Background
Physical education (PE) participation has declined substantially in the past two decades and levels of moderate-to-vigorous physical activity (MVPA) during PE are often low. Building on interventions promoting active PE and other school-based physical activity promotion strategies, school districts and states have implemented policies and programs to improve physical activity levels on a broader scale. In March 2010, the Boston Public Health Commission received $6.4 million in Communities Putting Prevention to Work (CPPW) obesity prevention funding for aggressive, high-impact policy, systems, and environmental change initiatives. In one initiative, the Boston Public Schools is implementing policies promoting an “Active School Day,” including increasing the quantity and quality of PE provided for students, integrating more MVPA throughout the school day, and conducting fitness testing in grades 4-9. Evaluation of school physical activity policy is needed in order to demonstrate potential effectiveness of policy change and to inform education leaders of best practice for improving school wellness. This research study capitalizes on a unique, time-sensitive opportunity to produce evidence documenting the potential effectiveness of policy change strategies and the key factors and outcomes related to policy change implementation in a diverse school setting.
Objectives
This study evaluates the impact of the Boston Public Schools’ CPPW-funded initiatives to increase and improve PE and physical activity in schools. The research aims to: 1) Collect accelerometer data from a student sample before and after “Active School Day” policy implementation; 2) Evaluate policy implementation within schools using quasi-experimental design; 3) Conduct cost-effectiveness analysis using evaluation findings; and 4) Rapidly communicate and disseminate research findings to key stakeholders via targeted, audience-specific strategies. Here we report preliminary baseline and process data among the student sample.
Methods
The study setting, the Boston Public Schools, is a school system with a large percentage of students of color and low income students. The evaluation has three prongs. First, a quasi-experimental non-randomized matched control study compares changes in physical activity levels pre- and post-intervention among a sample of fourth and fifth grade students using accelerometer and observational data. We collected observational data among 480 students in 26 classrooms at 6 schools at baseline (March 2011) and follow up (June 2011). Second, a quasi-experimental interrupted time series regression model using local Youth Risk Behavior Survey data 1993-2012 compares trends in high school PE participation pre- and post-intervention in Boston and Massachusetts. Third, we complete a cost-effectiveness analysis using evaluation findings. Main outcome measures are minutes of MVPA during the school day, minutes and proportion of PE class spent in MVPA, and days per week students report PE participation. Dissemination strategies will vary by audience/sector, mode, and materials to engage stakeholders in discussion of implications for populations and policy.
Results
Among 480 fourth and fifth grade students observed, we collected valid accelerometer data from 427 (89%) students at baseline. We collected 20 weekly physical activity logs from classroom teachers, and observed 13 PE lessons and 9 recess periods. Students wore accelerometers for an average of 5.5 (SD 0.4) hours on 4.3 (SD 0.8) days. Preliminary results indicate that on average, students participated in 17.3 (SD 9.9) minutes of MVPA during the school day. On the average school day, 17% (SD 10%) of students engaged in at least 30 minutes of MVPA. On days when students attended PE class, they engaged in 8.0 more minutes of MVPA (95% CI 4.0, 12.0) compared to days when they did not attend PE class. Baseline activity level estimates were similar among students attending intervention and control schools. During “Active School Day” implementation, four PE teachers at the three intervention schools each attended two SPARK trainings and one FitnessGram training, and one teacher also attended a “Wellness Champion” training to promote movement breaks throughout the school day. One of three PE specialists serving as district-wide instructional coaches visited each intervention school an average of 7 times to help plan PE lessons, deliver new equipment, observe and co-teach PE lessons, conduct fitness assessments, celebrate end of year accomplishments, collect feedback, and plan support for the following year. During the follow up data collection period, 434 students wore accelerometers for at least two school days. We collected 25 weekly physical activity logs from classroom teachers, and observed 16 PE lessons and 12 recess periods.
Conclusions
During school hours, fourth and fifth grade students in Boston were engaging in approximately 29% of the recommended 60 minutes of MVPA per day. Students came closer to meeting daily physical activity recommendations on days when they attended PE class. Comparison of these MVPA levels with levels observed following teacher training, instructional coaching, curriculum and equipment provision, and fitness assessments implemented through Boston Public Schools’ “Active School Day” initiatives will provide evidence documenting the potential effectiveness of school-based physical activity policy change.
Support/Funding
Supported by Active Living Research (grant #68591).
