Increasing Physical Activity in Schools: Strategies for School Health Practitioners

The role of education attainment on 24-hour movement behavior in emerging adults: evidence from a population-based study

Purpose

The purpose of this study was to explore the relationship between education level and health behavior including sleep, work activity, exercise activity, and sedentary behavior among emerging adults.

Methods

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2007 and 2018. The study sample included 4,484 emerging adults aged 18-25 years and the weighted participants were 30,057,813. Weighted multivariable regression analysis was performed to investigate the association between education level and the aforementioned health behavior, adjusting for age, gender, race/ethnicity, marital status, poverty-income ratio, BMI, smoking, and alcohol drinking status.

Results

This study revealed that higher education level was associated with shorter sleep duration [Fully adjusted model, β (95% CI): -0.588 (-0.929, -0.246), p < 0.001]. Additionally, those with higher education levels were more likely to allocate time in sedentary behavior [β (95% CI): 90.162 (41.087, 139.238), p < 0.001]. Moreover, higher education level was related to less work activity [β (95% CI): -806.991 (-1,500.280, -113.703), p = 0.023] and more exercise activity time [β (95% CI): 118.196 (-21.992, 258.385), p = 0.097]. Subgroup analysis further verified this trend and detected that males with higher education level tended to participate in less work activity [β (95% CI): -1,139.972 (-2,136.707, -143.237), p = 0.026] while females with higher education level tended to engage in more exercise activity [Fully adjusted model, β (95% CI): 141.709 (45.468, 237.950), p = 0.004].

Conclusion

This study highlighted the importance of education level as a significant factor in promoting healthy behavior among emerging adults. The findings underscored the need for the Ministry of Education to prioritize educating this demographic about the significance of maintaining adequate sleep patterns and reducing sedentary habits. Encouraging them to allocate more time for work and physical activities can significantly contribute to their overall wellbeing and success, ultimately fostering a healthier next generation.

Recess Policy Implementation: Beliefs and Perceptions of Site-Based Decisions-Makers

METHODS

Using the Theory of Planned Behavior (Ajzen 1991) as a theoretical framework, this study examined what administrators and teachers at a public elementary school located in a district in Northeast Georgia communicated as to their salient behavioral beliefs (attitude), normative beliefs (subjective norms), and control beliefs (perceived behavioral control) relative to the implementation of the district's written recess policy.

RESULTS

The results of this study demonstrated that teachers new to the field and those certified in early childhood education were more supportive of implementing the practice. The results further demonstrated that more experienced teachers and those certified in elementary education were less supportive.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

The findings in this study revealed that obtaining participant buy-in was critical for the implementation and that targeted professional development would be a suitable vehicle for improving school health for students.

CONCLUSIONS

The most cited reasons for support for the policy were an understanding that an unstructured break was beneficial for students and that participants considered it a non-negotiable. The most cited reasons for a lack of support included more time needed for academics and a need for expanded behavioral consequences.

Effects of School-Based Physical Activity Programs on Health-Related Physical Fitness of Korean Adolescents: A Preliminary Study

As adolescents spend the majority of their time focused on exams and assignments, they do not have sufficient time to engage in physical activity; this lack of physical activity is an important public health concern. This study aimed to investigate how school-based physical activity programs affect the health-related physical fitness of adolescents in the Republic of Korea. For this study, a total of 120 high school students participated in a school-based physical activity program that included badminton and table tennis for 15 weeks each (35 min/day, three times a week), with a total of 30 weeks for one academic year. The parameters for health-related physical fitness measured muscle strength (handgrip strength), power (standing long jump), cardiorespiratory fitness (shuttle run test), flexibility (sit and reach), body mass index (BMI), and the total score. The results revealed a statistically significant improvement in muscle strength (p < 0.001), power (p < 0.001), cardiorespiratory fitness (p < 0.001), flexibility (p = 0.005), and the overall health-related physical fitness score (p = 0.001). However, students’ BMI showed no significant difference before and after participation (p = 0.825). The results of this study indicated that school-based physical activity programs can have a positive effect on the health-related physical fitness of adolescents.

School health assessment tools: a systematic review of measurement in primary schools

Background

This systematic review aimed to investigate the psychometric properties of the school health’s assessment tools in primary schools through COSMIN Risk of Bias checklist. We examined the studies that have addressed the measurement properties of school-health instruments to give a clear overview of the quality of all available tools measuring school health in primary schools. This systematic review was registered in PROPERO with the Registration ID: CRD42020158158.

Method

Databases of EBSCOhost, PubMed, ProQuest, Wily, PROSPERO, and OpenGrey were systematically searched without any time limitation to find all full-text English journal articles studied at least one of the COSMIN checklist measurement properties of a school-health assessment tool in primary schools. The instruments should be constructed based on a school health model. The eligible studies were assessed by COSMIN Risk of Bias checklist to report their quality of methodology for each measurement property and for the whole study by rating high, moderate or low quality.

Results

At the final screening just seven studies remained for review. Four studies were tool development, three of them were rated as “adequate” and the other study as “very good”; five studies examined the content validity, three of them were appraised as “very good”, and the two remaining as “inadequate”. All seven studies measured structural validity, three of them were evaluated as “very good”, three other were scored as “adequate”, and the last study as “inadequate”. All the seven studies investigated the internal consistency, five of them were assessed as “very good”, one was rated as “doubtful”, and the last one as “inadequate”. Just one study examined the cross-cultural validity and was rated as “adequate”. Finally, all seven studies measured reliability, two of them were rated as “very good” and the rest five studies were appraised as “doubtful”. All rating was based on COSMIN checklist criteria for quality of measurement properties assessment.

Conclusion

The number of studies addressing school health assessment tools was very low and therefore not sufficient. Hence, there is a serious need to investigate the psychometric properties of the available instruments measuring school health at primary schools. Moreover, the studies included in the present systematic review did not fulfill all the criteria of the COSMIN checklist for assessing measurement properties. We suggest that future studies consider these criteria for measuring psychometric properties and developing school health assessment tools.