Sarah M. Lee

Physical Education and Physical Activity: Results from the School Health Policies and Programs Study 2006.

BACKGROUND Comprehensive school-based physical activity programs consist of physical education and other physical activity opportunities including recess and other physical activity breaks, intramurals, interscholastic sports, and walk and bike to school initiatives. This article describes the characteristics of school physical education and physical activity policies and programs in the United States at the state, district, school, and classroom levels. METHODS The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n=453). Computer-assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n=988) and with a nationally representative sample of teachers of required physical education classes and courses (n=1194). RESULTS Most states and districts had adopted a policy stating that schools will teach physical education; however, few schools provided daily physical education. Additionally, many states, districts, and schools allowed students to be exempt from participating in physical education. Most schools provided some opportunities for students to be physically active outside physical education. Staff development for physical education was offered by states and districts, but physical education teachers generally did not receive staff development on a variety of important topics. CONCLUSIONS To enhance physical education and physical activity in schools, a comprehensive approach at the state, district, school, and classroom levels is necessary. Policies, practices, and comprehensive staff development at the state and district levels might enable schools to improve opportunities for students to become physically active adults.

Physical Education and Academic Achievement in Elementary School: Data From the Early Childhood Longitudinal Study

OBJECTIVES We examined the association between time spent in physical education and academic achievement in a longitudinal study of students in kindergarten through fifth grade. METHODS We used data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998 to 1999, which employed a multistage probability design to select a nationally representative sample of students in kindergarten (analytic sample = 5316). Time spent in physical education (minutes per week) was collected from classroom teachers, and academic achievement (mathematics and reading) was scored on an item response theory scale. RESULTS A small but significant benefit for academic achievement in mathematics and reading was observed for girls enrolled in higher amounts (70-300 minutes per week) of physical education (referent: 0-35 minutes per week). Higher amounts of physical education were not positively or negatively associated with academic achievement among boys. CONCLUSIONS Among girls, higher amounts of physical education may be associated with an academic benefit. Physical education did not appear to negatively affect academic achievement in elementary school students. Concerns about adverse effects on achievement may not be legitimate reasons to limit physical education programs.

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.

BMI Measurement in Schools

BACKGROUND AND OBJECTIVE: School-based BMI measurement has attracted attention across the nation as a potential approach to address obesity among youth. However, little is known about its impact or effectiveness in changing obesity rates or related physical activity and dietary behaviors that influence obesity. This article describes current BMI-measurement programs and practices, research, and expert recommendations and provides guidance on implementing such an approach. METHODS: An extensive search for scientific articles, position statements, and current state legislation related to BMI-measurement programs was conducted. A literature and policy review was written and presented to a panel of experts. This panel, comprising experts in public health, education, school counseling, school medical care, and parenting, reviewed and provided expertise on this article. RESULTS: School-based BMI-measurement programs are conducted for surveillance or screening purposes. Thirteen states are implementing school-based BMI-measurement programs as required by legislation. Few studies exist that assess the utility of these programs in preventing increases in obesity or the effects these programs may have on weight-related knowledge, attitudes, and behaviors of youth and their families. Typically, expert organizations support school-based BMI surveillance; however, controversy exists over screening. BMI screening does not currently meet all of the American Academy of Pediatrics’ criteria for determining whether screening for specific health conditions should be implemented in schools. CONCLUSION: Schools initiating BMI-measurement programs should adhere to safeguards to minimize potential harms and maximize benefits, establish a safe and supportive environment for students of all body sizes, and implement science-based strategies to promote physical activity and healthy eating.

The Role of Schools in Preventing Childhood Obesity

The childhood obesity epidemic is one of the major public health, social, and economic challenges of the 21st century. Consequences of this epidemic include increased risk for chronic diseases, social and psychological problems among young people, and high health care costs. Physical activity and eating behaviors that affect the childhood obesity epidemic are infl uenced by many sectors of society, including families, community organizations, health care providers, faith-based institutions, government agencies, the media, and schools. While schools cannot solve the problem alone, they have a unique role to play in addressing childhood obesity. This issue of the President s Council on Physical Fitness and Sports Research Digest summarizes data on overweight among young people, describes 10 evidence-based strategies schools can use to improve student nutrition and physical activity, and addresses challenges to improvement. The complete article appears in the September 2006 issue of the President s Council on Physical Fitness and Sports Research Digest. The Research Digest is published four times a year and includes manuscripts related to physical activity and health. Articles are available free through the Presidentʼs Council on Physical Fitness and Sports at http://www.fi tness.gov/pcpfs_research_digs.htm

Influence of limit-setting and participation in physical activity on youth screen time.

OBJECTIVES: To examine the associations of demographics, rules associated with television-viewing, and physical activity with daily screen time (including television, non–school-related computer use, and video games) in children and adolescents. METHODS: We analyzed data from a telephone survey of 7415 youth aged 9 to 15 years from the Youth Media Campaign Longitudinal Survey. We used logistic regression models to calculate odds of exceeding recommended screen-time limits (>120 minutes/day) according to demographics, rules, and physical activity. RESULTS: Odds that children would exceed recommended screen-time limits were positively associated with age and black race/ethnicity and negatively associated with income level. Children and adolescents who reported that they really agreed that their parents had rules about time spent watching television and playing video games were less likely to exceed recommended limits than those who strongly disagreed that their parents had rules. Similarly, when parents reported always or very often having limits on television watching (versus rarely or never) and when parents correctly identified the recommended limits, children were less likely to exceed recommended limits. Children whose parents reported consistent limits and who themselves reported consistent rules about time spent watching television had the lowest prevalence of exceeding recommended limits. Odds that children would exceed recommended limits decreased as physical activity in the previous week increased. CONCLUSIONS: Parental rules regarding screen time and participation in physical activity play a role in the amount of screen time among children and adolescents. Programs that encourage limit-setting by parents and promote physical activity may reduce screen time among youth.

Obesity and Other Correlates of Physical Activity and Sedentary Behaviors among US High School Students

Understanding correlates of physical activity (PA) can help inform and improve programs that promote PA among youth. We analyzed data from the 2010 National Youth Physical Activity and Nutrition Study, a representative sample of US students in grades 9–12. Logistic regression was used to examine associations between PA correlates (obesity, physical education classes, sports team participation, attitude toward PA, adult support for PA, and environmental support for PA) and participation in daily PA (DPA), vigorous PA (VPA), muscle-strengthening activity (MSA), viewing television (TV), and using computers or video games (C/VG). A positive attitude toward PA and adult support for PA were both associated with increased PA and decreased sedentary behavior. However, among students who lived in neighborhoods that were not safe for PA, a positive attitude toward PA was not associated with increased DPA or decreased sedentary behavior and was less strongly associated with VPA and MSA. Efforts to increase PA among youth should promote a positive attitude toward PA among youth and encourage adult family members to support their efforts to be active. Policies that promote safe neighborhoods may work synergistically with a positive attitude toward PA to increase participation in PA and decrease sedentary behaviors.

Weight Management and Fruit and Vegetable Intake Among US High School Students

BACKGROUND Consumption of fruits and vegetables is often recommended to promote healthy weight. The purpose of this study was to examine associations between fruit and vegetable intake and common weight management behaviors among US high school students who were trying to lose or stay the same weight. METHODS Data from the 1999, 2001, and 2003 national high school Youth Risk Behavior Surveys were combined and the analyses stratified by gender (females, N = 16,709; males, N = 10,521). We considered 3 common weight management strategies--being physically active (ie, moderate activity for 30 minutes on 5 or more days per week or vigorous activity for 20 minutes on 3 or more days per week), eating a reduced calorie or fat diet, and limiting TV viewing. Sufficient fruit and vegetable intake was defined as eating 5 or more servings per day. Odds ratios (ORs) were calculated using logistic regression. RESULTS Only 21.3% of females and 24.7% of males ate sufficient fruits and vegetables. Being physically active was associated with sufficient fruit and vegetable intake. Eating a reduced calorie or fat diet and limiting TV viewing (among males) were associated with sufficient fruit and vegetable intake only among physically active students. The odds of sufficient fruit and vegetable intake were greatest among female (OR = 3.01) and male (OR = 2.91) students who combined all 3 strategies (31.5% of females, 21.6% of males). CONCLUSIONS Interventions that promote fruit and vegetable intake within the context of healthy weight management may be more effective if they combine nutrition and physical activity strategies. Further research is needed to test this approach.

Opportunities for public health to increase physical activity among youths

Despite the well-known benefits of youths engaging in 60 or more minutes of daily physical activity, physical inactivity remains a significant public health concern. The 2008 Physical Activity Guidelines for Americans (PAG) provides recommendations on the amount of physical activity needed for overall health; the PAG Midcourse Report (2013) describes effective strategies to help youths meet these recommendations. Public health professionals can be dynamic change agents where youths live, learn, and play by changing environments and policies to empower youths to develop regular physical activity habits to maintain throughout life. We have summarized key findings from the PAG Midcourse Report and outlined actions that public health professionals can take to ensure that all youths regularly engage in health-enhancing physical activity.

Associations of School Violence With Physical Activity Among U.S. High School Students

BACKGROUND This study investigated associations of violence-related behaviors with physical activity (PA)-related behaviors among U.S. high school students. METHODS Data from the 2009 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of 9th-12th grade students, were analyzed. Sex-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated for associations between violence-related behaviors and being physically active for ≥60 minutes daily, sports participation, TV watching for ≥3 hours/day, and video game/computer use for ≥3 hours/day. RESULTS Among male students, at-school bullying victimization was negatively associated with daily PA (aOR: 0.72; 95% CI: 0.58-0.87) and sports participation; skipping school because of safety concerns was positively associated with video game/computer use (1.42; 1.01-2.00); and physical fighting was positively associated with daily PA. Among female students, at-school bullying victimization and skipping school because of safety concerns were both positively associated with video game/computer use (1.46; 1.19-1.79 and 1.60; 1.09-2.34, respectively), and physical fighting at school was negatively associated with sports participation and positively associated with TV watching. CONCLUSIONS Bullying victimization emerged as a potentially important risk factor for insufficient PA. Schools should consider the role of violence in initiatives designed to promote PA.