Background
In 2010 Governor Sonny Perdue signed HB 229, the Student Health and Physical Education (SHAPE) Act. The legislation mandated that all children in Georgia public schools who are enrolled in physical education courses should have annual fitness assessments taken and that those results would be reported to the Governor annually. Georgia State University was contracted to conduct an evaluation of the implementation of the SHAPE Act.

Objectives
The goals of the evaluation were to 1) assess the degree to which teachers accurately administered the FITNESSGRAM® test (e.g., instructing students, accurate scoring) and 2) explore the perceptions of teachers and students with the testing requirement and protocol.

Methods
Observational Data. Two types of direct observations were made of samples of teachers.  One of the observations was conducted with a checklist of key pieces of information that teachers should communicate to students before they perform each test component.  A trained observer and certified FITNESSGRAM® test administrator observed teachers administering test components. Descriptive statistics were computed to determine the percent of correct and complete instructions provided to students before taking each portion of the FITNESSGRAM® test. The mean for correct and complete items on the four tests was determined overall and according to the three levels of training teachers received. The second type of observations checked for differences between scores recorded by teachers/volunteers/students and those recorded by independent, trained recorders.  Trained observers watched and counted as one student completed a component of the FITNESSGRAM® test.  Their counts were made strictly according to each test’s protocol and then recorded along with the count made by the teacher/volunteer/student who was assigned that responsibility. Total observations for each test component were: curl up (n=334), PACER (n=809), push-ups (n=854), sit and reach (n=296), and BMI (n=300). Descriptive statistics were computed to determine the percent difference between teacher scores and trained expert scores.   Focus groups. Eleven focus groups with 56 students and 57 PE teachers were conducted in six school districts to better understand their perceptions and experiences related to administering and completing FITNESSGRAM®. A range of questions was asked related to knowledge and perceptions of the SHAPE Act, training to implement and complete fitness testing, experience conducting testing, innovative ideas for facilitating FITNESSGRAM® implementation, and recommendations for improving testing. Data was transcribed, coded and analyzed using NVivo Qualitative Software.

Results
Observations of testing completed in schools showed that the required instructions for the following test components were communicated to students by the teacher/tester correctly and completely as follows: push-ups 77.6% (range 28.6%-100%); PACER 73.8% (28.6%-100%), back saver sit and reach 66.7% (44.4%-100%), curl ups 56.4% (9.1%-81.8%). The overall mean for correct and complete test items was 69.9%. Scores were also analyzed across categories of teacher training the tester received. Scores for correct and complete testing direction were as follows: Level 1 (most highly trained teachers) 75.4%, Level 2 47.5%, and Level 3 (least trained) 33.3%.   Observations of testing to assess reliability between teachers and trained experts showed exact agreement in scores as follows: curl up 43.7%, PACER 60.3%, push up 37.5%, sit and reach 78.7%, BMI 100%. Agreement based on +/-1 were as follows: curl up 62.3%, PACER 79.3%, push-ups 52.3%, sit and reach 82.4%, BMI 100%. Overall agreement with the Healthy Fitness Zone designation was as follows: curl-up 96.3%, push-ups 87.5%, sit and reach 98%, aerobic capacity 97.3%.   Focus group findings suggest widespread support among teachers and students for fitness testing. Major concerns included time required to test, which was reported to range from 3 days in high schools to 1 ½  months in elementary schools, and varied based on ratio of student to teacher, equipment available, size of gym, and school schedule (e.g., block or semester); inaccurate scoring, which was driven by student participation in administering testing and reports of cheating when their peers/friends assisted; excessive sitting (i.e., sedentary time), which occurred when students wait on others to be tested. Teachers also reported challenges with the FITNESSGRAM® software, both with entering, maintaining, and printing data. Participants provided numerous recommendations to improve testing.

Conclusions
Findings from statewide fitness testing raise questions about the fidelity to testing protocols and the accuracy and usefulness of data collected. Yet, agreement with FITNESSGRAM® Healthy Fitness Zones was high. Many students enjoy testing, and teachers value the effort because they sense that there is potential for testing to have impact on student health and family engagement in student physical activity. There are concerns related to excessive instructional time taken for testing, cheating and inaccurate scoring, and increased sedentary time while students wait to be tested.

Implications
This evaluation informs physical activity policy implementation efforts by highlighting challenges and areas where more attention and training may be needed.

Support / Funding Source
This evaluation was supported by Children's Healthcare of Atlanta on behalf of the SHAPE Partnership.