Background and Purpose
Given the central role of physical activity (PA) in the prevention of obesity and the current high prevalence rates of childhood obesity, there is an urgent need for the effective implementation of policy, program and environmental supports to help children be more physically active. Schools are an important setting for this. The focus of this study is the implementation of a new RI law that specifies both the quantity and quality of physical education (PE) offered to RI students. In 2008, Rhode Island passed General Law 16-22-4, mandating the amount (100 minutes/week) and type (i.e. focus on health-related fitness rather than sports/competition) of physical education (PE) to be offered to school students. RI schools were supposed to be in compliance with Law by 2012 but few were. Experience with RI school nutrition regulations suggests that providing training and technical assistance to schools prior to implementing new state-wide regulations results in better outcomes. A similar approach could be helpful for physical activity. To evaluate the effectiveness of providing training and technical assistance to RI schools to improve compliance with a new law (RI General Law 16-22-4), which mandates the amount (100 minutes/week) and type of PE (i.e. focus on developing and maintaining health-related fitness, rather than on sports/competition).

Objectives
The overall goal of this study is to evaluate whether the two schools that receive coaching, training and technical assistance in their final year of implementing RI’s new PE Law  have better PA outcomes than two matched control schools that receive no coaching, training or technical assistance.

Specific Aim 1: Evaluate whether the intervention schools’ teachers, administrators, students and school improvement teams have greater increases in knowledge, skills, enthusiasm, motivation and support for the new PE law than their counterparts in the control schools; Specific Aim 2: Evaluate whether the intervention schools have a greater increase in compliance with the new PE law than the control schools; Specific Aim 3: Evaluate whether students attending the intervention schools have greater increases in PA levels (during school) than students in the control schools.

Methods
Four low-income, elementary schools in two RI cities were recruited and demographically matched. Baseline measures were conducted in Fall/Winter 2011-12 and follow-up data was collected in Fall/Winter 2012-13 with school staff and 220, 3rd and 4th grade students and included: Accelerometer measurement of students' PA  on the days of PE class over a 2-eeek period; Observations of the quality and quantity of PA during PE classes for 2 weeks using the System for Observing Fitness Instruction (SOFIT) tool; Pre-post student surveys regarding behaviors, perspectives and PA and PE practices; Pre-post focus groups with students; and Pre-post key informant interviews with principals, PE teachers, classroom teachers and parents. Intervention: Training and technical assistance was provided to the 2 intervention schools' PE teachers by an 'expert' PE coach/teach between March and June and in Sept and Oct of 2012.

Results

1. RI elementary schools fall short of state legislation guidelines for amount and type of PE. At both baseline and follow-up, none of the schools met the RI-law mandated 100 minutes per week of PE.
2. The average # of weekly minutes spent in PE class was 72.
3. Baseline PA levels did not differ by school.
4. Baseline SOFIT data showed that 79% of time spent in PE class was non-moderate/vigorous PA (MVPA)
5. Baseline accelerometer data showed that 76% of time in PE class was spent in non-moderate/vigorous PA (MVPA) and only 24% of PE class time  was spent in moderate-vigorous PA (MVPA).
6. At follow-up, accelerometer data showed that intervention school students had statistically significant higher levels of MVPA during PE class; however overall levels were still low.
7. One of the biggest issues was that teachers spent too much time talking and instructing children and the children were inactive during these times.
8. The number of minutes of PE did not change over time.

Conclusions
Students in the intervention schools (where PE teachers received training and technical assistance) demonstrated a significantly larger increase in MVPA during the school day than students in control schools where PE teachers received no training. However, overall rates of PA in PE class were still low. We will discuss the challenges encountered and the implications of these findings.

Implications for Practice and Policy
Many states, cities and towns are in the process of, and/or considering, changing laws governing PE in schools to increase students' PA levels. In order to obtain the desired results from these laws, they should consider including funding for, and/or mandating, PE teacher training and technical assistance prior to the final policy implementation date to provide them with the necessary knowledge, skills and resources to make effective changes in their teaching methods and practices so that policy changes can be more effective.

Support / Funding Source
Robert Wood Johnson Foundation, Active Living Research.