Evaluation of a comprehensive school physical activity program: Be a Champion!

Implementation of Physical Activity in US Elementary Schools: The Role of Administrative Support, Financial Resources, and Champions

The intentional integration of physical activity in elementary school classrooms-including brief instructional breaks for activity, or integration into lessons-can benefit children's physical activity and education outcomes. Teachers are key implementation agents, but despite physical activity in the classroom being an evidence-informed practice, many teachers do not regularly implement it. The aim of this study was to obtain updated nationally representative prevalence estimates in United States public elementary schools, regarding four key outcomes: (1) school adoption of physically active lessons (PA lessons); (2) school adoption of physical-activity breaks (PA breaks); (3) penetration in the classroom, defined as ≥50% of teachers using PA breaks; and (4) dose, defined as an average of at least 50 min per week of PA breaks. We examined variations in outcomes by school demographic characteristics, and by three factors hypothesized to be implementation facilitators (administrative support, financial resources, and presence of a wellness champion at the school). In the 2019-20 school year, surveys were distributed to a nationally representative sample of 1010 public elementary schools in the US; responses were obtained from 559 (55.3%). The weighted prevalence of schools reporting adoption of PA lessons was 77.9% (95% CI = 73.9% to 81.9%), and adoption of PA breaks was nearly universal at 91.2% (95% CI = 88.4% to 94.1%). Few demographic differences emerged, although adoption of PA lessons was less prevalent at higher-poverty schools (73.9%) and medium-poverty schools (77.0%) as compared to schools with lower poverty levels (87.1%; p < 0.01). Across all four outcomes, associations emerged with facilitators in multivariable logistic regression models. The prevalence of adoption of PA lessons, adoption of PA breaks, and dose of PA breaks were all significantly higher at schools where administrative encouragement occurred more frequently. Financial support was associated with implementation outcomes, including adoption of PA lessons, and penetration and dose of PA breaks. Presence of a champion was associated with higher prevalence of reporting adoption of PA lessons. School leaders can play a crucial role in supporting teachers' implementation of PA breaks and lessons in the classroom, through providing financial resources, encouragement, and supporting champions. Effective school-leadership practices have the potential to positively impact students at a large-scale population level by supporting implementation of PA lessons and breaks.

A Pilot Study of a Comprehensive School Physical Activity Program in Elementary Schools: Be a Champion!

Objective

In the present study, we sought to determine if a comprehensive school physical activity program (CSPAP) delivered using the Be a Champion! (BAC) framework was effective in increasing moderate-to-vigorous physical activity (MVPA) and decreasing sedentary time in elementary school youth.

Methods

We implemented a CSPAP in 3 elementary schools to determine its effectiveness to youth behaviors compared to 2 control schools. Youth physical activity was assessed via accelerometry in spring 2015 and spring 2016 during school hours on school days. Implementation of the BAC components and youth behavior was assessed through direct observation from fall 2015 through winter 2016.

Results

In a multilevel, mixed model examining the effects of intervention, we found no statistically significant effect of the intervention on overall MVPA. However, a significant increase in MVPA was observed among girls (but not boys) in the intervention schools relative to controls. No differences in sedentary behaviors were observed by group.

Conclusion

CSPAP implementation may be effective in reducing sedentary time and increasing MVPA in girls, but not boys. Research is necessary to increase implementation dose and fidelity to best practices in physical activity promotion.

Comprehensive School Physical Activity Program Policies and Practices Questionnaire (CSPAP-Q)

Purpose: The Comprehensive School Physical Activity Program (CSPAP) model has recently been adopted as a national framework for physical activity (PA) promotion in schools. As a result, there is a need to develop an instrument to help leaders of PA measure policies and practices across the five component areas of a CSPAP. To address this gap, our team systematically developed and assessed the psychometric properties of the CSPAP-Q, an instrument designed to assess school policies and practices related to the five components of CSPAP. Methods: The instrument development process began by reviewing existing school health and PA surveys. The Delphi method was then used to evaluate face and content validity through expert feedback. Thirty-eight physical education teachers completed the CSPAP-Q twice over a 14-day period to further establish validity and to assess test-retest reliability. Results: In total, 117 items were identified for the initial review. Upon completion of expert feedback, 22 items were eliminated and 66 items were revised. After reliability testing, three additional items were eliminated due to low test-retest agreement levels (Kappa <.40; non-significant χ²). Ninety-two items were retained in the final version of the CSPAP-Q and kappa values indicated moderate to substantial agreement among items. Conclusions: After validity and reliability testing, results suggest that the CSPAP-Q is a valid and reliable tool for assessing policies and practices related to CSPAP.

Healthy for Life Pilot Study: A Multicomponent School and Home Based Physical Activity Intervention for Disadvantaged Children

The study aimed to develop and evaluate a multicomponent school and home based physical activity (PA) intervention in children in grades 3–7 (aged 8–13 years) and determine the psychological variables that influence PA; 10 × 1 h school-based training sessions, a home-based activity program and 4 × 1 h lifestyle workshops for parents. PA was assessed at an intervention and nearby control school using accelerometers and self-report at 3-time points: baseline, post intervention and 10-week follow-up. Self-efficacy, self-management strategies, enjoyment, perceived barriers to PA, outcome-expectancy and social support were evaluated. The study showed 73% of the children with complete data sets at the intervention school (n = 27) did not increase device measured moderate to vigorous PA (MVPA) in the after-school period (3 p.m. to 6 p.m.) or over the whole day or during school break time immediately following the intervention or at follow-up, as compared to 70% of children with complete data sets at the control school (n = 35; p > 0.05 for all). Overall, 59% of boys attained more than double the recommended 120 min of MVPA each day compared to 42% of girls (p = 0.013). At the baseline, children’s self-reported PA in the intervention school positively correlated with: outcome expectancy (R = 0.240, p = 0.015), enjoyment (R = 0.339, p < 0.001), self-efficacy (R = 0.399, p < 0.001), self-management (R = 0.617, p < 0.001), social support at home (R = 0.406, p < 0.001), and social support at school (R = 0.407, p < 0.001). Similar relationships were observed after the intervention and at follow-up. Focus groups with the children, parents and interviews with teachers identified areas for improvement of the intervention. In conclusion, while the multifaceted approach to improve PA was ineffective over the time span of the study, important predictors of PA in this sample of disadvantaged children were identified.