper (i) situates movement integration amid policy and research related to childrens health and the school as a health‐promoting environment; (ii) highlights the benefits of movement integration; (iii) summarizes movement integration programs and interventions; (iv) examines factors associated with classroom teachers’ movement integration; (v) offers strategies for translating research to practice and (vi) forwards recommendations for future inquiry related to the effectiveness and sustainability of efforts to integrate movement into classroom routines. This paper provides a comprehensive resource for developing state‐of‐the‐art initiatives to maximize childrens movement in academic classrooms as a key strategy for important goals in both education and public health.

A Quantitative Review of Physical Activity, Health, and Learning Outcomes Associated With Classroom-Based Physical Activity Interventions

Research suggests that physical activity may foster improved academic performance, yet schools are receiving more pressure to achieve high academic standards. It is important for classroom teachers, administrators and school psychologists to understand the benefits of incorporating physical activity into the school day. This article serves as a quantitative review of classroom physical activity interventions in terms of their physical activity, health and learning outcomes for students, with implications of findings discussed for school personnel.

Promoting Children's Health Through Physically Active Math Classes: A Pilot Study

School-based interventions are encouraged to support youth physical activity (PA). Classroom-based PA has been incorporated as one component of school wellness policies. The purpose of this pilot study is to examine the effects of integrating PA with mathematics content on math class and school day PA levels of elementary students. Participants include four teachers and 75 students. Five math classes are taught without PA integration (i.e., baseline) followed by 13 math classes that integrate PA. Students wear pedometers and accelerometers to track PA during math class and throughout the school day. Students perform significantly more PA on school days and in math classes during the intervention. In addition, students perform higher intensity (step min-1) PA during PA integration math classes compared with baseline math classes. Integrating PA into the classroom is an effective alternative approach to improving PA levels among youth and is an important component of school-based wellness policies.

National Physical Education Standards: A Summary of Student Performance and Its Correlates

This study was one of the first to examine elementary student performance on the first four national standards for physical education (National Association for Sport and Physical Education, 2004). Motor skill competency, strategic knowledge, physical activity, and physical fitness measures were collected from fourth- and fifth-grade students (N = 180) in the midwestern United States. Students demonstrated difficulty in attaining all four standards, particularly physical activity. Both personal demographics and physical attributes influenced performance. In particular, gender was a correlate of motor competency. Although the expectations may not be attainable at given times because of developmental differences, the study results provide some support for the value of guiding students to competency in all standards, as opposed to a single expectation. These findings also suggest continued use of the standards as a framework for physical education. Further research is warranted to explain student performance levels and develop effective methods for competency.

Comprehensive School-Based Physical Activity Promotion: A Review

Physical activity (PA) participation levels among youth remain well below national recommendations. Thus, a variety of strategies to promote youth PA have been advocated, including multifaceted, school-based approaches. One identified as having great potential is a comprehensive school physical activity program (CSPAP). The goal of a CSPAP is to develop a school culture conducive to promoting lifelong PA across five integral components, each serving as a plausible point of intervention: (a) physical education, (b) PA during school, (c) PA before and after school, (d) staff involvement, and (e) family/community involvement. The purpose of this article is to provide an up-to-date review on all CSPAP components, propose the potential of such comprehensive interventions in increasing youth PA levels, and provide future directions for CSPAP research.