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School-based Programs to Increase Physical Activity

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What are school-based programs to increase physical activity?

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School-based programs to increase physical activity can include programs to expand school-based physical education (PE)[1, 2] and incorporate physical activity into regular classroom curricula.[3] Physical education may be expanded by increasing the length of PE classes and increasing the number of fitness activities during PE classes.[1, 2] Physical activity also may be incorporated into academic classes through physically active lessons or classroom activity breaks.[4] Programs may be combined with other school- and community-based interventions such as student health education about physical activity, activities that foster family involvement, and community partnerships to increase opportunities for physical activity.[1, 5]

These programs can be implemented at the state or local school district level.[1, 2, 6] An example of a state moving towards this goal is West Virginia, which in 2016 became the first state to enroll all of its public elementary schools in the Let’s Move! Active Schools physical activity initiative.[7] The purpose of these school-based programs is to increase students’ physical activity levels, and thereby help improve student fitness and weight status.[1-3]

What’s the public health Issue?

Physical activity is an important contributor to health, and engaging in regular physical activity can decrease the risk for numerous adverse health outcomes, including hypertension, diabetes, heart disease and some cancers.[8, 9] Physical activity also is an important factor in achieving a healthy weight and maintaining it over time.[8] In 2008 the U.S. Department of Health and Human Services (HHS) recommended that young people aged 6–17 years participate in at least 60 minutes of physical activity daily.[8] In its 2012 report, HHS recommended that programs in school settings should be included as a key component of strategies to increase physical activity and address childhood obesity.[10] However, in 2014, only 27 percent of high school students surveyed had participated in at least 60 minutes of physical activity per day during the week before the survey, and only 30 percent attended physical education class daily while in school.[11]

What is the evidence of health impact and cost effectiveness?

Multiple systematic reviews of school-based programs to increase physical activity have found that these interventions are associated with increased physical activity among students.[1, 12-14] Reviews also found evidence that these interventions are associated with positive effects on BMI[12] and obesity prevention [15].

A 2015 benefit-cost analysis by the Washington State Institute for Public Policy (WSIPP) on school-based programs to increase physical activity found that they were associated with a positive benefit to cost ratio.[16] The WSIPP analysis estimated that elementary or middle school programs that added additional physical activity to the school day for students could result in a benefits to cost ratio of approximately $33:1 (in 2015 dollars) over time.[17] These benefits were calculated from decreased health care costs due to reductions in obesity and increased labor market earnings due to the positive impact of physical activity on academic achievement.

For questions or additional information, email healthpolicynews@cdc.gov.

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References

  1. The Guide to Community Preventive Services, Behavioral and Social Approaches to Increase Physical Activity: Enhanced School-Based Physical Education. The Community Guide: What Works to Promote Health 2013 February 4, 2016 [cited 2016 July 5]; Available from: Behavioral and Social Approaches to Increase Physical Activity: Enhanced School-Based Physical Education.
  2. County Health Rankings & Roadmaps, School-based physical education. 2014 January 10, 2014 [cited 2016 July 5]; Available from: School-based physical education.
  3. County Health Rankings & Roadmaps, Physically active classrooms. 2015 December 7, 2015 [cited 2016 July 5]; Available from: Physically active classrooms.
  4. Donnelly, J.E. and K. Lambourne, Classroom-based physical activity, cognition, and academic achievement. Preventive medicine, 2011. 52: p. S36-S42.
  5. Centers for Disease Control Prevention, School health guidelines to promote healthy eating and physical activity. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports/Centers for Disease Control, 2011. 60(RR-5): p. 1.
  6. Slater, S.J., et al., The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of US public elementary schools. Arch Pediatr Adolesc Med, 2012. 166(4): p. 311-6. doi: 10.1001/archpediatrics.2011.1133
  7. West Virginia Becomes First State to have All Public Elementary Schools Join Let’s Move! Active Schools. Let's Move Active Schools 2016 June 22, 2016 [cited 2016 July 5]; Available from: West Virginia Becomes First State to have All Public Elementary Schools Join Let’s Move! Active Schools.
  8. U.S. Department of Health and Human Services, Physical activity guidelines for Americans, 2008. Available from: Physical activity guidelines for Americans
  9. Centers for Disease Control Prevention, Barriers to children walking to or from school--United States, 2004. MMWR: Morbidity and mortality weekly report, 2005. 54(38): p. 949-952.
  10. Physical Activity Guidelines for Americans Midcourse Report Subcommittee of the President’s Council on Fitness, Sports & Nutrition, Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth, U.S. Department of Health and Human Services, 2012: Washington D.C. Available from: Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth
  11. Kann L, M.T., Harris WA, et al., Youth Risk Behavior Surveillance—United States, 2015. MMWR. Surveillance Summaries, 2016. 65(No. SS-6).
  12. Demetriou, Y. and O. Höner, Physical activity interventions in the school setting: A systematic review. Psychology of sport and exercise, 2012. 13(2): p. 186-196.
  13. Dobbins, M., et al., School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database Syst Rev, 2013(2): p. CD007651. doi: 10.1002/14651858.CD007651.pub2
  14. Norris, E., et al., Physically active lessons as physical activity and educational interventions: a systematic review of methods and results. Preventive medicine, 2015. 72: p. 116-125.
  15. Wang, Y., et al., What childhood obesity prevention programmes work? A systematic review and meta‐analysis. Obesity Reviews, 2015. 16(7): p. 547-565.
  16. Washington State Institute for Public Policy, Benefit-Cost Technical Documentation: Washington State Institute for Public Policy Benefit-Cost Model. 2015: Washington State. Available from: Benefit-Cost Technical Documentation: Washington State Institute for Public Policy Benefit-Cost Model
  17. Washington State Institute for Public Policy, School-based programs to increase physical activity. Benefit-Cost Results, December 2015 [cited 2016 February 8]; Available from: School-based programs to increase physical activity.

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