Obesity is a huge problem in America. When promoted through specific policies guiding the length of physical education, schools can support physical activity in children and hopefully foster healthier lifestyles and waistlines.
Public health is the science of protecting and improving the health of communities; policy is but one tool to achieve this goal. Many public policies currently exist to nudge the public in a direction that maintains health. Given that childhood obesity affects the health of communities and physical education (PE) is known to be one part of the solution for childhood obesity, physical education policies have been created in jurisdictions across the nation. However, not all physical education programs are alike. Not all states have the same type of policies governing physical education programs. This study sought to determine an evidence-based evaluation of the effectiveness of different types of state policies in the execution of quality physical education programs.
States may have either specific policies outlining the quantity and quality of physical education in school, they might have nonspecific policies merely recommending physical education, or they may have none. Researchers hypothesized that states with the most specific physical education policies would be more effective in producing higher quality results (defined by more time dedicated to actual physical activity).
High quality physical education programs were determined by the primary outcome variable, reported exercise quantified in minutes per week. The highest quality standard possible for amount of time dedicated to physical education was 150 minutes per school week for elementary schools and 225 minutes per week for middle schools. These times are recommended by the national Physical Activity Guidelines for Americans by the United States Department of Health and Human Services (2008). Reporting of weekly minutes of exercise were derived from available data in the CDCs School Health Policies and Programs Survey (SHPPS).
State policies were classified as being more or less specific as per the 6-item Physical Education-Related State Policy Classification System (PERSPCS) available on the Classification of Laws Associated with School Students website. Although the PERSPCS covers four domains, only time spent in physical education was analyzed in this study.
PERSPCS scores differ based on the degree of required physical education (scores 0 & 1 indicate no requirement, 2 implies a nonspecific requirement, 3, 4, & 5 indicate a specific time requirement up to the maximum set by the Physical Activity Guidelines. PERSPCS scores are higher when a state provides a requirement to have physical education and gives a specific time requirement in the policy.
A total of 410 public schools were assessed. Some schools in poorer districts were less likely to be sampled. Overall, the schools encompassed variable socioeconomic demographics throughout the United States and included all ages (elementary, middle school, high school).
States with policies outlining specific physical education time requirements resulted in significantly higher reported minutes per week of exercise at the elementary (40 minutes) and middle school levels (60 minutes). Although a similar trend existed for high schools (40 minutes), no statistically significant differences occurred at the high school level.
Schools in states with specific physical education policies and longer physical education time requirements, thus higher PERSPCS scores, averaged 60 minutes per week more reported physical education time at the middle school level and 27 minutes per week more reported physical education time at the elementary school level than the schools in states with nonspecific policies.
The differences in time spent in physical education did not differ significantly in states with no policy versus states with nonspecific policies.
Physicians are expected to treat patients based on the effectiveness of treatments noted from evidence-based evaluations; public health officials should treat communities with policies whose effectiveness is based on evidence-based evaluations (such as from this study).
This study concludes that state physical education policies which specify time requirements for physical activity result in actual PE programs that achieve outcomes closer to the high quality Physical Activity Guidelines standards. Nonspecific policies do not accomplish this goal.
States with weak, nonspecific recommendations for physical education must go the added step of specifying a set amount of time of physical activity for young children at school.
Clearly, the next step would be to correlate these physical education policies with measures of childhood obesity. Hopefully, physical education policies actually lead to outcomes that reverse the trend of childhood obesity and therefore actually impact the health of the community. However, we should applaud evidence-based evaluation of public health policy and demand its implementation.
Jennifer Shine Dyer, MD, MPH, FAAP