Karin K. Coyle

The association between school-based physical activity, including physical education, and academic performance: A systematic review of the literature☆ , ☆☆

OBJECTIVE The purpose of this review is to synthesize the scientific literature that has examined the association between school-based physical activity (including physical education) and academic performance (including indicators of cognitive skills and attitudes, academic behaviors, and academic achievement). METHOD Relevant research was identified through a search of nine electronic databases using both physical activity and academic-related search terms. Forty-three articles (reporting a total of 50 unique studies) met the inclusion criteria and were read, abstracted, and coded for this synthesis. Findings of the 50 studies were then summarized. RESULTS Across all the studies, there were a total of 251 associations between physical activity and academic performance, representing measures of academic achievement, academic behavior, and cognitive skills and attitudes. Slightly more than half (50.5%) of all associations examined were positive, 48% were not significant, and 1.5% were negative. Examination of the findings by each physical activity context provides insights regarding specific relationships. CONCLUSION Results suggest physical activity is either positively related to academic performance or that there is not a demonstrated relationship between physical activity and academic performance. Results have important implications for both policy and schools.

Older boyfriends and girlfriends increase risk of sexual initiation in young adolescents

PURPOSE To explore the prevalence and impact of older boyfriends or girlfriends on sexual behavior in sixth graders (mean age 11.5 years). METHODS Students in 19 ethnically diverse middle schools in an urban area were surveyed (n = 2829, response rate 68%). Instrument measured demographics, age of oldest boyfriend or girlfriend, unwanted sexual advances, peer norms, and sexual behavior. Students with older, same-age, or no boyfriend or girlfriend were compared on demographic and psychosocial variables using analysis of variance. Separate multivariate logistic regressions for both boys and girls were used to predict sexual behavior from demographics, psychosocial variables, and age categories of boyfriend or girlfriend. RESULTS One-half of the respondents (56%) had never had a serious boyfriend or girlfriend, 35% reported that their oldest boyfriend or girlfriend was <2 years older than they, and 8.5% reported a partner > or =2 years older. Those reporting an older boyfriend or girlfriend were more likely to be Hispanic, were less acculturated, reported more unwanted sexual advances and more friends who were sexually active, and, among girls, were more likely to have experienced menarche. Overall, 4% of students reported ever having had sex. Students with an older boyfriend or girlfriend were over 30 times more likely than those with no boyfriend or girlfriend ever to have had sex (odds ratio = 33.8 for boys and 44.2 for girls). In the multivariate logistic regressions, peer norms about sexual behavior, having experienced unwanted sexual advances, and having a boyfriend or girlfriend were strongly associated with having had sex. CONCLUSIONS Having an older boyfriend or girlfriend, although rare, is associated with early sexual onset and unwanted sexual activity in this population of sixth graders.

Safer choices: reducing teen pregnancy, HIV, and STDs.

Objectives. This study evaluated the long-term effectiveness of Safer Choices, a theory-based, multi-component educational program designed to reduce sexual risk behaviors and increase protective behaviors in preventing HIV, other STDs, and pregnancy among high school students. Methods. The study used a randomized controlled trial involving 20 high schools in California and Texas. A cohort of 3869 ninth-grade students was tracked for 31 months from fall semester 1993 (baseline) to spring semester 1996 (31-month follow-up). Data were collected using self-report surveys administered by trained data collectors. Response rate at 31-month follow-up was 79%. Results. Safer Choices had its greatest effect on measures involving condom use. The program reduced the frequency of intercourse without a condom during the three months prior to the survey, reduced the number of sexual partners with whom students had intercourse without a condom, and increased use of condoms and other protection against pregnancy at last intercourse. Safer Choices also improved 7 of 13 psychosocial variables, many related to condom use, but did not have a significant effect upon rates of sexual initiation. Conclusions. The Safer Choices program was effective in reducing important risk behaviors for HIV, other STDs, and pregnancy and in enhancing most psychosocial determinants of such behavior.

Draw the Line/Respect the Line: A Randomized Trial of a Middle School Intervention to Reduce Sexual Risk Behaviors

OBJECTIVES This study evaluated the long-term effectiveness of Draw the Line/Respect the Line, a theoretically based curriculum designed to reduce sexual risk behaviors among middle school adolescents. METHODS The randomized controlled trial involved 19 schools in northern California. A cohort of 2829 sixth graders was tracked for 36 months. RESULTS The intervention delayed sexual initiation among boys, but not girls. Boys in the intervention condition also exhibited significantly greater knowledge than control students, perceived fewer peer norms supporting sexual intercourse, had more positive attitudes toward not having sex, had stronger sexual limits, and were less likely to be in situations that could lead to sexual behaviors. Psychosocial effects for girls were limited. CONCLUSIONS The program was effective for boys, but not for girls.

The protective role of social capital and cultural norms in Latino communities: a study of adolescent births

This study investigates how community characteristics can protect adolescents from the negative effects of poverty. Using economic predictors, eight communities with low or high birthrates for 15- to 17-year-old Latinas were identified. Quantitative data on birth-rates, demographics, and the physical environment were obtained from government, hospital, and local sources. Qualitative data on the physical environment and social processes in the community were collected by interviews and observations in these eight communities. The low- and high-birthrate communities differed in their physical environment, the characteristics of the population, social capital, and cultural norms. The zip codes with low adolescent birthrates had a higher percentage of residents of Latino descent, stronger social networks, and more ties to their countries of origin. The findings support a model of community building that focuses on strengthening informal social networks and supporting protective cultural norms.

Schoolwide Effects of a Multicomponent HIV, STD, and Pregnancy Prevention Program for High School Students

Few studies have tested schoolwide interventions to reduce sexual risk behavior, and none have demonstrated significant schoolwide effects. This study evaluates the schoolwide effects of Safer Choices, a multicomponent, behavioral theory–based HIV, STD, and pregnancy prevention program, on risk behavior, school climate, and psychosocial variables. Twenty urban high schools were randomized, and cross-sectional samples of classes were surveyed at baseline, the end of intervention (19 months after baseline), and 31 months after baseline. At 19 months, the program had a positive effect on the frequency of sex without a condom. At 31 months, students in Safer Choices schools reported having sexual intercourse without a condom with fewer partners. The program positively affected psychosocial variables and school climate for HIV/STD and pregnancy prevention. The program did not influence the prevalence of recent sexual intercourse. Schoolwide changes in condom use demonstrated that a school-based program can reduce the sexual risk behavior of adolescents.

Manifestations of Poverty and Birthrates Among Young Teenagers in California Zip Code Areas

CONTEXT Given that many communities are implementing community-wide initiatives to reduce teenage pregnancy or childbearing, it is important to understand the effects of a communitys characteristics on adolescent birthrates. METHODOLOGY Data from the 1990 census and from California birth certificates were obtained for zip codes in California. Regression analyses were conducted on data from zip code areas with at least 200 females aged 15-17 between 1991 and 1996, to predict the effects of race and ethnicity marital status, education, employment, income and poverty, and housing on birthrates among young teenagers. RESULTS In bivariate analyses, the proportion of families living below poverty level within a zip code was highly related to the birthrate among young teenagers in that zip code (r=.80, p<.001). In multivariate analyses, which controlled for some of the correlates of family poverty level, the proportion of families living below poverty level remained by far the most important predictor of the birthrate among young teenagers (b=1.54), followed by the proportion of adults aged 25 or older who have a college education (b=-0.80). Race and ethnicity were only weakly related to birthrate. In all three racial and ethnic groups, poverty and education were significantly related to birthrate, but the effect of college education was greater among Hispanics (b=-2.98) than among either non-Hispanic whites (b=-0.53) or blacks (b=-1.12). Male employment and unemployment and female unemployment were highly related to the birthrate among young teenagers in some racial or ethnic groups, but not in others. CONCLUSIONS Multiple manifestations of poverty, including poverty itself, low levels of education and employment, and high levels of unemployment, may have a large impact upon birthrates among young teenagers. Addressing some of these issues could substantially reduce childbearing among young adolescents.

School-based Programs to Reduce Sexual Risk-taking Behavior

Abstract This paper synthesizes 35 evaluations of specific school-based programs designed to reduce sexual risk-taking behavior, including sex and HIV education programs, school-based health centers, and school condom-availability programs. This paper summarizes the effects of those programs on several sexual and contraceptive behaviors. Although the studies have several limitations that restrict any conclusions, the evidence suggests that a few programs have produced credible evidence that they have reduced sexual risk-taking behavior by delaying the onset of intercourse, by reducing the frequency of intercourse, by reducing the number of sexual partners, or by increasing the use of condoms or other forms of contraception. The majority of studies, however, found no statistically significant impact on risk-taking behaviors. Of considerable importance in this controversial field, none of the studies found statistically significant results indicating that any of the programs increased any measure of sexual activity, as is often feared.

Boyfriends girlfriends and teenagers risk of sexual involvement.

CONTEXT Having a boyfriend or girlfriend, especially an older one, is associated with increased sexual risk in early adolescence. The mechanisms underlying this association are unclear. METHODS Middle school students in Northern California were surveyed annually from 1997 to 2000. For a sample of 1,214 males and 1,308 females who were sexually inexperienced in seventh grade, logistic and linear regression were used to explore associations between relationship status in seventh grade and sexual activity in ninth grade, controlling for sixth-grade and eighth-grade characteristics. RESULTS Males who had had a girlfriend their age by seventh grade were more likely than those who had had no relationship to report sexual activity in ninth grade (odds ratio, 2.1). Similarly, for females, the odds of being sexually active in ninth grade were elevated among those who had had a boyfriend their age (2.9); however, they also were higher among those who had had an older boyfriend than among those who had had one their age (2.1). With sixth-grade risk factors controlled, relationship status in seventh grade remained significant only for females; the association was explained by early menarche and by participation in situations that could lead to sex and riskier peer norms in eighth grade. For males, eighth-grade situations that could lead to sex, Hispanic ethnicity and sixth-grade peer norms explained ninth-grade sexual behavior. CONCLUSIONS To reduce the risk of adolescent sexual activity, parents and communities should encourage youth in middle school, especially females who experience early menarche, to delay serious romantic relationships.

What Works? Process Evaluation of a School-Based Fruit and Vegetable Distribution Program in Mississippi

BACKGROUND During the 2004-2005 school year, the Mississippi Department of Education, Office of Child Nutrition, initiated a pilot program to distribute free fruit and vegetable snacks to students during the school day. This article describes the first-year implementation of the Mississippi Fruit and Vegetable Pilot Program. METHODS The process evaluation addressed where, when, and how produce was distributed; what was distributed; challenges and successes; and recommended modifications. Five of the 25 program schools were selected to participate in the evaluation; selection was based on grade levels served and demographic characteristics. Data were collected from program staff (N = 11) and administrators (N = 6) via interviews and logs; student (N = 42) and parent (N = 19) focus groups; student questionnaires (N = 660); and school staff questionnaires (N = 207). RESULTS Distributing fresh fruit and vegetable snacks at school was well received by staff and students. Most schools distributed the fresh fruit and vegetable snacks at morning break in classrooms or a central courtyard. Twenty-two types of fresh fruit, 4 types of dried fruit, and 7 types of vegetables were served to students during the program year. Commonly distributed fruit included apples, oranges, pears, bananas, and tangerines. Carrots were the staple vegetable, followed by celery. Key challenges included getting students to try new foods and receiving the produce in a timely manner without spoiling. Main successes included seeing students try new fruit and vegetable snacks, having the program run smoothly, and teacher support. CONCLUSIONS The program fit well within the school structure and could be an effective component of a multifaceted approach to enhancing child nutrition.