Associations Between State Laws Governing Recess Policy with Children's Physical Activity and Health

Association of Recess Provision With Accelerometer-Measured Physical Activity and Sedentary Time in a Representative Sample of 6- to 11-Year-Old Children in the United States

PURPOSE

To assess the association between the amount of recess provision and children's accelerometer-measured physical activity (PA) levels.

METHODS

Parents/guardians of 6- to 11-year-olds (n = 451) in the 2012 National Youth Fitness Survey reported recess provision, categorized as low (10-15 min; 31.9%), medium (16-30 min; 48.0%), or high (>30 min; 20.1%). Children wore a wrist-worn accelerometer for 7 days to estimate time spent sedentary, in light PA, and in moderate to vigorous PA using 2 different cut points for either activity counts or raw acceleration. Outcomes were compared between levels of recess provision while adjusting for covariates and the survey's multistage, probability sampling design.

RESULTS

Children with high recess provision spent less time sedentary, irrespective of type of day (week vs weekend) and engaged in more light or moderate to vigorous PA on weekdays than those with low recess provision. The magnitude and statistical significance of effects differed based on the cut points used to classify PA (eg, 4.7 vs 11.9 additional min·d-1 of moderate to vigorous PA).

CONCLUSIONS

Providing children with >30 minutes of daily recess, which exceeds current recommendations of ≥20 minutes, is associated with more favorable PA levels and not just on school days. Identifying the optimal method for analyzing wrist-worn accelerometer data could clarify the magnitude of this effect.

Advocacy for Equitable Recess in Washington State

Recess in schools is a critical opportunity for children to engage in important behaviors that can promote their health and well-being, and daily recess is recommended by the American Academy of Pediatrics and other national organizations. In Washington state, school recess is not equitably provided, with parents reporting a wide range from as little as 10 minutes to >45 minutes daily. State laws can help promote equitable and high-quality recess, but most states in the United States do not have recess laws. In 2023, a bill (Senate Bill 5257) mandating a minimum of 30 minutes of daily recess for all elementary students with provisions for other recess best practices (including not withholding recess as punishment and encouraging movement breaks for middle/high-schoolers) passed with bipartisan support in the Washington state Legislature and was signed into law. In this case study, we describe the process undertaken and lessons learned by the cross-sector coalition that spearheaded the advocacy efforts, which included pediatricians, parents, educators, community organizations, and youth.

A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools

BACKGROUND

In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not.

METHODS

PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess.

RESULTS

Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one.

CONCLUSIONS

Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

Adherence to Recess Guidelines in the United States Using Nationally Representative Data: Implications for Future Surveillance Efforts

BACKGROUND

National adherence to the recess recommendations of the Centers for Disease Control and Prevention (CDC) has not been comprehensively studied in the United States.

METHODS

Data from 6 nationally representative data sets over the last decade (Classification of Laws Associated with School Students, Early Childhood Longitudinal Study, National Health and Nutrition Examination Survey, National Youth Fitness Survey, School Health Policies and Practices Survey, and the School Nutrition and Meal Cost Study) provided estimates for adherence to CDC recess guidelines.

RESULTS

While approximately 65-80% of elementary school-children receive the recommended 20+ minutes of daily recess according to parent-, principal-, and school-report, adherence declines by sixth grade, and little information is available for middle/high school students. Adherence to playground safety was high (90%), but adherence to recommendations about recess before lunch (<50%), withholding recess as punishment (∼50%), and training recess staff (<50%) were lower.

CONCLUSIONS

School policy and practice should align with CDC recommendations, with the aim of providing sufficient quality recess to all youth, K-12th grade. Comprehensive, on-going national surveillance of multiple recess domains is needed to inform policy and ensure equitable provision of recess.

Not all fun and games: Disparities in school recess persist, and must be addressed

School recess is an evidence-backed approach to increase school-based opportunities for students to play, accrue necessary physical activity, and socialize with peers, to the benefit of their physical, academic, and socioemotional health. As such, the Centers for Disease Control recommend at least 20 min of daily recess in elementary schools. However, unequal provision of recess contributes to persistent health and academic disparities for students, which remain to be addressed. We analyzed data from the 2021-22 school year from a sample of low-income (Supplemental Nutrition Assistance Program Education-eligible) elementary schools (n = 153) across California. Just 56 % of schools reported providing more than 20 min of recess daily. Differences in daily recess provision were apparent, with students in larger and lower-income schools receiving less daily recess than students in smaller and higher income schools. These findings support the enactment of legislation mandating health-sufficient daily recess in California elementary schools. They also highlight the importance of, and need for, annually-collected data sources to enable monitoring of recess provision, and potential disparities, over time, in order to assist in identifying additional interventions to address this public health problem.

The Relationship Between Policy Strength and Physical Activity Practices in Arizona Public Elementary Schools

BACKGROUND

Many school-based physical activity statutes and regulations have been enacted, with the expectation that schools will comply. However, policy alone does not equate to implementation, and many policies fail for a variety of reasons. The purpose of the study was to determine whether the strength of reported state, district, and school-level physical activity policies were associated with reported recess, physical education, and other school-based physical activity practices at elementary schools in Arizona.

METHODS

A modified Comprehensive School Physical Activity Program (CSPAP) Questionnaire was administered to staff at elementary schools across Arizona (N = 171). Summative indices of the number of school physical activity policies and best practices at the state, district, and school levels were created. Relationships between policy strength and best practices were examined using linear regression analyses stratified by recess, physical education, and other school-based physical activity practices.

RESULTS

Stronger physical activity-related policies were associated with a greater number of recess (F1,142 = 9.87, P < .05), physical education (F4,148 = 4.58, P < .05, Adj. R2 = .09), and other school-based physical activity (F4,148 = 4.04, P < .05, Adj. R2 = .07) best practices at all levels while controlling for school-level demographic factors.

CONCLUSIONS

The strength of policies may improve opportunities for comprehensive physical activity for children in schools. Strengthening policy language (eg, specifying duration and frequency) may contribute to better physical activity practices in schools, improving children's health at the population level.

Models of school recess for combatting overweight in the United States

Objectives

The aim of the study was to quantify and compare potential energy expenditure associated with school recess in the U.S. based on four scenarios: professional recommendations and state policies for the conduct of recess, previous studies that measured physical activity intensity during recess (i.e., reality), and no daily recess.

Methods

Estimated energy expenditure (kcal) was modeled using secondary data over six years of elementary school for boys and girls using a standard formula: Intensity × duration × frequency × mass .

Results

Boys and girls would expend similar energy under the professional recommendation (boys, 69,146 kcal; girls, 63,993 kcal) and state policy (boys, 69,532 kcal; girls, 64,351 kcal) scenarios. These values are significantly greater than a no recess scenario (boys, 26,974 kcal; girls, 24,821 kcal). The greatest energy expenditure was found for the reality scenario, based on actual studies that measured physical activity intensity (boys, 82,208 kcal; girls, 75,628 kcal).

Conclusions

Professional recommendations and state policies for recess duration may be overly conservative and recommendations for percentage of MVPA may be overly liberal compared to the reality of energy expended during recess. Both potential and real estimates dwarf a scenario of withholding recess (i.e., no recess), which is discouraged in only six state policies. Mandated reporting with "groundtruthing" is needed to determine true recess frequency/duration and state policy compliance.