2. Quality Physical Education Works: Now What Do We Do? Harold W. (Bill) Kohl, Ph.D. Palm Beach, Aruba – June 2012 Professor of Epidemiology and Kinesiology University of Texas and University of Texas School of Public Health, Texas USA

3. Dr. Andrew Springer – University of Texas School of Public Health

4. 1 hour or more of PA every day. Most of the 1 hour should be moderate-intensity of vigorous intensity PA. Vigorous intensity activity on at least 3 days per week. Muscle-strengthening and bone-strengthening activity on at least 3 days/ week. (USDHHS 2008)

5. It’s where the children are. Existing resources and infrastructure Trained and committed staff (teachers) Community trust

7. Guidelines for health state goal of 60 minutes/day Even the best PE classes only accelerate heart rate to a moderate- intensity 15-20 minutes Where should the remainder (40-45 minutes/day) come from?

8. How can schools promote children’s physical activity beyond PE?

9. Ecological Perspectives for PA School-Based Strategies for PA Promotion

10. AusDiab Accelerometer Study: Increased breaks in sitting beneficially associated with waist circumference, BMI, and other physiological measures., independent of total sedentary time & MVPA. (Healy et al., 2008). Canada Fitness Survey: Canadians who reported most of day sitting had poorer long-term mortality outcomes. Associations held even among those who were physically active (Katzmarzyk 2009). Follow up AusDiab Study: Each 1-h increment in TV time associated with increased risk of all cause and CVD mortality rates, respectively (Independent of PA)(Dunstan et al., 2010). U.S. (n=7744 men): >10hrs sitting/week in cars & more than 23 hrs/week watching TV and in cars = 82% and 64% increased risk of dying from CVD (Warren et al., 2010)

11. “Substantial evidence that PA can improve academic achievement” (CDC, 2010, Review of 50 studies) Recess period of >15 minutes/1 or more times/day: improved class behavior scores (Barroso et al ‘09).

16. Policy Sallis et al., 2006 (Sallis et al 2006)

17.  Opportunity for Physical Activity Times per week Minutes per session Times during the day: before, during and after school.  Structured vs. Unstructured Structured: PE class; structured activity breaks (classroom-based energizers; structured recess); intramural sports  Teacher-Led vs. Student-Led vs. Free-Play Unstructured: Free-play activity time (e.g., recess)  Quality of Physical Activity How much time spent in MVPA? (Nader et al., 2003: 37%) How enjoyable is PA? (e.g., only running?)

18.  Policy/Social Environment Mandated PA Time PE Organization/Training Supervised Free-Play Time Activity Breaks Community-School Partnership Active Commuting (i.e., walk/bike to school)  Built Environment

19.  Policy/Social Environment Mandated PA Time PE Organization/Training Supervised Free-Play Time (before, during, after school) Activity Breaks Community-School Partnership Active Commuting (i.e., walk/bike to school)  Built Environment

20. Aim: to encourage middle school students to engage in 60 minutes of PA every day. Components  Get ur 60 wristbands and cards  Discounts with community partner organizations (25+ organizations )  Prizes for wearing wristband/ being active  Increased opportunities for activity: Open Gym

21. Percentage of Open Gym Time 6-8 th Grade Students Engaged in MVPA (n=5 schools) Spring 2010 Mean time: 24 min. Students: 45-100 Kelder, Springer et al., in process

22. Today’s PA Menu (Delicious!) Zone A: Four Square Zone B: Soccer Zone C: Hula Hoops Zone D: Freeze Tag

23.  Policy/Social Environment Mandated PA Time PE Organization/Training Supervised Free-Play Time Activity Breaks Community-School Partnership Active Commuting (i.e., walk/bike to school)  Built Environment

24. “Promoting Lifetime Activity in Youth” (PLAY) (Pangrazi et al., 2003; Ernst et al., 1999) Teacher-led games. (Connolly & McKenzie, 1995) “TAKE 10!” (Stewart et al, 2004) “KISS”( RCT: Switzerland) (Kriemler et al., 2010) ABC “Activity Bursts in the Classroom” (Katz et al., 2010)

25. Energy Expenditure Profiles 8 7 6 5 4 3 2 1 6789101112123456789 a.m. p.m. METS

27. The Program Integrates 10 minute periods of physical activity into school day combined with age-appropriate lessons of math, science, language arts, etc.

28. The Program Designed to complement, not replace, other physical activity opportunities such as physical education and after-school programs.

29. Primary Core Academic Objectives GradeLanguage Arts MathSocial Studies Science Kindergarten13 Lessons10 lessons7 Lessons7 lessons 1 st Grade14 Lessons9 Lessons7 Lessons4 Lessons 2 nd Grade13 Lessons7 Lessons5 Lessons 3 rd Grade12 Lessons7 Lessons6 Lessons5 Lessons 4 th Grade12 Lessons7 Lessons5 Lessons7 Lessons 5 th Grade12 Lessons6 Lessons5 Lessons7 Lessons

30. GradeHealth and Nutrition Character Education Physical Education Kindergarten3 Lessons6 Lessons30 Lessons 1 st Grade3 Lessons4 Lessons30 Lessons 2 nd Grade7 Lessons4 Lessons30 Lessons 3 rd Grade7 Lessons4 Lessons30 Lessons 4 th Grade10 Lessons5 Lessons30 Lessons 5 th Grade7 Lessons6 Lessons30 Lessons Secondary Curriculum Objectives

31. Frequency of Teacher Implementation, TAKE 10! 1999 - 2001 Times per week Percent

33. Texas SB 19/530: 30 minutes daily structured PA Austin Independent School District WOW Time  Objective: To assess the effect of low-cost strategies for promoting children’s MVPA during recess and WOW time (3 rd grade).  Strategies: Peer-led Games Approach Teacher-led Approach Playground Markings Funding: Michael & Susan Dell Foundation

34. Active Play Project Peer-Led Games Process  Student Teams (3 rd Grade)  Leadership Roles  High Activity Games (CATCH)  Process & Guidelines Lessons Learned so far… Students = capable High satisfaction Training needed

35. Methods SOFIT-R 8 schools (>60% econ disadvantage) October, November, Dec 2009 2 classes/school, n=77 observations Mean minutes of recess = 21 Initial Findings: 66.4% of time in MVPA Boys: 71.2% vs. 61.6% in girls (p<.05) Compares with McKenzie et al (2010) study of 13 schools in California (66.2% vs. 60.0% for boys and girls)

36. p<.05

37.  Policy/Social Environment Mandated PA Time PE Organization/Training Supervised Free-Play Time Activity Breaks Community-School Partnership Active Commuting (i.e., walk/bike to school)  Built Environment

39.  Policy/Social Environment Mandated PA Time PE Organization/Training Supervised Free-Play Time Activity Breaks Community-School Partnership Active Commuting (i.e., walk/bike to school)  Built Environment

40. “We shape our buildings, and thereafter they shape us.” -Winston Churchill (1874-1965)

41.  Stratton (2000): Children 5-7 yrs (UK). MVPA increased by 18 mins/d.  Stratton & Mullan (2005): 4-11 yrs: MVPA increased from 37% to 50%.  Ridgers et al. (2007)

42. WOW Time Increased MVPA during recess? Increased “Active Learning”?

43. Ecological Models: a framework for guiding action for PA: Policy Environment, Information Environment, Social- Cultural Environment, Built Environment Expand from a Student to a School Focus: PA Policies & Practices: activity breaks; PA opportunities before, during & after school; PE MVPA; active commuting; PA built environment; community-school partnerships…

44. Recess Policy: How much time? NASPE: elementary school children should be provided at least one daily period of recess of at least 20 minutes in length. Not withholding recess: behavior mgmnt/tutoring. When to hold recess? (e.g., before lunch?) Structured vs. Unstructured (RWJ: structured) Classroom Activity Breaks= How do we promote? Quality PE: 50% MVPA : Training & Accountability School-community partnerships: how to increase? School faculty: Social support for children’s PA…

45. Guidelines for health state goal of 60 minutes/day Even the best PE classes only accelerate heart rate to a moderate- intensity 15-20 minutes Where should the remainder (40-45 minutes/day) come from?

46. Quality Physical Education Free play time Active Transport to School Sports Curriculum Integration