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‘Physical education makes you fit and healthy’. Physical education's contribution to young people's physical activity levels

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S. Fairclough, G. Stratton, ‘Physical education makes you fit and healthy’. Physical education's contribution to young people's physical activity levels, Health Education Research , Volume 20, Issue 1, February 2005, Pages 14–23, https://doi.org/10.1093/her/cyg101

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The purpose of this study was to assess physical activity levels during high school physical education lessons. The data were considered in relation to recommended levels of physical activity to ascertain whether or not physical education can be effective in helping young people meet health-related goals. Sixty-two boys and 60 girls (aged 11–14 years) wore heart rate telemeters during physical education lessons. Percentages of lesson time spent in moderate-and-vigorous (MVPA) and vigorous intensity physical activity (VPA) were recorded for each student. Students engaged in MVPA and VPA for 34.3 ± 21.8 and 8.3 ± 11.1% of lesson time, respectively. This equated to 17.5 ± 12.9 (MVPA) and 3.9 ± 5.3 (VPA) min. Boys participated in MVPA for 39.4 ± 19.1% of lesson time compared to the girls (29.1 ± 23.4%; P < 0.01). High-ability students were more active than the average- and low-ability students. Students participated in most MVPA during team games (43.2 ± 19.5%; P < 0.01), while the least MVPA was observed during movement activities (22.2 ± 20.0%). Physical education may make a more significant contribution to young people's regular physical activity participation if lessons are planned and delivered with MVPA goals in mind.

Regular physical activity participation throughout childhood provides immediate health benefits, by positively effecting body composition and musculo-skeletal development ( Malina and Bouchard, 1991 ), and reducing the presence of coronary heart disease risk factors ( Gutin et al. , 1994 ). In recognition of these health benefits, physical activity guidelines for children and youth have been developed by the Health Education Authority [now Health Development Agency (HDA)] ( Biddle et al. , 1998 ). The primary recommendation advocates the accumulation of 1 hour's physical activity per day of at least moderate intensity (i.e. the equivalent of brisk walking), through lifestyle, recreational and structured activity forms. A secondary recommendation is that children take part in activities that help develop and maintain musculo-skeletal health, on at least two occasions per week ( Biddle et al. , 1998 ). This target may be addressed through weight-bearing activities that focus on developing muscular strength, endurance and flexibility, and bone health.

School physical education (PE) provides a context for regular and structured physical activity participation. To this end a common justification for PE's place in the school curriculum is that it contributes to children's health and fitness ( Physical Education Association of the United Kingdom, 2004 ; Zeigler, 1994 ). The extent to which this rationale is accurate is arguable ( Koslow, 1988 ; Michaud and Andres, 1990 ) and has seldom been tested. However, there would appear to be some truth in the supposition because PE is commonly highlighted as a significant contributor to help young people achieve their daily volume of physical activity ( Biddle et al. , 1998 ; Corbin and Pangrazi, 1998 ). The important role that PE has in promoting health-enhancing physical activity is exemplified in the US ‘Health of the Nation’ targets. These include three PE-associated objectives, two of which relate to increasing the number of schools providing and students participating in daily PE classes. The third objective is to improve the number of students who are engaged in beneficial physical activity for at least 50% of lesson time ( US Department of Health and Human Services, 2000 ). However, research evidence suggests that this criterion is somewhat ambitious and, as a consequence, is rarely achieved during regular PE lessons ( Stratton, 1997 ; US Department of Health and Human Services, 2000 ; Levin et al. , 2001 ; Fairclough, 2003a ).

The potential difficulties of achieving such a target are associated with the diverse aims of PE. These aims are commonly accepted by physical educators throughout the world ( International Council of Sport Science and Physical Education, 1999 ), although their interpretation, emphasis and evaluation may differ between countries. According to Simons-Morton ( Simons-Morton, 1994 ), PE's overarching goals should be (1) for students to take part in appropriate amounts of physical activity during lessons, and (2) become educated with the knowledge and skills to be physically active outside school and throughout life. The emphasis of learning during PE might legitimately focus on motor, cognitive, social, spiritual, cultural or moral development ( Sallis and McKenzie, 1991 ; Department for Education and Employment/Qualifications and Curriculum Authority, 1999 ). These aspects may help cultivate students' behavioural and personal skills to enable them to become lifelong physical activity participants [(thus meeting PE goal number 2 ( Simons-Morton, 1994 )]. However, to achieve this, these aspects should be delivered within a curriculum which provides a diverse range of physical activity experiences so students can make informed decisions about which ones they enjoy and feel competent at. However, evidence suggests that team sports dominate English PE curricula, yet bear limited relation to the activities that young people participate in, out of school and after compulsory education ( Sport England, 2001 ; Fairclough et al. , 2002 ). In order to promote life-long physical activity a broader base of PE activities needs to be offered to reinforce the fact that it is not necessary for young people to be talented sportspeople to be active and healthy.

While motor, cognitive, social, spiritual, cultural and moral development are valid areas of learning, they can be inconsistent with maximizing participation in health-enhancing physical activity [i.e. PE goal number 1 ( Simons-Morton, 1994 )]. There is no guidance within the English National Curriculum for PE [NCPE ( Department for Education and Employment/Qualifications and Curriculum Authority, 1999 )] to inform teachers how they might best work towards achieving this goal. Moreover, it is possible that the lack of policy, curriculum development or teacher expertise in this area contributes to the considerable variation in physical activity levels during PE ( Stratton, 1996a ). However, objective research evidence suggests that this is mainly due to differences in pedagogical variables [i.e. class size, available space, organizational strategies, teaching approaches, lesson content, etc. ( Borys, 1983 ; Stratton, 1996a )]. Furthermore, PE activity participation may be influenced by inter-individual factors. For example, activity has been reported to be lower among students with greater body mass and body fat ( Brooke et al. , 1975 ; Fairclough, 2003c ), and higher as students get older ( Seliger et al. , 1980 ). In addition, highly skilled students are generally more active than their lesser skilled peers ( Li and Dunham, 1993 ; Stratton, 1996b ) and boys tend to engage in more PE activity than girls ( Stratton, 1996b ; McKenzie et al. , 2000 ). Such inter-individual factors are likely to have significant implications for pedagogical practice and therefore warrant further investigation.

In accordance with Simons-Morton's ( Simons-Morton, 1994 ) first proposed aim of PE, the purpose of this study was to assess English students' physical activity levels during high school PE. The data were considered in relation to recommended levels of physical activity ( Biddle et al. , 1998 ) to ascertain whether or not PE can be effective in helping children be ‘fit and healthy’. Specific attention was paid to differences between sex and ability groups, as well as during different PE activities.

Subjects and settings

One hundred and twenty-two students (62 boys and 60 girls) from five state high schools in Merseyside, England participated in this study. Stage sampling was used in each school to randomly select one boys' and one girls' PE class, in each of Years 7 (11–12 years), 8 (12–13 years) and 9 (13–14 years). Three students per class were randomly selected to take part. These students were categorized as ‘high’, ‘average’ and ‘low’ ability, based on their PE teachers' evaluation of their competence in specific PE activities. Written informed consent was completed prior to the study commencing. The schools taught the statutory programmes of study detailed in the NCPE, which is organized into six activity areas (i.e. athletic activities, dance, games, gymnastic activities, outdoor activities and swimming). The focus of learning is through four distinct aspects of knowledge, skills and understanding, which relate to; skill acquisition, skill application, evaluation of performance, and knowledge and understanding of fitness and health ( Department for Education and Employment/Qualifications and Curriculum Authority, 1999 ). The students attended two weekly PE classes in mixed ability, single-sex groups. Girls and boys were taught by male and female specialist physical educators, respectively.

Instruments and procedures

The investigation received ethical approval from the Liverpool John Moores Research Degrees Ethics Committee. The study involved the monitoring of heart rates (HRs) during PE using short-range radio telemetry (Vantage XL; Polar Electro, Kempele, Finland). Such systems measure the physiological load on the participants' cardiorespiratory systems, and allow analysis of the frequency, duration and intensity of physical activity. HR telemetry has been shown to be a valid and reliable measure of young people's physical activity ( Freedson and Miller, 2000 ) and has been used extensively in PE settings ( Stratton, 1996a ).

The students were fitted with the HR telemeters while changing into their PE uniforms. HR was recorded once every 5 s for the duration of the lessons. Telemeters were set to record when the teachers officially began the lessons, and stopped at the end of lessons. Total lesson ‘activity’ time was the equivalent of the total recorded time on the HR receiver. At the end of the lessons the telemeters were removed and data were downloaded for analyses. Resting HRs were obtained on non-PE days while the students lay in a supine position for a period of 10 min. The lowest mean value obtained over 1 min represented resting HR. Students achieved maximum HR values following completion of the Balke treadmill test to assess cardiorespiratory fitness ( Rowland, 1993 ). This data was not used in the present study, but was collated for another investigation assessing children's health and fitness status. Using the resting and maximum HR values, HR reserve (HRR, i.e. the difference between resting and maximum HR) at the 50% threshold was calculated for each student. HRR accounts for age and gender HR differences, and is recommended when using HR to assess physical activity in children ( Stratton, 1996a ). The 50% HRR threshold represents moderate intensity physical activity ( Stratton, 1996a ), which is the minimal intensity required to contribute to the recommended volume of health-related activity ( Biddle et al. , 1998 ). Percentage of lesson time spent in health enhancing moderate-and-vigorous physical activity (MVPA) was calculated for each student by summing the time spent ≥50% HRR threshold. HRR values ≥75% corresponded to vigorous intensity physical activity (VPA). This threshold represents the intensity that may stimulate improvements in cardiorespiratory fitness ( Morrow and Freedson, 1994 ) and was used to indicate the proportion of lesson time that students were active at this higher level.

Sixty-six lessons were monitored over a 12-week period, covering a variety of group and individual activities ( Table I ). In order to allow statistically meaningful comparisons between different types of activities, students were classified as participants in activities that shared similar characteristics. These were, team games [i.e. invasion (e.g. football and hockey) and striking games (e.g. cricket and softball)], individual games (e.g. badminton, tennis and table tennis), movement activities (e.g. dance and gymnastics) and individual activities [e.g. athletics, fitness (circuit training and running activities) and swimming]. The intention was to monitor equal numbers of students during lessons in each of the four designated PE activity categories. However, timetable constraints and student absence meant that true equity was not possible, and so the number of boys and girls monitored in the different activities was unequal.

Number and type of monitored PE lessons

Student sex, ability level and PE activity category were the independent variables, with percent of lesson time spent in MVPA and VPA set as the dependent variables. Exploratory analyses were conducted to establish whether data met parametric assumptions. Shapiro–Wilk tests revealed that only boys' MVPA were normally distributed. Subsequent Levene's tests confirmed the data's homogeneity of variance, with the exception of VPA between the PE activities. Though much of the data violated the assumption of normality, the ANOVA is considered to be robust enough to produce valid results in this situation ( Vincent, 1999 ). Considering this, alongside the fact that the data had homogenous variability, it was decided to proceed with ANOVA for all analyses, with the exception of VPA between different PE activities.

Sex × ability level factorial ANOVAs compared the physical activity of boys and girls who differed in PE competence. A one-way ANOVA was used to identify differences in MVPA during the PE activities. Post-hoc analyses were performed using Hochberg's GT2 correction procedure, which is recommended when sample sizes are unequal ( Field, 2000 ). A non-parametric Kruskal–Wallis ANOVA calculated differences in VPA during the different activities. Post-hoc Mann–Whitney U -tests determined where identified differences occurred. To control for type 1 error the Bonferroni correction procedure was applied to these tests, which resulted in an acceptable α level of 0.008. Although these data were ranked for the purposes of the statistical analysis, they were presented as means ± SD to allow comparison with the other results. All data were analyzed using SPSS version 11.0 (SPSS, Chicago, IL).

The average duration of PE lessons was 50.6 ± 20.8 min, although girls' (52.6 ± 25.4 min) lessons generally lasted longer than boys' (48.7 ± 15.1 min). When all PE activities were considered together, students engaged in MVPA and VPA for 34.3 ± 21.8 and 8.3 ± 11.1% of PE time, respectively. This equated to 17.5 ± 12.9 (MVPA) and 3.9 ± 5.3 (VPA) min. The high-ability students were more active than the average- and low-ability students, who took part in similar amounts of activity. These trends were apparent in boys and girls ( Table II ).

Mean (±SD) MVPA and VPA of boys and girls of differing abilities

Boys > girls, P < 0.01.

Boys > girls, P < 0.05.

Boys engaged in MVPA for 39.4% ± 19.1 of lesson time compared to the girls' value of 29.1 ± 23.4 [ F (1, 122) = 7.2, P < 0.01]. When expressed as absolute units of time, these data were the equivalent of 18.9 ± 10.5 (boys) and 16.1 ± 14.9 (girls) min. Furthermore, a 4% difference in VPA was observed between the two sexes [ Table II ; F (1, 122) = 4.6, P < 0.05]. There were no significant sex × ability interactions for either MVPA or VPA.

Students participated in most MVPA during team games [43.2 ± 19.5%; F (3, 121) = 6.0, P < 0.01]. Individual games and individual activities provided a similar stimulus for activity, while the least MVPA was observed during movement activities (22.2 ± 20.0%; Figure 1 ). A smaller proportion of PE time was spent in VPA during all activities. Once more, team games (13.6 ± 11.3%) and individual activities (11.8 ± 14.0%) were best suited to promoting this higher intensity activity (χ 2 (3) =30.0, P < 0.01). Students produced small amounts of VPA during individual and movement activities, although this varied considerably in the latter activity ( Figure 2 ).

Mean (±SD) MVPA during different PE activities. ** Team games > movement activities ( P < 0.01). * Individual activities > movement activities ( P < 0.05).

Mean (±SD) VPA during different PE activities. ** Team games > movement activities ( Z (3) = −4.9, P < 0.008) and individual games ( Z (3) = −3.8, P < 0.008). † Individual activities > movement activities ( Z (3) = −3.3, P < 0.008). ‡ Individual game > movement activities ( Z (3) = −2.7, P < 0.008).

This study used HR telemetry to assess physical activity levels during a range of high school PE lessons. The data were considered in relation to recommended levels of physical activity ( Biddle et al. , 1998 ) to investigate whether or not PE can be effective in helping children be ‘fit and healthy’. Levels of MVPA were similar to those reported in previous studies ( Klausen et al. , 1986 ; Strand and Reeder, 1993 ; Fairclough, 2003b ) and did not meet the US Department of Health and Human Services ( US Department of Health and Human Services, 2000 ) 50% of lesson time criterion. Furthermore, the data were subject to considerable variance, which was exemplified by high standard deviation values ( Table II , and Figures 1 and 2 ). Such variation in activity levels reflects the influence of PE-specific contextual and pedagogical factors [i.e. lesson objectives, content, environment, teaching styles, etc. ( Stratton, 1996a )]. The superior physical activity levels of the high-ability students concurred with previous findings ( Li and Dunham, 1993 ; Stratton, 1996b ). However, the low-ability students engaged in more MVPA and VPA than the average-ability group. While it is possible that the teachers may have inaccurately assessed the low and average students' competence, it could have been that the low-ability group displayed more effort, either because they were being monitored or because they associated effort with perceived ability ( Lintunen, 1999 ). However, these suggestions are speculative and are not supported by the data. The differences in activity levels between the ability groups lend some support to the criticism that PE teachers sometimes teach the class as one and the same rather than planning for individual differences ( Metzler, 1989 ). If this were the case then undifferentiated activities may have been beyond the capability of the lesser skilled students. This highlights the importance of motor competence as an enabling factor for physical activity participation. If a student is unable to perform the requisite motor skills to competently engage in a given task or activity, then their opportunities for meaningful participation become compromised ( Rink, 1994 ). Over time this has serious consequences for the likelihood of a young person being able or motivated enough to get involved in physical activity which is dependent on a degree of fundamental motor competence.

Boys spent a greater proportion of lesson time involved in MVPA and VPA than girls. These differences are supported by other HR studies in PE ( Mota, 1994 ; Stratton, 1997 ). Boys' activity levels equated to 18.9 min of MVPA, compared to 16.1 min for the girls. It is possible that the characteristics and aims of some of the PE activities that the girls took part in did not predispose them to engage in whole body movement as much as the boys. Specifically, the girls participated in 10 more movement lessons and eight less team games lessons than the boys. The natures of these two activities are diverse, with whole body movement at differing speeds being the emphasis during team games, compared to aesthetic awareness and control during movement activities. The monitored lessons reflected typical boys' and girls' PE curricula, and the fact that girls do more dance and gymnastics than boys inevitably restricts their MVPA engagement. Although unrecorded contextual factors may have contributed to this difference, it is also possible that the girls were less motivated than the boys to physically exert themselves. This view is supported by negative correlations reported between girls' PE enjoyment and MVPA ( Fairclough, 2003b ). Moreover, there is evidence ( Dickenson and Sparkes, 1988 ; Goudas and Biddle, 1993 ) to suggest that some pupils, and girls in particular ( Cockburn, 2001 ), may dislike overly exerting themselves during PE. Although physical activity is what makes PE unique from other school subjects, some girls may not see it as such an integral part of their PE experience. It is important that this perception is clearly recognized if lessons are to be seen as enjoyable and relevant, whilst at the same time contributing meaningfully to physical activity levels. Girls tend to be habitually less active than boys and their levels of activity participation start to decline at an earlier age ( Armstrong and Welsman, 1997 ). Therefore, the importance of PE for girls as a means of them experiencing regular health-enhancing physical activity cannot be understated.

Team games promoted the highest levels of MVPA and VPA. This concurs with data from previous investigations ( Strand and Reeder, 1993 ; Stratton, 1996a , 1997 ; Fairclough, 2003a ). Because these activities require the use of a significant proportion of muscle mass, the heart must maintain the oxygen demand by beating faster and increasing stroke volume. Moreover, as team games account for the majority of PE curriculum time ( Fairclough and Stratton, 1997 ; Sport England, 2001 ), teachers may actually be more experienced and skilled at delivering quality lessons with minimal stationary waiting and instruction time. Similarly high levels of activity were observed during individual activities. With the exception of throwing and jumping themes during athletics lessons, the other individual activities (i.e. swimming, running, circuit/station work) involved simultaneous movement of the arms and legs over variable durations. MVPA and VPA were lowest during movement activities, which mirrored previous research involving dance and gymnastics ( Stratton, 1997 ; Fairclough, 2003a ). Furthermore, individual games provided less opportunity for activity than team games. The characteristics of movement activities and individual games respectively emphasize aesthetic appreciation and motor skill development. This can mean that opportunities to promote cardiorespiratory health may be less than in other activities. However, dance and gymnastics can develop flexibility, and muscular strength and endurance. Thus, these activities may be valuable to assist young people in meeting the HDA's secondary physical activity recommendation, which relates to musculo-skeletal health ( Biddle et al. , 1998 ).

The question of whether PE can solely contribute to young people's cardiorespiratory fitness was clearly answered. The students engaged in small amounts of VPA (4.5 and 3.3 min per lesson for boys and girls, respectively). Combined with the limited frequency of curricular PE, these were insufficient durations for gains in cardiorespiratory fitness to occur ( Armstrong and Welsman, 1997 ). Teachers who aim to increase students' cardiorespiratory fitness may deliver lessons focused exclusively on high intensity exercise, which can effectively increase HR ( Baquet et al. , 2002 ), but can sometimes be mundane and have questionable educational value. Such lessons may undermine other efforts to promote physical activity participation if they are not delivered within an enjoyable, educational and developmental context. It is clear that high intensity activity is not appropriate for all pupils, and so opportunities should be provided for them to be able to work at developmentally appropriate levels.

Students engaged in MVPA for around 18 min during the monitored PE lessons. This approximates a third of the recommended daily hour ( Biddle et al. , 1998 ). When PE activity is combined with other forms of physical activity support is lent to the premise that PE lessons can directly benefit young people's health status. Furthermore, for the very least active children who should initially aim to achieve 30 min of activity per day ( Biddle et al. , 1998 ), PE can provide the majority of this volume. However, a major limitation to PE's utility as a vehicle for physical activity participation is the limited time allocated to it. The government's aspiration is for all students to receive 2 hours of PE per week ( Department for Education and Employment/Qualifications and Curriculum Authority, 1999 ), through curricular and extra-curricular activities. While some schools provide this volume of weekly PE, others are unable to achieve it ( Sport England, 2001 ). The HDA recommend that young people strive to achieve 1 hour's physical activity each day through many forms, a prominent one of which is PE. The apparent disparity between recommended physical activity levels and limited curriculum PE time serves to highlight the complementary role that education, along with other agencies and voluntary organizations must play in providing young people with physical activity opportunities. Notwithstanding this, increasing the amount of PE curriculum time in schools would be a positive step in enabling the subject to meet its health-related goals. Furthermore, increased PE at the expense of time in more ‘academic’ subjects has been shown not to negatively affect academic performance ( Shephard, 1997 ; Sallis et al. , 1999 ; Dwyer et al. , 2001 ).

Physical educators are key personnel to help young people achieve physical activity goals. As well as their teaching role they are well placed to encourage out of school physical activity, help students become independent participants and inform them about initiatives in the community ( McKenzie et al. , 2000 ). Also, they can have a direct impact by promoting increased opportunities for physical activity within the school context. These could include activities before school ( Strand et al. , 1994 ), during recess ( Scruggs et al. , 2003 ), as well as more organized extra-curricular activities at lunchtime and after school. Using time in this way would complement PE's role by providing physical activity opportunities in a less structured and pedagogically constrained manner.

This research measured student activity levels during ‘typical’, non-intensified PE lessons. In this sense it provided a representative picture of the frequency, intensity and duration of students' physical activity engagement during curricular PE. However, some factors should be considered when interpreting the findings. First, the data were cross-sectional and collected over a relatively short time frame. Tracking students' activity levels over a number of PE activities may have allowed a more accurate account of how physical activity varies in different aspects of the curriculum. Second, monitoring a larger sample of students over more lessons may have enabled PE activities to be categorized into more homogenous groups. Third, monitoring lessons in schools from a wider geographical area may have enabled stronger generalization of the results. Fourth, it is possible that the PE lessons were taught differently, and that the students acted differently as a result of being monitored and having the researchers present during lessons. As this is impossible to determine, it is unknown how this might have affected the results. Fifth, HR telemetry does not provide any contextual information about the monitored lessons. Also, HR is subject to emotional and environmental factors when no physical activity is occurring. Future work should combine objective physical activity measurement with qualitative or quantitative methods of observation.

During PE, students took part in health-enhancing activity for around one third of the recommended 1-hour target ( Biddle et al. , 1998 ). PE obviously has potential to help meet this goal. However, on the basis of these data, combined with the weekly frequency of PE lessons, it is clear that PE can only do so much in supplementing young people's daily volume of physical activity. Students need to be taught appropriate skills, knowledge and understanding if they are to optimize their physical activity opportunities in PE. For improved MVPA levels to occur, health-enhancing activity needs to be recognized as an important element of lessons. PE may make a more significant contribution to young people's regular physical activity participation if lessons are planned and delivered with MVPA goals in mind.

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Stratton, G. ( 1997 ) Children's heart rates during British physical education lessons, Journal of Teaching in Physical Education . 16 , 357 –367.

US Department of Health and Human Services ( 2000 ) Healthy People 2010: Understanding and Improving Health . USDHHS, Washington DC.

Vincent, W. ( 1999 ) Statistics in Kinesiology , Human Kinetics, Champaign, IL.

Zeigler, E. ( 1994 ) Physical education's 13 principal principles. Journal of Physical Education, Recreation and Dance , 65 , 4 –5.

Author notes

1REACH Group and School of Physical Education, Sport and Dance, Liverpool John Moores University, Liverpool L17 6BD and 2REACH Group and Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 2ET, UK

• physical activity
• valproic acid
• physical education
• high schools

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Integrating Strength and Conditioning Into High School Physical Education

As physical education teachers, we want students to leave our programs with a toolbox full of knowledge and skills to support meaningful physical activity engagement. This can be done using a variety of instructional methods and curriculums.

While traditional activities such as sports and team games can still play an important role in our programs, strength and conditioning is a lifetime activity that continues to grow, particularly as a part of high school physical education programs.

Many schools have the facilities and equipment needed to integrate strength and conditioning into high school physical education classes and are already providing this type of programming for their athletes.

However, given the breadth of related content and equipment, along with important instructional and safety considerations, some physical education teachers might not know where to start when adding a strength and conditioning program to their high school PE curriculum.

This blog post will give you a starting point, but we encourage you to read “ Integrating Strength and Conditioning Into a High School Physical Education Curriculum: A Case Example ,” which we coauthored for the May/June 2021 issue of JOPERD . The article not only provides more details related to what strength and conditioning is, its benefits, and the components of a strength and conditioning program, but it also provides a detailed case example of a well-developed high school strength and conditioning program.

What is Strength and Conditioning?         

Strength and conditioning, resistance training, strength training, weight training, and weightlifting are terms that are often used interchangeably. Some of these terms may even be names of classes at your school.

However, strength and conditioning is the overarching term that includes these types of training along with agility, plyometrics, and speed training. The overall goal of strength and conditioning is to improve performance.

Benefits of Strength and Conditioning

Students can experience physiological, psychological, and health benefits when participating in a strength and conditioning program.

• Physiological Benefits — Students can experience increases in strength, explosiveness, proprioceptive abilities, general body awareness, athleticism, durability, balanced physical development, and more efficient use of training times and energies from participation in a strength and conditioning program.
• Psychological Benefits — Students who participate in strength and conditioning can experience increases and improvements in resistance training self-efficacy, physical self-worth, global self-worth, self-esteem, perceived body fat and appearance, and physical self-concept.
• Health Benefits — Students can experience improvements in overall body composition, reduced body fat, strengthened bones, increased resistance to sports-related injuries, and improvements in cardiorespiratory fitness, skeletal muscle mass, and insulin sensitivity. Students also exhibit lower levels of diastolic and systolic blood pressure, pulse pressure, and rate of pulse pressure after participation in strength and conditioning programs.

5 Key Components of High School Strength and Conditioning Programs

When adding strength and conditioning to a high school PE curriculum, the goal is to help students be successful and lay the foundation for an active lifestyle after graduation.

Here are several guidelines high school PE teachers can consider when developing their strength and conditioning program:

• Student Readiness — Are students mentally and physically ready to participate? Do they follow instructions? Are students capable of handling the stress of the training program? Do they have competent levels of balance and postural control?
• NSCA Certified Strength and Conditioning Specialist
• Collegiate Strength and Conditioning Coaches Association Strength and Conditioning Coach Certified
• USAW Level 1 Coach
• International Sports Sciences Association Strength and Conditioning Coach
• National Council of Strength and Fitness Certified Strength Coach
• Developmentally Appropriate — Select exercises that are appropriate for students’ body sizes, fitness levels, and resistance training experience. Exercises should also promote muscle balance across joints and between opposing muscle groups. Make sure to base training volume and intensity on program goals, the interests of students, and students’ technique levels. Additionally, make sure students are provided with plenty of rest time between exercises. Most importantly, it is essential to emphasize the use of correct form when performing strength and conditioning exercises.
• Program Structure — The program structure, or periodization, should maximize the athletic development of the students while also meeting their individualized overall training goals. Keep in mind that longer programs tend to be more supportive of positive performance outcomes. Also, remember to keep in mind important school dates, such as holidays or testing, when deciding on your program’s structure. You do not want a holiday or a scheduled test to interrupt students’ progress through a phase or cause a student to miss a testing week, for example.
• Assessment in Strength and Conditioning Programs — Use a variety of tests to track students’ progress through the training program and allow students to track their own progress. Help student develop goals to meet their personal performance expectations. Tests can measure maximal strength, power, strength endurance, reactive strength, rate of force development, speed, agility, and flexibility.

3 Key Takeaways From a High School Case Example

Our April/May 2021 JOPERD article includes a detailed example of a high school that integrated a well-developed, inclusive strength and conditioning program into its PE curriculum.

While you may not be able to implement a strength and conditioning program of this caliber, here are the key takeaways from this example that may be helpful as you begin thinking about adding this type of program in your school:

• Coach Certifications — Both coaches involved with this program have high level, accredited strength and conditioning certifications. The head coach holds a NSCA Certified Strength and Conditioning Specialist certification and a Collegiate Strength and Conditioning Coaches Association Strength and Conditioning Coach Certified certification. The assistant coach also holds a Collegiate Strength and Conditioning Coaches Association Strength and Conditioning Coach Certified certification.
• Different Levels of Programming — The coaches of this program have put a lot of thought and effort into the programming they provide to students. There are five different levels of programming that students are placed in based off their initial testing results. These different levels meet the needs of beginner or foundational students all the way up to the advanced athletes who intend to compete in sports at the collegiate or elite levels. Different programming not only allows students to improve and excel based on their ability level, but it also provides students with the motivation to get better so they can move up to the next level.
• Technology — This program has also integrated many different types of technology into its programming to support student learning. For example, students use Tendo units , PUSH Bands , Jump Mats , and more recently, Vitruve devices, to measure the speed, power, and height at which exercises are performed. The use of these devices also gives students immediate feedback on their performance, which allows them to determine if the exercise was performed correctly or incorrectly. Additionally, students can track their progress over the course of a program phase, semester, and year through the use of the TeamBuildr app.

Starting a strength and conditioning program can be a daunting task, especially if you have limited experience with this type of content development and instruction. However, here are some steps you can take to get started:

• Use the information provided in this blog post.
• Read some of the literature related to strength and conditioning to help familiarize yourself with some of the opinions, best practices, and types of exercises that can be used in the programming (some good resources are provided at the end of this post).
• Pursue professional development through accredited certification programs. Certification will ensure you are prepared to develop the programming and implement best teaching/coaching practices involved in a strength and conditioning program.

Overall, we want to emphasize the importance of making sure students are ready to participate and that the programming is developmentally appropriate and enjoyable for the group of students you are working with.

Additional Resources

• Integrating Strength and Conditioning Into a High School Physical Education Curriculum: A Case Example (May/June 2021 Issue of JOPERD )
• Youth Resistance Training: Updated Position Statement Paper From the National Strength and Conditioning Association
• Position Statement on Youth Resistance Training: The 2014 International Consensus
• Integrating Resistance Training Into High School Curriculum
• New Functional Training for Sports
• Youth Strength Training
• Essentials of Strength Training and Conditioning
• NSCA’s Guide to Program Design
• Strength Training Manual: The Agile Periodization Approach
• The Coach’s Strength Training Playbook

Featured image by Alora Griffit hs on Unsplas h.

Kacie Lanier is a doctoral student in the Physical Education Teacher Education Program at Georgia State University. She also teaches undergraduate courses and supervises student teachers. Her research interests include studying the impact of physical education participation on students’ mental health and the role strength and conditioning plays within the physical education curriculums.

Chad Killian is an assistant professor of kinesiology at Georgia State University in Atlanta where he teaches undergraduate and graduate courses in physical education and advises doctoral students. His primary research interests involve studying the use and efficacy of digital instruction in the K-12 physical education environment.

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Introduction.

Physical activity is essential for health and wellbeing of children and adolescents 1 . Physical activity improves musculoskeletal, cardiac, metabolic, psychosocial, and cognitive health, and enhances cardiorespiratory and muscular fitness of children and adolescents 1 , 2 , 3 , 4 . Regular participation also decreases adiposity in those who are overweight 3 . For optimal health benefits, the current international guidelines (i.e., the World Health Organization [WHO]) recommends that those aged 5–17-years accumulate at least 60 min of moderate-to-vigorous physical activity daily 5 . Globally, four out of five (81%) adolescents aged 11–17 years do not meet this recommendation and are insufficiently active 6 . Such inactive behaviours during adolescence have both current and future ramifications on health and wellbeing as behaviours such as physical activity established during adolescence can carry over to adulthood 7 , 8 . Therefore, pragmatic strategies to promote physical activity during adolescence around the globe are of critical importance 9 .

Adolescent physical activity occurs in different settings and domains including at home, in the community, for transportation, and at school. Opportunities for physical activity at school include during recess and lunch breaks, school sport and physical education lessons. Physical education classes may provide resources and opportunities for students to accumulate the daily physical activity level and can contribute to daily energy expenditure 10 , 11 . Recent meta-analyses found that 41% of secondary school 12 and 45% of elementary school 13 physical education lessons comprised moderate-to-vigorous physical activity. In many countries, physical education provides children and adolescents the understanding and motivation for an active lifestyle and also creates an environment to acquire knowledge and skills for physical activity throughout life 14 , 15 . In addition, adolescents who may have limited access to space and equipment outside of school can benefit from attending physical education classes at school 10 , 11 . School-based physical education, therefore, can be an accessible source of physical activity for many adolescents and can help develop an active healthy lifestyle 16 . In addition to the number of physical education classes, access to high-quality physical education experience (e.g., teacher behaviours, learning outcomes), which forms the foundation for lifelong engagement in physical activity, is also important for children and adolescents 17 , 18 , 19 .

Available evidence suggest that participation in physical education classes are positively associated with higher levels of physical activity 20 , 21 , 22 , 23 , 24 . However, the evidence is mostly based on single-country studies from high-income countries with limited multi-country study and lack of representation of low- and lower-middle-income countries 25 . A recent multi-country study reported country- and regional-level differences in physical education class participation, which was also differed by sex, age, and country-income classification 26 . In addition, delivery, content and quality of physical education also vary within and between countries 27 , 28 . It is often provided infrequently in schools across countries, and therefore the potential impact on total moderate-to-vigorous physical activity among boys and girls may be limited 29 . In order to obtain a comprehensive global perspective on the relationship between physical education and physical activity, large multi-country studies with representative samples are essential. Given the context and the opportunities that exist in schools for physical activity promotion, in this study, we aimed to examine whether participation in physical education classes (i.e., number of physical education class attendance) is associated with sufficient level of physical activity among adolescents (overall, and by sex and age-group) from 65 countries around the globe. We hypothesised that higher number of physical education class participation would be positively associated with sufficient level of physical activity among adolescents.

Data source

Data for this study were from the Global School-based Student Health Survey (GSHS), a population-based survey of school-going children and adolescents around the world 30 . In all participating countries, the GSHS uses the same standardised sampling technique and study methodology. All participants completed a standardised self-administered anonymous questionnaire, which included, but was not limited to, questions on demographics (e.g., age, sex), participation in physical education classes and physical activity. GSHS adopted questionnaire items, including items to measure physical activity and physical education from the Youth Risk Behavior Survey of American Adolescents. Countries, where GSHS were implemented, were encouraged to use culturally appropriate examples, words, and phrases to ensure sociocultural adaptability of the items. Furthermore, using a rigorous translation and back-translation process with the assistance of WHO and US CDC, countries were allowed to translate the questionnaire into their local language 31 .

As of 8 December 2019, 98 countries/territories around the globe had at least one GSHS dataset publicly available with the surveys being conducted between 2007 and 2016. For countries with more than one GSHS dataset, we used the most recent one available. Of the 98 countries, 84 countries had data on PA, while 67 countries had data on physical education. Two countries (Niue and Tokelau) were excluded from the analyses due to their small sample size (n < 140). The analytical sample consists of 206,417 adolescents aged 11 or younger to 17 years from 65 countries. Only a small proportion of students (1.05%) were in the age group “11 years old or younger”, and for modelling purposes, they were considered as 11 years old for this analysis, as it was not possible to determine what proportion of 1.05% students were younger than 11 years old. All countries provided nationally representative samples.

The GSHS received ethics approval from the Ministry of Education or a relevant Institutional Ethics Review Committee, or both in each of the participating countries. Only those adolescents and their parents who provided written or verbal consent participated. As the current study used retrospective, de-identified, publicly available data, ethics approval was not required for this secondary analysis. Detailed methods of the GSHS have been described on both the US CDC and the WHO websites 30 , 32 .

Outcome measure—physical activity participation

Physical activity was assessed with one item: ‘During the past 7 days, on how many days were you physically active for a total of at least 60 min per day?’ The response options were 0–7 days. Consistent with the WHO recommendations 5 , we defined participants as ‘sufficiently active’ who did ≥ 60 min/day of physical activity on seven days of the week.

Study factor—physical education participation

Physical education class attendance was assessed with one item: ‘During this school year, on how many days did you go to physical education (PE) class each week?’ The responses were classified into three groups: ‘0 day/week’, ‘1–2 days/week’, and ‘≥ 3 days/week’ as used elsewhere 25 , 33 .

Adolescents self-reported age, sex, and daily hours of sitting (when not in school or doing homework) in the survey. Food insecurity was assessed by asking: ‘During the past 30 days, how often did you go hungry because there was not enough food in your home?’ with response options being never, rarely, sometimes, most of the time, and always. As the GSHS did not include any direct measure of socioeconomic status, this variable was used as a proxy measure of socioeconomic status 34 , 35 . Self-reported height and weight were used to compute body mass index (BMI), which was categorised as underweight (BMI < −2SD), overweight (BMI >  + 1SD), and obese (BMI >  + 2SD), relative to median BMI, by age and sex based on the WHO Child Growth Standards 36 .

Statistical analyses

Of the 65 countries with data on physical activity and physical education, nine countries were from Africa, 20 from the Americas, 15 from Eastern Mediterranean, five from South East Asia, and 16 from the Western Pacific region. Using the World Bank country classification, collected at the time of the survey for the respective countries, seven countries were classified as low‐income, 21 lower‐middle‐income, 18 upper‐middle‐income, and 18 high-income. Income classification information was not available for Cook Island. The prevalence estimates of physical activity and physical education were obtained by using a Stata command ‘svyset’ to take into account sampling weights and the clustered sampling design of the surveys.

In examining the country-level association of physical education with physical activity, a set of covariates was considered including age, sex, weight status (i.e., BMI), food insecurity, and sitting time. Sitting time was considered as an adjusting factor given its demonstrated association with physical activity in adolescents 37 . Given the binary nature of physical activity outcome, logistic regression analysis with robust standard errors was used to examine the association at the country level, by taking into account the sampling weight that was applied to each participant record to adjust for non-response and the varying probability of selection. This GSHS weighting factor was applied in an identical way to estimate the association in each participating country. Within the GSHS protocol, weighting accounted for the probability of selection of schools and classrooms, non-responding schools and students, and distribution of the population by sex and grade.

Random effects meta-analysis was used to generate pooled estimates of the association between physical education and physical activity for the overall sample, by country income category (e.g., low-income, lower-middle income, upper-middle income, and high-income), and by WHO region, stratified by sex and age groups (11–14 years vs 15–17 years). Two age groups (11–14 years [early adolescence] and 15–17 years [middle adolescence]) 38 were considered to stratify the analysis in order to examine whether the association estimates vary across phases of adolescence. This analysis used DerSimonian and Laird method 39 with the estimate of heterogeneity being taken from the Mantel–Haenszel model. As the GSHS were conducted across different cultural settings in 65 countries around the world over a long period of time (2007–2016), it was reasonable to assume that the association estimates across countries were likely to vary from survey to survey, which supports the use of random effects meta-analysis that can adjust heterogeneity among studies 40 . The percentage of variability in estimates across studies that is attributable to between study heterogeneity (I 2 ) in our analysis ranges from 54.3 to 80.2%, which suggests a strong presence of heterogeneity in the association estimates, and further supports the use of random effects meta-analysis. All adjusted estimates of the association parameters are presented in the form of odds ratio (OR) and 95% confidence interval (CI). All analyses were conducted by StataSE V14.0.

Ethics approval and consent to participate

The GSHS received ethics approval from both a national government administration and an institutional review board or ethics committee. Only adolescents and their parents who provided written/verbal consent participated. As the current study used retrospective publicly available data, we did not require ethics approval from any Institutional Ethics Review Committee for this secondary analysis.

The mean age of the participating adolescents (n = 206,417) was 14.35 (SD = 1.45) years, 54.4% aged 11–14 years, and 49.2% were girls. The prevalence of sufficient physical activity was 15.0%, with boys having higher prevalence (18.3%) than girls (11.5%). Over half (56.5%) of adolescents participated in physical education classes 1–2 days/week (boys 54.7%; girls 58.3%) and about a quarter (24.2%) participated in physical education classes ≥ 3 days/week (boys 26.8%; girls 21.6%). As shown in Fig.  1 , the overall percentage of adolescents being sufficiently active was greater for those who attended more physical education classes in both sexes.

Proportion of adolescents sufficiently physically active by participation in physical education classes, Global School-based Student Health Survey, 2007–2016.

Estimates of associations of physical education class participation with sufficient physical activity by country are shown in Table 1 . The country-level analysis shows that 50 out of 65 participating countries (77%) demonstrated significant and positive associations between attending physical education classes ≥ 3 days/week and being sufficiently active with 33 countries (51%) revealing at least double the odds (OR ≥ 2.0) of meeting physical activity guidelines. For example, Bolivian adolescents who attended physical education classes ≥ 3 days/week had threefold odds of reporting sufficient physical activity compared with their counterparts who attended no physical education class (OR 3.00, 95% CI 1.93–4.67). In examining the association between attending physical education classes 1–2 days/week and being sufficiently active, 20 countries (31%) demonstrated significant positive associations. For example, Thai adolescents who attended physical education classes 1–2 days/week had double the odds to reporting sufficient physical activity compared with their counterparts who attended no physical education class (OR 2.11, 95% CI 1.39–3.19). As shown in Table 1 , attending physical education classes ≥ 3 days/week was positively and strongly associated with physical activity in all WHO regions with South East Asia region showing the strongest association (OR 2.89, 2.11–3.97), followed by Africa (OR 2.45, 1.72–3.48) and Western Pacific region (OR 2.40, 1.92–3.00). The analysis also showed evidence of positive and moderate association between attending physical education classes 1–2 days/week and being sufficiently active in all WHO regions with the pooled association estimates ranging from OR 1.19 (1.01–1.41) in the Americas region to OR 1.86 (1.03–3.36) in South East Asia.

Overall, adolescents who took physical education classes ≥ 3 days/week, compared to those who did not take any physical education classes, had double the odds of being sufficiently active (OR 2.05, 95% CI 1.84–2.28) with no apparent gender (OR 2.09, 1.88–2.33 for boys; and OR 1.95, 1.69–2.25 for girls) or age (OR 2.19, 1.93–2.48 for 11–14-year-old; and OR 2.03, 1.80–2.28 for 15–17-year-old adolescents) differences (Table 2 ). Adolescents who participated in physical education classes 1–2 days/week had 26% higher odds of being sufficiently active (OR 1.26, 1.15–1.37) with relatively higher odds for boys (OR 1.30, 1.17–1.46) than girls (OR 1.15, 1.03–1.29) and younger adolescents aged 11–14 years (OR 1.28, 1.16–1.42) that older adolescents aged 15–17 years (OR 1.19, 1.08–1.32).

The odds of attending physical education classes ≥ 3 days/week and being sufficiently active were lower in country with higher income (Table 2 ). In low-income countries, adolescents who participated in physical education classes ≥ 3 days/week had 137% higher odds of being sufficiently active (OR 2.37, 1.51–3.73) with comparable odds for boys (OR 2.51, 1.70–3.70) and girls (OR 2.36, 1.31–4.26) and slightly higher odds for younger (OR 2.94, 1.92–4.51) than older adolescents (OR 2.32, 1.36–3.96). In high-income countries, the odds of being sufficiently active was 85% higher for adolescents who attended physical education classes ≥ 3 days/week (OR 1.85; 1.52–2.25) with no apparent gender (boys OR 1.89, 1.50–2.37; girls OR 1.69, 1.36–2.10) or age (younger OR 1.83, 1.47–2.28; older OR 1.80 (1.48–2.19) differences. In lower-middle income countries, adolescents who attended physical education classes 1–2 days/week had 39% higher odds of being sufficiently active (OR 1.39, 1.19–1.62) compared to their counterparts who did not take any physical education classes, with relatively higher odds for boys (OR 1.46, 1.21–1.76) than girls (OR 1.30, 1.03–1.65), and similar odds for younger (OR 1.36, 1.09–1.68) and older adolescents (OR 1.33, 1.16–1.51).

Boys of South East Asian region who participated in physical education classes ≥ 3 days/week had the highest odds of being sufficiently active (OR 3.29, 1.97–5.47), followed by the boys of Africa region (OR 2.41, 1.74–3.33) (Supplementary Table S1 ). Girls of Western Pacific and Africa region who participated in physical education classes ≥ 3 days/week had the highest odds of being sufficiently active (OR 2.68, 1.89–3.77, and OR 2.63, 1.63–4.26, respectively). Even by attending physical education classes 1–2 days/week, boys of the Americas region and girls of Africa region can increase their odds, though not considerably, of being sufficiently active (OR 1.29, 1.06–1.58, and OR 1.41, 1.15–1.73, respectively).

Both younger and older adolescents in all WHO regions demonstrated positive association between ≥ 3 days/week physical education class attendance and meeting the physical activity recommendations (Supplementary Table S1 ). Younger adolescents in South East Asia (OR 3.03, 2.42–3.79) and Africa (OR 2.95, 2.07–4.20), and older adolescents in South East Asia (OR 3.24, 1.57–6.67) who participated in physical education classes ≥ 3 days/week had over three times higher odds of being sufficiently active. There were moderate positive associations between physical education class attendance for 1–2 days/week and meeting the physical activity recommendations for younger adolescents in Africa (OR 1.38, 1.03–1.84), the Americas (OR 1.29, 1.07–1.56), and Eastern Mediterranean regions (OR 1.24, 1.06–1.44), and for older adolescents in Africa (OR 1.24, 1.03–1.48), Eastern Mediterranean (OR 1.26, 1.07–1.49), and Western Pacific region (OR 1.19, 1.01–1.41).

To our knowledge, this is the most extensive global study to assess the association of physical education class attendance with physical activity of adolescents, based on nationally representative samples from 65 countries around the globe. The key finding of our study is that adolescents, irrespective of sex or age, who had a higher frequency (≥ 3 days/week) of physical education class attendance had significantly higher odds of meeting the WHO’s physical activity recommendations. The estimates of association between the frequency of attending physical education and meeting physical activity recommendations were lower among countries with higher income. We observed some regional differences with South East Asia having the highest associations and the Americas having the lowest. Our findings suggest that adolescents, especially girls and those aged 15–17 years, are mostly benefited from a higher frequency (i.e., ≥ 3 days/week) of physical education participation. Our study also found some benefits of less frequent participation in physical education classes (1–2 days/week) in meeting the physical activity guidelines, which is encouraging. About one-third of the countries demonstrated positive association between less frequent participation in physical education classes and meeting the physical activity recommendations, and such association was prominent in boys and younger adolescents in all but low-income countries. Our study thus argues that even less frequent participation in physical education classes can bring some benefits for some adolescents.

Our finding that a higher frequency of physical education class attendance was positively associated with meeting the physical activity recommendations is consistent with other studies in children and adolescents 20 , 21 , 24 , 25 . It has been argued that participation in physical education classes acts as a positive reinforcement to “keep young people going” by being more physically active with less time in sedentary behaviour throughout the day 25 . Physical education classes provide children with an opportunity to familiarise themselves with different types of physical activity, motivates them to be active within the school environment, and potentially also encourages more out-of-school physical activity 41 . Physical activity during physical education classes may reduce fatigue and improve mood by changing neurophysiological stimulation and the brain’s information processing function (i.e., cerebral cortex), which may improve children’s preparedness to move more throughout the day 25 . While the frequency of physical education class is important, it is also critical that children have access to quality physical education 18 , 19 . Previously, researchers have suggested that in spite of the traditional class-based and sports-centred physical education curriculum, physical education ought to be a health-centred dynamic learning experience for children 19 , 42 . Quality physical education is important for age-appropriate cognitive learning and to acquire fitness, develop motor skills and psychosocial and emotional skills, which can help children to lead an active lifestyle, inside and outside of the school environment, throughout their life course 18 , 19 , 42 . Given the role of physical education for active and healthy lifestyle, different stakeholders, including United Nations agencies (i.e., UNESCO) 19 , European Commission 17 , have recommended to ensure quality physical education for children and adolescents, and called for political commitments and actions from Governments and supports from the international communities.

In our study, adolescents boys and girls in low-income countries with ≥ 3 days/week physical education class attendance had the highest odds of meeting the physical activity recommendations, and the associations became smaller (yet significant) with a higher country income classification for both sexes. A previous 12-country study 25 reported similar findings for boys, but not for girls. Unlike our study that is based on self-reported data, the earlier study used a device-based physical activity measure and included Australia and other high-income countries of Europe and North America. In addition to high-income countries, our study included adolescents from low- and lower-middle-income countries. It is possible that for many children, regardless of sex or country income, schools provide the most pragmatic and readily accessible opportunities for various physical activity, while out-of-school physical activity options, logistics, and environments might be variable 10 , 11 . The environments, in general, may be more supportive of out of school physical activity for children in high-income countries than their counterparts in low-income countries; however, high-income countries may have other challenges including gender and socioeconomic disparities in physical activity. For example, children from high-poverty neighbourhood may have fewer opportunities for out of school physical activity in many high-income countries 43 , 44 . Appreciating the heterogeneity in resources for physical education within- and across countries, all governments should consider schools as the primary focus to promote an active and healthy lifestyle among children and adolescents, which is likely to be a cost-effective and opportunistic initiative to get them moving. Our findings also show that physical education is potentially more important in South East Asia than the Americas in promoting physical activity. In addition to environmental support, such variations could be a sign of the quality of the respective physical education programs, including time allocated for physical education across the countries. There is a large heterogeneity in weekly time allocated for physical education in countries around the globe. For example, weekly time for physical education of secondary school students in Bangladesh (180 min) is reportedly higher than in Peru (90 min) 28 . Research is needed to understand whether physical education classes are designed to facilitate physical activity and/or how much time students actually spend in physical activity during physical education classes. It is also important to understand how physical education lessons can help the students to develop skills so that they can be more active both inside and outside of school. This information can help in designing a physical education curriculum with balanced components of physical activity and physical education lessons on other health and wellbeing so that the students can develop a healthy lifestyle. Opportunities for quality physical education should be equitable and inclusive, and available for all children regardless their gender, disability status, socio-economic position, and cultural or religious backgrounds, and the delivery of physical education should be ensured for marginalised and vulnerable groups 19 .

The strengths of our study are the inclusion of a large number of countries around the globe, representing different world regions and income groups. All countries included in our study provided nationally representative data. We used the GSHS sample weighting to account for distribution of the population by age and sex in countries for whose data were analysed. Any potential skewness, by sex or age, in the observed data is unlikely to impact the weighted analysis results. All countries where GSHS was implemented, used a standardised data collection procedure. In all countries, a standardised questionnaire with the same survey items to assess physical activity and physical education class attendance was used, which facilitated our regional comparisons. We adjusted our estimates for several potential covariates to avoid possible confounding effects of these factors.

The findings of our study should be interpreted in light of its limitations. Data for our study were collected using self-reported questionnaire; these data are vulnerable to social desirability and recall bias. Unavailability of GSHS data from European and North American countries, some of the Latin/Central American and Asia and Pacific countries, limits the generalisability of the findings only to the GSHS participating countries. Although a standardised questionnaire was used in all participating countries, there is a lack of information on the reliability and validity of GSHS measures across different countries or cultures. Physical education classes can have different meanings and can constitute different components, including a knowledge-based curriculum component (i.e., lessons and discussions) and/or skill-based physical activity session, in different settings. We did not have any information on components of physical education classes across the participating countries. The cross‐sectional design of the study limits our ability to make any causal inferences from the association estimates. Some adolescents in our study may have had difficulties with understanding the questionnaire because of poor reading skills. In this study, we used data collected between 2007 and 2016, which may have biased the results because of the period effect.

Conclusions

Our study suggests a positive association between regular participation in physical education classes and meeting the physical activity guidelines among children and adolescents around the globe regardless of sex or age group. The odds were lower in high- than low-income countries. The benefits of regular participation in physical education classes to enhance physical activity are universal across all WHO regions, with the highest being observed among adolescents from South East Asian countries. Even less frequent participation in physical education classes (i.e., 1–2 days a week) was related to higher odds of being sufficiently active in all but low-income countries, especially in boys. Thus, the findings support the importance of physical education for ensuring sufficient physical activity among school-going children and adolescents around the globe. Countries must not miss the opportunity to ensure schools deliver a daily or at least 3 days per week of well-designed physical education classes, which can play a vital role in creating active nations around the world.

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Acknowledgements

The authors would like to thank the US Centers for Disease Control and Prevention and the World Health Organization for making the Global School-based Student Health Survey (GSHS) data publicly available for analysis. The authors thank the GSHS country coordinators and other staff members. R.U. is supported by Alfred Deakin Postdoctoral Research Fellowship. J.S. is supported by a National Health and Medical Research Council Leadership Level 2 Fellowship (APP 1176885). S.M.S.I. is supported by the Institute for Physical Activity and Nutrition, Deakin University and a post doctorate fellowship from the National Heart Foundation of Australia (Award #102112).

This research received no external funding.

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R.U.: concept and design study, data analysis and interpretation, drafting manuscript, critical revision of manuscript, final approval; J.S.: data interpretation, critical revision of manuscript, final approval; S.M.S.I.: data interpretation, critical revision of manuscript, final approval; A.K.: concept and design study, data analysis and interpretation, statistical analysis, drafting manuscript, critical revision of manuscript, final approval.

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Uddin, R., Salmon, J., Islam, S.M.S. et al. Physical education class participation is associated with physical activity among adolescents in 65 countries. Sci Rep 10 , 22128 (2020). https://doi.org/10.1038/s41598-020-79100-9

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New Research Examines Physical Education in America

By Morgan Clennin, PhD, MPH, Kaiser Permanente of Colorado, University of South Carolina, and National Physical Activity Plan

School-based physical education (PE) is recommended by the Community Guide as an effective strategy to promote physical activity among youth. Unfortunately, many have speculated that PE exposure has declined precipitously among U.S. students in the past decade. Limited resources and budgets, prioritization of core academic subjects, and several other barriers have been cited as potential drivers of these claims. However, few large-scale studies have explored the merit of these claims – leaving the answers following questions unknown:

Has PE attendance decreased among U.S. students in the past decades?

What policies and practices are in place to support quality PE?

To answer these questions, the President’s Council on Sports, Fitness & Nutrition tasked the National Physical Activity Plan Alliance (NPAPA) to review the available evidence and summarize their findings. The primary objective of this effort was to better understand PE exposure over time to inform national recommendations and strategies for PE.

The NPAPA began by establishing a collaborative partnership with experts in the federal government, industry, and academia. The group analyzed existing national data sources that could be used to examine changes in PE attendance and current implementation of PE policies and practices. These efforts culminated in a final report and two peer-reviewed manuscripts. A summary of the group’s findings are outlined below.

Key Findings:

• 1/2 of U.S. high school students did not attend PE classes—which is consistent over the 24-year period studied (1991-2015).
• The percentage of U.S. high school students reporting PE attendance did not change significantly between 1991 and 2015 for the overall sample or across sex and race/ethnicity subgroup.
• Daily PE attendance did decrease 16% from 1991 to 1995 then attendance rates remained stable through 2015.
• > 65% of schools implemented 2-4 of the 7 essential PE policies
• Implementation of PE policies varied by region, metropolitan status, and school level.
• Data indicates minority students have been disproportionately affected by cuts to school PE programs during the past two decades.

Recommendations Based on Key Findings:

• Prioritize efforts to expand collection of surveillance data examining trends in PE attendance among elementary and middle school students.
• Develop policies to improve PE access for all students in order for PE to contribute to increased physical activity among youth.
• Adopt policies and programs that prioritize PE to maximize the benefits of PE.
• Utilize the findings of these efforts to target professional development and technical assistance for PE practitioners.

The Education sector of the NPAP provides evidence-based strategies and tactics that can guide efforts to support the provision of quality PE to all students. More information, and links to the respective manuscripts, can be found on the NPAPA website: http://physicalactivityplan.org/projects/physicaleducation.html

The Office of Disease Prevention and Health Promotion (ODPHP) cannot attest to the accuracy of a non-federal website.

Linking to a non-federal website does not constitute an endorsement by ODPHP or any of its employees of the sponsors or the information and products presented on the website.

You will be subject to the destination website's privacy policy when you follow the link.

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Supporting Physical Education in Schools for All Youth

• Policy Statements and Advocacy
• Policy Statement Database
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• Date: Oct 26 2021
• Policy Number: 20211

Key Words: Physical Activity, Education, School Health, Obesity

Abstract This policy statement provides scientific evidence that schools are unique places where children should be engaged in physical activity. However, most school policies and programs are not supportive of physical activity in the school day, specifically physical education. Considering that 30.4% of youth are overweight or obese and that 76.8% do not meet the daily physical activity recommendations, and considering the benefits of physical activity with respect to increased ability to concentrate and learn, it is of the utmost importance to incorporate policies and programs that facilitate healthy engagement in physical activity in schools. Marginalized youth from low-income families, communities of color, immigrant communities, and others are disproportionately impacted by lack of supportive policies and programming. This policy statement calls for comprehensive and cooperative actions from the public health community, schools, administrators, researchers, and community members to increase physical activity opportunities through physical education in order to engage youth in at least 60 minutes of physical activity daily.

Relationship to Existing Policy Statements 

• APHA Policy Statement 20137: Improving Health and Wellness through Access to Nature
• APHA Policy Statement 20172: Supporting the Updated National Physical Activity Plan
• APHA Policy Statement 201515: The Role of Health Education Specialists in a Post-Health Reform Environment
• APHA Policy Statement 20079: Building a Public Health Infrastructure for Physical Activity Promotion
• APHA Policy Statement 9709: Promoting Public Health Through Physical Activity
• APHA Policy Statement 20044: Creating Policies on Land Use and Transportation Systems that Promote Public Health
• APHA Policy Statement 20058: Supporting the WHO Global Strategy on Diet, Physical Activity and Health
• APHA Policy Statement 200619: Urgent Call for a Nationwide Public Health Infrastructure and Action to Reverse the Obesity Epidemic
• APHA Policy Statement 201514: Building Environments and a Public Health Workforce to Support Physical Activity Among Older Adults
• APHA Policy Statement 20121: Supporting the National Physical Activity Plan
• APHA Policy Statement 201415: Support for Social Determinants of Behavioral Health and Pathways for Integrated and Better Public Health

Problem Statement Obesity is an important health issue among children in the United States. According to the 2019 National Health and Nutrition Examination Survey, 16.1% of U.S. youth are overweight and 19.3% are obese.[1] Moreover, racial, socioeconomic, and gender disparities exist in terms of risk factors associated with being overweight or obese. The chronic disease burden is consistent with the disproportionately high percentages of overweight and obese youth in racial minority and socioeconomically disadvantaged populations. According to data from the 2019 Youth Risk Behavior Surveillance System (YRBSS), 37.7% of Black youth and 38.8% of Hispanic youth are overweight or obese, as compared with just 27.7% of White youth.[2]

P hysical inactivity is a significant risk factor for obesity and other chronic conditions.[3] As the proportion of students who are overweight or obese has increased, so has inactivity. Empirical evidence suggests that physical activity may be used as a standalone strategy to decrease adiposity among children.[4] It is recommended that school-aged children and adolescents (6–17 years of age) engage in 60 minutes of physical activity seven days per week.[5] According to data from the 2019 YRBSS, 76.8% of youth do not meet the recommended amounts of physical activity.[2] The same data set indicates that adolescent girls, in particular, are at a higher risk for being inactive as they age; 84.6% of girls do not meet the physical activity guideline of 60 minutes per day seven days a week, as compared with 69.1% of boys.[2] In addition, inactive youth are more likely to be inactive as adults.[6] Starting physical activity early is essential to prevent inactivity in adulthood and older adulthood.

Physical activity provides benefits beyond physical health. For example, it is associated with a reduced risk for depression.[7] Trends for contemplating and making a plan for suicide are increasing among White, Hispanic, and Black youth, and there are racial and ethnic disparities in terms of mental health challenges among youth.[5] In 2019, 40.0% of Hispanic youth reported persistent feelings of sadness or hopelessness, as compared with 36.0% of White youth and 31.5% of Black youth.[5]

In addition to the long-term health benefits of child physical activity, there are numerous academic-related benefits, which the body of evidence continues to expand.[8] Extensive research has demonstrated strong positive correlations between physical activity and higher levels of physical fitness and academic achievement, educational attainment, academic performance, and brain functioning.[8–10] In fact, physical activity participation has both intermediate and long-term benefits with respect to academic performance. Research has shown that, immediately following engagement in physical activity, children have improved concentration on classroom tasks, which may potentially enhance learning.[8]

It is recommended that schools provide 150 minutes of instructional physical education for elementary school children and 225 minutes for middle and high school students per week for the entire school year.[11] However, only Oregon and the District of Columbia have requirements that meet the recommendations for minutes of physical education.[12] Physical education requirements notably decrease after the fifth grade, which aligns with significant decreases in physical activity in youth. Only 8.7% of schools require physical education for 12th grade, as compared with 45.1% of schools for fifth grade.[13]

The lack of universal physical education requirements at all grade levels and the lack of funding dedicated to physical education facilitate inactivity. The median school physical education budget in the United States is just $764 per year,[12] which may further hinder schools from meeting physical education recommendations. Ohinmaa and colleagues suggested that grants, donations, and fundraising account for about half of all funding for school health.[14] Improving physical education policies nationwide has the potential to reduce overall health care costs by $60.5 million within 10 years.[15]

Students who attend physical education in school are two to three times more likely to be physically active outside of school and nearly twice as likely to be active in adulthood.[16] Furthermore, physical education has been shown to be an opportunity for students to gain many of their recommended minutes of physical activity, but many students do not attend or participate in these classes.[13] According to 2019 YRBSS data, about half of high school students attend physical education classes one or more days per week.[2] Therefore, targeting middle and high schools is uniquely important because a significant drop in physical education attendance and physical activity participation occurs between the seventh and 12th grades.[11]

Evidence-Based Strategies to Address the Problem   Youth spend a significant portion of their time at school[17]; therefore, schools are one of the most important places for physical activity interventions.[18] According to the Society of Health and Physical Educators, schools should require physical education for students in kindergarten through grade 12.[19] Specifically, all students within secondary school (which includes middle school and high school) should achieve 225 minutes of physical activity per week, while students in primary school (which includes elementary school) should achieve 150 minutes per week.[19]

Current evidence-based strategies to increase physical activity among youth are described below.

Improving school-based physical education: According to the Community Preventive Services Task Force (CPSTF),[20] enhanced school-based physical education involves changing the curriculum and coursework for K–12th-grade students to increase the amount of time students spend engaging in moderate to vigorous physical activity (MVPA) during physical education classes. Enhanced school-based physical education is defined as increasing the amount of time students spend completing MVPA during physical education classes to at least 50% of class time.[20] The CPSTF specifically recommended improving physical education teaching strategies by (1) incorporating modified games and substituting sedentary games with active games and (2) including physical education lesson plans that incorporate fitness and circuit training activities.[20]

Lonsdale and colleagues highlighted effective strategies to increase MVPA, which included teacher professional learning focusing on class organization, management, and instruction and supplementing the usual physical education lessons with high-intensity activity (i.e., fitness infusion).[21] A systematic review of 14 studies showed that students who participated in enhanced school-based physical education classes engaged in 24% more MVPA.[21] Also, groups that received enhanced school-based physical education spent on average 53% of their time engaged in MVPA.[21] In addition, Zhou and Wang found that team games were reported to accumulate the most MVPA time, with movement-based activities (such as gymnastics and dance) having the highest amounts of MVPA and knowledge-based activities (i.e., lesson-based instruction) having the lowest amounts.[22] Implementation of enhanced school-based physical education aligns with the Healthy People 2030 objectives, which aim to increase the proportion of adolescents who meet current federal physical activity guidelines for aerobic physical activity and muscle-strengthening activity.[23]

It is important that physical education classes be taught by state‐licensed or state‐certified teachers who are endorsed to teach physical education. In a meta-analytic review, Hollis and colleagues found that youth were engaged in MVPA for an average of 44.8% of lesson time.[24] Low MVPA levels in physical education lessons could be the result of pedagogical characteristics often observed in typical lessons, such as stopping physical activity to provide instruction, observing demonstrations related to the activity, or organizing equipment or student groups.[25] An examination of time allotment in terms of lesson context revealed that 30% of lesson time was spent in game play, 29% in fitness, 20% in classroom management, 9% in knowledge-related activities, and 5% in skill-related activities.[15] Similar results were found in a study by Powell and colleagues in which the average length of physical education lessons was 35.3 minutes, with only 15 minutes of MVPA during physical education.[26] Results further demonstrated that 34% of the lesson was spent standing and 21.7% was spent sitting, with time sitting being directly linked to knowledge attainment.[26] 

In conclusion, a significant proportion of physical education instruction time is spent on classroom management, instruction, and transitional periods. While these periods are necessary, they detract from the overall time youth spend participating in MVPA. It is, therefore, recommended that all physical education courses be taught by qualified individuals who have received formal training in physical education pedagogy. SHAPE America has specifically recommended that physical education be taught by an endorsed state‐licensed or state‐certified teacher.[11] This educational licensure or certification requirement would ensure that the physical education curriculum used in schools is appropriate and maximizes the time students spend engaging in MVPA while also aligning with national and/or state physical education standards for K–12 physical education.[11] 

Increasing the frequency of physical education: Scientific evidence has shown that increasing the frequency of physical education can improve overall physical activity among youth. Research indicates that only 25.9% of high school students attend physical education classes five days per week.[5]  Findings from the School Health Policies and Practices Study showed that less than 4% of elementary and middle schools require physical education or similar activity every day throughout the school year.[18] Moreover, less than 9% of middle schools require physical education at least three days per week.[18] Physical education instruction for high school students decreased from 29.9% in 2017 to 25.9% in 2019.[5]

The benefits of regular physical activity are well documented and include improvements in bone and muscle development, cardiorespiratory fitness, and weight control; reduced symptoms of depression and anxiety; and reduced risks of heart disease, cancer, type 2 diabetes, and hypertension.[3] Research has demonstrated that physical activity throughout the school day is associated with better school performance.[8] Healthy People 2030 objectives highlight the importance of increased physical activity through improved physical education in both public and private school systems. Specifically, the Educational and Community-Based Programs workgroup aims to increase the proportion of adolescents who participate in daily school-based physical education.[7]

Reduction or removal of waivers, substitutions, and exemptions for physical education: Another important strategy to increase school-based MVPA is the reduction or removal of waivers, substitutions, and exemptions for physical education. According to the Shape of the Nation 2016 report, 30 U.S. states allow student exemptions from physical education classes, and 31 states allow students to substitute activities such as marching band, cheerleading, drill team, or intramural sports for physical education credit.[12] SHAPE America issued a position statement according to which school districts and schools should not allow waivers or exemptions from physical education class time or credit requirements.[11] Specifically, SHAPE firmly asserted that all students should be required to complete physical education courses and that state, district, and school policies should not allow substitutions, waivers, or exemptions for physical education courses, class time, or credit requirements. By allowing waivers, substitutions, and exemptions for physical education, schools and districts eliminate opportunities for students to be active at a time when physical activity levels are at an all-time low among youth.[11] As mentioned, schools offer a unique setting to teach children the value of physical activity as well as a structured, supervised environment in which children can learn the necessary skills to encourage lifelong physical activity.[11]

Culturally tailored physical education: Multiple organizations have reported the need to ensure culturally tailored physical education for all populations, especially marginalized populations such as minority racial, ethnic, and cultural groups; girls and women; refugees; people experiencing homelessness; LGBTQ+ (lesbian, gay, bisexual, transgender, queer or questioning) populations; and others.[27,28] The United Nations Educational, Scientific and Cultural Organization’s Guidelines for Policy-Makers on Quality Physical Education stated the need for and importance of providing physical education for minority groups. According to the guidelines, (1) curricula should be flexible and adaptable for all groups, (2) teachers should be professionally qualified and capable of providing physical education for all students, and (3) school policies and practices should provide appropriate infrastructure, faculties, equipment, and teaching material for all students.[28]

Lastly, it is recommended that teachers have access to resources such as community health workers who can provide culturally specific guidance on physical education. Community health workers are particularly effective because of the cultural and linguistic connections they have with the communities they serve.[29] Providing culturally appropriate physical education may increase physical activity,[30] decrease obesity,[31] and improve the overall health of minority groups by increasing social support, promoting healthy lifestyles, and increasing knowledge of disease prevention.[32]

Adaptive physical education: According to the Physical Activity Guidelines for Americans, children and adolescents with disabilities are more likely to be inactive than those without disabilities.[7] It is recommended that children and adolescents with disabilities still aim to meet the key guideline of 60 minutes of physical activity every day when possible. If youth are unable to participate in the physical activities or durations needed to meet the key guidelines, it is recommended that they be as active as possible and avoid being inactive.[7]

Youth with disabilities should work with health care professionals or physical activity specialists to learn about the types and amounts of physical activity appropriate for them.[7] The Adapted Physical Education National Standards were developed to ensure that physical education for children with disabilities be delivered by a qualified adapted physical educator. According to these standards,  physical education teachers should use sound teaching practices to ensure the inclusion and representation of all skill and ability levels.[33] Specifically, master physical educators should be well prepared to provide knowledge acquisition as well as physical activity opportunities for all abilities to create active and healthy lifestyles for all students. In addition, the standards outline high expectations for a physically active lifestyle. Lastly, it is expected that master physical educators will maintain a stimulating, productive learning environment that holds all students to the highest expectations for a physically active lifestyle.[33]

Conclusion: In conclusion, schools are the ideal and recommended setting for the promotion of physical activity among youth, and physical education is the primary vehicle through which to achieve this objective in schools.[34] Improving the quality and quantity of physical education courses will give youth more opportunities to attain the recommended amount of physical activity each day. Reducing physical education waivers would ensure that youth are not exploiting a loophole in the system. Advocating for culturally tailored physical education and adaptive physical education would foster an inclusive environment in which all children are able to be physically active and healthy.

Opposing Arguments/Evidence  Few would disagree that physical activity and time spent engaged in physical education are important for youth development and overall health. The primary opposing arguments tend to stem from the poorly designed physical education curriculum and the time taken away from other subjects amid increased pressure to raise standards and scores in subjects such as math, science, and English. As a result, time allocated to physical education and the perceived importance of physical education lessons have been reduced.  However, there is a substantial amount of evidence that physical activity can help improve academic achievement, including overall grades and standardized test scores.[34] In a systematic review of 43 articles and 50 studies, the Centers for Disease Control and Prevention (CDC) determined that physical activity has a positive impact on cognitive skills, attitudes, and academic achievement.[34] Specifically, physical activity enhanced concentration and attention and improved classroom behavior.[34] The review also showed that increasing time during the school day for physical activity does not appear to take away from overall academic performance.[34]  Therefore, the CDC recommended that schools increase the amount of time students spend in physical education or consider adding components to increase the quality of physical education classes.[34] As highlighted in the evidence-based strategies to improve school-based MVPA, the CPSTF recommended use of enhanced physical education, including improved physical education teaching strategies, by incorporating modified, more active games and physical education lesson plans that involve fitness and circuit training activities.[20]

Alternative Strategies Enhancing, encouraging, and maintaining physical education class duration and quality are vital to the health and well-being of children, particularly in terms of their physical activity behaviors. However, there are several alternative strategies to increase the physical activity of youth that should be considered in conjunction with retaining the importance of physical education.

Before- and after-school physical activity programs: According to the World Health Organization, after-school activities are a key avenue to supplement youth MVPA levels.[35] After-school physical activity could include physical activity clubs, intramural programs, informal play on school grounds, physical activity in school-based before- and after-care programs, and interscholastic sports.[18] Mayorga-Vega and colleagues found that physical activity that took place after school hours achieved 36% of the recommended 60 minutes of MVPA per day.[36] However, adolescents still reported a higher level of MVPA during physical education classes than during school recess and after-school programs.[36]

Only about 26% of the nation’s public and private schools provide access to their physical activity spaces and facilities for all individuals outside of normal school hours. In addition, a steady decline has been observed in provision of access to physical activity facilities during nonschool hours.[37] Therefore, schools can further encourage physical activity by opening up their facilities for community use.[18]

Increasing active transportation to and from school: According to the CPSTF, walking or bicycling to and from school provides children and adolescents with an opportunity to be physically active most days of the week.[38] Interventions such as the Safe Routes to School program could increase active transportation to and from school and reduce pedestrian and bicycle injury rates. However, there is not enough evidence to show that school travel leads to increases in students’ overall daily physical activity.[38]

Recess: Recess is defined as a regularly scheduled period during the school day for physical activity and play that are monitored by trained staff or volunteers.[13] Recess has been directly related to increased physical activity, improved memory, improved attention, improved concentration, decreased classroom disruptive behavior, improved social and emotional development, and academic achievement.[8,39–41] It is recommended that elementary, middle, and high school students have a minimum of 20 minutes of daily recess.[39] The CDC has further recommended that recess and physical education be separate, distinct physical activity opportunities, which creates separate times for skill acquisition (physical education) and active play (recess).[39] Also, the CDC has recommended that schools provide students with adequate, designated, and safe spaces, facilities, equipment, and supplies for both indoor and outdoor recess (e.g., playground markings, physical activity zones, activity cards).[39] Lastly, students should not be excluded from recess for disciplinary reasons or academic performance because such practices promote negative reinforcement.[39]

Classroom-based physical activity: Classroom-based physical activity, including single physical activity sessions, may increase student attention, concentration, and memory; increase motivation and enjoyment of learning; and reduce behavior issues.[8,40] Classroom-based physical activity integration may include physically active lessons, physical activity before a test, physical activity breaks, energizers, brain boosters, and active classrooms (a teaching technique that intentionally blends physical activity into academic lessons to satisfy the learning outcomes of the classroom without sacrificing time spent engaging in physical activity).[8,40,42] Further guidance by the CDC and other national organizations includes providing teachers with ongoing professional development to integrate physical activity into planned academic instruction as a means of reinforcing academic concepts.[40]

Action Steps Increasing physical activity among school-aged children is a vital investment in the health and well-being of youth in the United States. Increasing physical activity at this critical age has the potential to build healthier, happier young adults. Schools should support physical activity through culturally appropriate, high-quality physical education. Schools; local, state, and federal education agencies; public health departments; policymakers; and researchers should address the following objectives relevant to public health priority setting in order to advance school-based physical activity programming and activities:

• Federal agencies should develop national policies on physical education that are consistent with the larger national strategies to increase physical activity among youth.
• Federal and state governments should increase funding for schools to implement high-quality physical education programming
• State and local education departments should improve physical education requirements to provide the opportunity for 60 minutes of MVPA each school day.
• Policymakers at state and local education departments should be made aware of the importance of physical education provided by schools.
• Schools should require that all physical education teachers be appropriately credentialed to deliver culturally appropriate, high-quality physical education.
• Schools should solicit involvement and expertise from state and local public health departments and physical activity researchers on culturally specific, evidence-based strategies to improve school-based physical education.
• Principals and superintendents of schools should develop action plans to improve physical education for all of their students. Youth should have the opportunity to engage in 60 minutes of physical activity during the school day.
• Principals and superintendents should reduce or eliminate policies allowing waivers for physical education. Waivers should be considered on a case-by-case basis.
• Schools and school districts should engage in collaborative efforts to share the results of successfully implemented physical education programs.
• Schools and researchers should collaborate in studying physical activity among diverse youth who have been traditionally understudied and systematically underserved. Furthermore, researchers should be encouraged to develop innovative programs for youth in school settings that promote physical activity for all.
• Greater diversity in programming should be implemented in schools so that youth can be exposed to a variety of activities that those of all abilities and cultures might enjoy.
• Youth, families, community members, and local organizations should advocate to their school districts and legislative bodies for culturally appropriate, high-quality physical education in their local schools.
• Public health departments should partner with and support physical education teachers and programs. This support should include school-based physical activity in community health assessments and community health improvement plans highlighting the importance of physical activity in preventing chronic disease and providing mental and cognitive benefits.

References 1. Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2017–2018. Available at: https://www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf. Accessed October 20, 2021. 2. Centers for Disease Control and Prevention. 2019 Youth Risk Behavior Survey Questionnaire. Available at: www.cdc.gov/yrbs. Accessed October 20, 2021.  3. Centers for Disease Control and Prevention. Division of Nutrition, Physical Activity, and Obesity at a glance. Available at: https://www.cdc.gov/chronicdisease/resources/publications/aag/dnpao.htm. Accessed October 20, 2021. 4. Laframboise MA, Degraauw C. The effects of aerobic physical activity on adiposity in school-aged children and youth: a systematic review of randomized controlled trials. J Can Chiropractic Assoc. 2011;55(4):256–268. 5. Center for Disease Control and Prevention. High School YRBS 2019. Available at: https://nccd.cdc.gov/youthonline/App/QuestionsOrLocations.aspx?CategoryId=C06. Accessed October 20, 2021. 6. Lounassalo I, Salin K, Kankaanpaa A, et al. Distinct trajectories of physical activity and related factors during the life course in the general population: a systematic review. BMC Public Health. 2019;19:1.   7. U.S. Department of Health and Human Services. Physical activity guidelines for Americans. Available at: https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf. Accessed October 20, 2021. 8. Castelli DM, Glowacki E, Barcelona JM, Calvert HG, Hwang J. Active education: growing evidence on physical activity and academic performance. Available at: https://activelivingresearch.org/sites/activelivingresearch.org/files/ALR_Brief_ActiveEducation_Jan2015.pdf. Accessed October 20, 2021. 9. Kari JT, Pehkonen J, Hutri-Kähönen N, Raitakari OT, Tammelin TH. Longitudinal associations between physical activity and educational outcomes. Med Sci Sports Exerc. 2017;49(11):2158–2166. 10. Kohl HW, Cook HD. Physical activity, fitness, and physical education: effects on academic performance. Available at: https://www.ncbi.nlm.nih.gov/books/NBK201501/. Accessed October 20, 2021. 11. Society of Health and Physical Educators. The essential components of physical education. Available at: https://www.shapeamerica.org/uploads/pdfs/TheEssentialComponentsOfPhysicalEducation.pdf. Accessed October 20, 2021. 12. Society of Health and Physical Educators (2016). 2016 shape of the nation: status of physical education in the U.S. Available at: https://www.shapeamerica.org//advocacy/son/2016/upload/Shape-of-the-Nation-2016_web.pdf. Accessed October 20, 2021. 13. Springboard to Active Schools. Keep recess in schools. Available at: https://www.cdc.gov/healthyschools/physicalactivity/pdf/Recess_Data_Brief_CDC_Logo_FINAL_191106.pdf. Accessed October 20, 2021. 14. Ohinmaa A, Langille JL, Jamieson S, Whitby C, Veugelers PJ. Costs of implementing and maintaining comprehensive school health: the case of the Annapolis Valley Health Promoting Schools program. Can J Public Health. 2011;102(6):451–454. 15. Barrett JL, Gortmaker SL, Long MW, et al. Cost effectiveness of an elementary school active physical education policy. Am J Prev Med. 2015;49(1):148–159. 16. Physical Activity Council. (2017). 2017 participation report. Available at: http://s3.amazonaws.com/ustaassets/assets/822/15/papc_study.pdf. Accessed October 20, 2021. 17. Synder TD, de Brey C, Dillow SA. Digest of education statistics. Available at: https://files.eric.ed.gov/fulltext/ED580954.pdf. Accessed October 20, 2021. 18. Centers for Disease Control and Prevention. School Health Policies and Practices Study, 2014. Available at: https://www.cdc.gov/healthyyouth/data/shpps/pdf/shpps-results_2016.pdf. Accessed October 20, 2021. 19. Society of Health and Physical Educators. A-Z of social justice physical education. Available at: https://www.shapeamerica.org/uploads/pdfs/2020/publications/joperd/The-A%E2%80%93Z-of-Social%20Justice-Physical-Education-P1.pdf. Accessed October 20, 2021.  20. Community Preventive Services Task Force. Annual report to Congress: 2013. Available at: https://www.thecommunityguide.org/content/tffrs-physical-activity-interventions-increase-active-travel-school. Accessed October 20, 2021. 21. Lonsdale C, Rosenkranz R, Peralta L, et al. A systematic review and meta-analysis of interventions designed to increase moderate-to-vigorous physical activity in school physical activity lessons. Prev Med. 2013;56:152–161. 22. Zhou Y, Wang L. (2019). Correlates of physical activity of students in secondary school physical education: a systematic review of literature. BioMed Res Int. 2019;2019:4563484.   23. U.S. Department of Health and Human Services. Healthy People 2030 physical activity objectives. Available at: https://health.gov/healthypeople/objectives-and-data/browse-objectives/physical-activity. Accessed October 20, 2021. 24. Hollis JL, Sutherland R, Williams AJ, et al. A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in secondary school physical education lessons. Int J Behav Nutr Phys Act. 2017;14(1):52.   25. Fairclough SJ, Stratton G. A review of physical activity levels during elementary school physical education. J Teach Phys Educ. 2006;25(2):240–258.   26. Powell E, Woodfield LA, Nevill AM, Powell AJ, Myers TD. ‘We have to wait in a queue for our turn quite a bit’: examining children’s physical activity during primary physical education lessons. Euro Phys Educ Rev. 2019;25(4):929–948. 27. Society of Health and Physical Educators. National PE standards. Available at: https://www.shapeamerica.org/standards/pe/. Accessed October 20, 2021.  28. United Nations Educational, Scientific and Cultural Organization. Guidelines for policy makers: quality physical education. Available at: https://en.unesco.org/inclusivepolicylab/sites/default/files/learning/document/2017/1/231101E.pdf. Accessed October 20, 2021. 29. Haughton J, Ayala G, Burke K, Elder J, Montanez J, Arrendondo E. Community health workers promoting physical activity. J Ambul Care Manage. 2015;38(4):309–320. 30. Hovell MF, Mulvihill MM, Buono MJ, et al. Culturally tailored aerobic exercise intervention for low-income Latinas. Am J Health Promotion. 2008;22(3):155–163. 31. Falbe J, Cadiz AA, Tantoco NK, Thompson HR, Madsen KA. Active and healthy families: a randomized controlled trial of a culturally tailored obesity intervention for Latino children. Acad Pediatr. 2015;15(4):386–395.   32. Joo JY, Liu MF. Culturally tailored interventions for ethnic minorities: A scoping review. Nurs Open. 2021;8(5):2078–2090. 33. APENS. Adapted Physical Education National Standards. Available at: https://apens.org/national_standard.html. Accessed October 20, 2021. 34. Centers for Disease Control and Prevention. The association between school based physical activity, including physical education, and academic performance. Available at: https://www.cdc.gov/healthyyouth/health_and_academics/pdf/pa-pe_paper.pdf. Accessed October 20, 2021.  35. World Health Organization. School policy framework: implementation of the WHO global strategy on diet, physical activity and health. Available at: https://www.who.int/dietphysicalactivity/SPF-en-2008.pdf. Accessed October 20, 2021.  36. Mayorga-Vega D, Saldias MP, Viciana J. Comparison of moderate-to-vigorous physical activity levels between physical education, school recess and after-school time in secondary school students: an accelerometer-based study. Kinesiology. 2017;49(2):242–251.   37. U.S. Department of Health and Human Services. Healthy People 2020. Physical activity objectives. Available at: https://www.healthypeople.gov/2020/topics-objectives/topic/physical-activity/objectives. Accessed October 20, 2021.  38. Community Guide. Physical activity: interventions to increase active travel to school. Available at: https://www.thecommunityguide.org/content/tffrs-physical-activity-interventions-increase-active-travel-school. Accessed October 20, 2021.  39. Centers for Disease Control and Prevention and Society of Health and Physical Educators. Strategies for recess in schools. Available at: https://www.shapeamerica.org/uploads/pdfs/recess/SchoolRecessStrategies.pdf. Accessed October 20, 2021.  40. Centers for Disease Control and Prevention. Strategies for classroom physical activity in schools. Available at: https://www.cdc.gov/healthyschools/physicalactivity/pdf/classroompastrategies_508.pdf. Accessed October 20, 2021. 41. Zavacky F, Michael SL. Keeping recess in schools. J Phys Educ Recreation Dance. 2017;88(5):46–53.   42. Bedard C, St. John L, Bremer E, Graham JD, Cairney J. A systematic review and meta-analysis on the effects of physically active classrooms on educational and enjoyment outcomes in school age children. PLoS One. 2019;14(6):1–19.

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Why PE matters for student academics and wellness right now

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This story about PE teachers was produced by The Hechinger Report , a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for Hechinger’s newsletter .

Amanda Amtmanis, an elementary physical education instructor in Middletown, Connecticut, handed out cards with QR codes to a class of third graders, and told them to start running.

The kids sprinted off around the baseball field in a light drizzle, but by the end of the first lap, a fifth of a mile, many were winded and walking. They paused to scan the cards, which track their mileage, on their teacher’s iPad and got some encouragement from an electronic coach — “Way to run your socks off!” or “Leave it all on the track!”

A boy in a red Nike shirt surged ahead, telling Amtmanis his goal was to run 5 miles. “Whoa, look at Dominic!” another boy exclaimed.

“We don’t need to compare ourselves to others,” Amtmanis reminded him.

The third graders finished a third lap, alternating running and walking, and were about to start on a scavenger hunt when the rain picked up, forcing them inside. Amtmanis thanked her students for their willingness to adjust — a skill many of them have practiced far more often than running these past 18 months.

The full impact of the pandemic on kids’ health and fitness won’t be known for some time. But it’s already caused at least a short-term spike in childhood obesity Rates of overweight and obesity in 5- through 11-year-olds rose nearly 10 percentage points in the first few months of 2020.

Amtmanis’ “mileage club,” which tracks students’ running, both in and out of school, and rewards them with Pokémon cards when they hit certain targets, is an example of how PE teachers around the country are trying to get kids back in shape.

But inclement weather isn’t the only thing PE teachers are up against as they confront what might be called “physical learning loss.” Physical education as a discipline has long fought to be taken as seriously as its academic counterparts. Even before the pandemic, fewer than half the states set any minimum amount of time for students to participate in physical education, according to the Society of Health and Physical Educators (SHAPE), which represents PE and health instructors.

Now, as schools scramble to help kids catch up academically, there are signs that PE is taking a back seat to the core subjects yet again. In some California schools, administrators are shifting instructional minutes from PE to academic subjects — or canceling class altogether so PE teachers can sub for classroom teachers; in others, they’re growing class sizes in the gym, so they can shrink them in the classroom.

Meanwhile, innovative instructors like Amtmanis, who has worked in her district for more than 20 years, are struggling to get their ideas off the ground. Over the summer, the principal of Macdonough Elementary, one of two schools where Amtmanis teaches, approved her request to participate in another running program called The Daily Mile, in which kids walk or run 15 minutes a day during school hours.

Daily running breaks “boost attentiveness, which has positive effects on academics,” Amtmanis argued.

But two weeks into the school year, not a single teacher had bought into the idea.

“The issue is their packed schedule,” Amtmanis said.

Last year, many schools conducted gym class remotely, with students joining in from their bedrooms and living rooms.

The online format presented several challenges. Many students lacked the equipment, space, or parental support to participate fully. And many instructors grappled with how to teach and assess motor skills and teamwork online.

Though instructors found creative ways to keep students moving — substituting rolled-up socks for balls, and “disguising fitness” in scavenger hunts and beat-the-teacher challenges — they still fretted that online gym wasn’t giving students the same benefits as in-person classes.

Compounding their concern was the fact that many students were also missing out on recess and extracurricular sports.

In a March 2021 survey conducted by the Cooper Institute, maker of the popular FitnessGram assessments, close to half the PE teachers and school and district administrators responding said their students were “significantly less” physically active during their schools’ closure than before it.

Schools that reopened last year faced their own set of challenges, including bans on shared equipment that made even a simple game of catch impossible. Schools that were open for in-person learning were also much more likely to cut back on PE instructional time, or eliminate it altogether, the survey found.

The consequences of these reductions in physical activity are hard to quantify, especially since many schools suspended fitness testing during the pandemic and have yet to resume it, but some PE teachers say they’re seeing more kids with locomotor delays and weaker stamina than normal.

“The second graders are like first graders, and some are even like kindergarteners,” said Robin Richardson, an elementary PE instructor in Kentucky. They can jump and hop, she said, but they can’t leap. They’re exhausted after 20 seconds of jumping jacks.

An unusually high number of Richardson’s first graders can’t skip or do windmills. Some lack the spatial awareness that’s essential to group games.

“They don’t know how to move without running into each other,” she said.

Other instructors are seeing an increase in cognitive issues, such as difficulty paying attention or following directions, particularly among kids who remained remote for most or all of last year.

Kyle Bragg, an elementary PE instructor in Arizona, has seen kids sitting with their backs to him, staring off into space when he’s talking. “I say ‘Knees, please,’ so they spin around to face me,” he said.

And some PE teachers say their students’ social-emotional skills have suffered more than their gross motor skills. “They forgot how to share; how to be nice to each other; how to relate to each other,” said Donn Tobin, an elementary PE instructor in New York.

PE has a key role to play in boosting those skills, which affect how kids interact in other classes, said Will Potter, an elementary PE teacher in California.

“We’re uniquely situated to handle the social-emotional needs that came out of the pandemic, in a way classroom teachers are not,” Potter said.

Amtmanis, for her part, worries about her students’ mental health. She sees the little signs of strain daily — the kid who got upset because he couldn’t pick his group, for example, and the one who was distressed that his Mileage Club card had gotten mixed up in the front office.

“Their emotional reserves are low,” she said.

Yet not all instructors are reporting drops in their students’ fitness and skill development. Teachers in some middle- and upper-income districts said they haven’t noticed much of a change at all. In some communities, families seemed to spend more time outdoors.

“We saw the skyrocketing sale of bicycles, we saw families going for walks,” said Dianne Wilson-Graham, executive director of the California Physical Education and Health Project.

But in Title I schools like Macdonough, where more than half the students are low-income, some kids didn’t even have access to a safe place to exercise or play during school closures.

“Not only are they not in soccer leagues, but sometimes they don’t even have a park,” Amtmanis said.

Amtmanis came up with the idea of doing the Daily Mile after spring fitness tests revealed drops in her students’ strength, flexibility and endurance.

But many schools still aren’t sure how much physical learning loss their students have experienced as a result of the pandemic. Most schools pressed pause on fitness testing last year, and some elementary-school instructors are reluctant to restart it. They say the tests aren’t valid with young children, even in ordinary times, and argue the time they take could be better spent on Covid catch-up.

Andjelka Pavlovic, director of research and education for the Cooper Institute, said its tests are scientifically proven to be valid for students who are 10 and up, or roughly starting in fourth grade.

Fitness testing requirements vary by state, county or even district. Some states specify how often students must be tested; others leave it largely to the teacher.

Bragg, the Arizona teacher, said he has put testing “on the backburner” because “right now it’s not at the forefront of what’s important.”

Richardson said she is avoiding testing because she doesn’t want to use up precious instructional time or demoralize her students. “I want my kids to enjoy movement,” she said. If they perform poorly on the tests, “they may not feel as strong.”

In Connecticut, where schools are required to test fourth graders’ fitness annually, Amtmanis approached testing cautiously last year. She didn’t want to embarrass her students, so she made it into a series of games.

Instead of Sit-and-Reach, they had a “flexibility contest,” in which kids broke into teams for tag then had to perform stretches if they were tagged. She measured the distances stretched with curling ribbon, tied the ribbons together, and attached a balloon to the end. The team whose balloon soared the highest won fidget putty.

Pushups became a Bingo game, with the center space representing pushups.

“My goal was to get through it without ever using the words ‘fitness” or ‘testing,’” she said.

As the pandemic drags on, some instructors are taking a similar approach to fitness remediation and acceleration.

Bragg likes a warmup called “ Touch Spots ,” in which first graders listen as the instructor reads off the name of a color, then run and touch a corresponding dot on the floor. It works on reaction time, cardiovascular endurance, spatial awareness and sequencing — but the kids don’t know that.

“Students are having so much fun that they don’t realize how much fitness they are doing,” Bragg said.

Differentiation — tailoring instruction to meet individual students’ needs — has become even more essential, with former remote learners often lagging behind their in-person peers, Bragg said.

When playing catch, for example, he offers his students different sized balls — the smaller ones are more challenging.

Potter, the California teacher, spent the first two weeks of school teaching his students how to connect with their partners, stressing the importance of eye contact and body language.

“When you’re on Zoom, you look at the camera to make eye contact,” he said. “It’s a very different environment.”

Bragg reminds his students how to include kids who are standing on the sidelines, modeling excited body language and tone of voice. Lately, he’s noticed that kids who were remote last year are being excluded from groups.

“Social interaction needs to be practiced, just like how to throw a ball,” he said.

Richardson, the Kentucky PE teacher, is trying to build up her students’ stamina gradually, through progressively longer intervals of exercise.

But she works in a school with pods, so she sees each group of kids for five consecutive days, every third week. The two weeks in between, she has to hope that teachers will provide recess and “movement breaks.” She’s trying to get them to give kids breaks “when they get glassy-eyed and frustrated.”

Recently, Richardson was at a staff training session at which depleted teachers were “popping candy in the back.” When she raised her hand and requested a break in the training, her colleagues cheered. She told them to remember how they felt when their students return to the building.

“I always say, ‘If your bum is numb, your brain is the same,’” she said.

Convincing classroom teachers to set aside more time for movement can be challenging, though. As students return from months of online learning, teachers are under enormous pressure to get them caught up academically.

Kate Cox, an elementary and middle-school PE teacher in California, wishes schools would “realize what they’re missing when they cut PE because of learning loss in other areas.” Physical education is “readying their minds and bodies to be more successful in other areas,” Cox said.

Terri Drain, the president of SHAPE, argued that schools fail students when they treat physical learning loss as less serious than its academic counterpart.

“In the primary grades, children develop fundamental motor skills, such as throwing, catching, running, kicking and jumping,” she said. Unless schools commit to helping kids catch up, “the impacts of this ‘missed learning’ will be lifelong.”

In Connecticut, Amtmanis hasn’t given up on convincing teachers to carve out time for the Daily Mile. She recently sent them a list of suggestions on how to fit 15 minutes of running into the day, including by incorporating it as an active transition between academic blocks.

“While it may seem like there aren’t minutes to spare,” she wrote, “the energizing effect of the active transition should result in more on-task behavior and more efficient working.”

In the meantime, Amtmanis plans to keep using the mileage club to motivate her students to run and to monitor their progress.

“I don’t want to call attention to the fact that not everyone is fit,” she said. “This is an unobtrusive way to keep the data.”

Kids need physical education – even when they can’t get it at school

College of Education Associate Dean for Research and Innovation and Professor of Physical Education, University of South Carolina

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When I noticed my 12-year-old son was spending about seven hours a day doing his school work online due to the COVID-19 pandemic, I immediately became concerned. As a researcher who focuses on how to get kids to be more physically active , I knew my son and his classmates were spending too much time sedentary.

Being physically active is good for everyone’s physical and mental health, including children of all ages and abilities.

Kids who are more physically active tend to get better grades and develop the self-confidence that can empower them to succeed later in life.

For people with disabilities, physical activity can help them gain independence .

A summer slide in physical activity

The arrival of summer vacation might allay concerns parents have about their children being too sedentary. I remember summer vacation as a welcome break from sitting in school and being stuck indoors. However, the reverse may be true for many kids today.

In the U.S., a study of 18,170 young children found that the share of children who were obese rose from 8.9% to 11.5% between kindergarten and second grade. The increase generally occurred over the summer, not when kids were in school.

Researchers think a lack of structured summertime activities can cause kids to make unhealthy choices. This idea is bolstered by a review of 37 studies that found children were less active on weekends than on school days, and research showing that kids spend more time using screens in the summer than during the school year.

One hour a day – an elusive goal

The Department of Health and Human Services recommends that school-aged children and adolescents spend at least a total of one hour each day running, biking or doing another physical activity. Yet, according to the Centers for Disease Control and Prevention , about 1 in 4 kids between the ages of 6 and 17 were meeting that recommendation prior to the pandemic.

Even children who participate in organized sports may not be obtaining the prescribed 60 minutes of activity per day. One study found that children in flag football leagues spent only 20 minutes exercising during team practices. This finding is fairly consistent across other sports, such as soccer and basketball , where no more than about half of practice time was spent exercising.

The level of physical activity plummets when kids reach middle school, and it doesn’t make much of a difference whether they’re on teams or not. A study in San Diego found that kids between 11 and 14 years old spent a total of seven minutes less on physical activity , as compared to children between 7 and 10 years old, during sport practices.

Meanwhile, children and adolescents spend as much as eight hours daily doing things like watching TV, using smartphones and playing video games.

School physical education – the pill not taken

When it comes to promoting physical activity, researchers have referred to physical education as “ the pill not taken .” Currently, only Oregon and the District of Columbia have policies that require schools to provide the nationally recommended amount of time for PE – 150 minutes weekly for elementary grades and 225 minutes for middle and high school students. Also, more than half of the states have loopholes that let high school students skip PE.

Overall, most school systems weren’t doing enough to keep kids fit before COVID-19 ushered in months of makeshift remote learning. The CDC gave schools a grade of D- for their efforts on that front.

In short, the vast majority of kids need to spend more time being active both in school and at home. Additional time spent in PE class increases students’ ability to learn the skills to stay active as adults.

What kids need from PE

Physical education provides kids with more than just exercise, which is why activities like marching band and even team sports are, in my view, a poor substitute.

In elementary school, PE should mainly support the development of fundamental motor skills, such as jumping, kicking, throwing and catching, which are essential for a wide range of activities, such as most team sports, dance and gymnastics. Children who have mastered these skills are more physically active than those who haven’t.

Middle and high school PE programs should focus on keeping kids motivated to stay active. Because adolescents are more motivated to be physically active when they feel like they’re in control of their learning, giving them a say in terms of what they do matters. Since different kids have different interests, the PE curriculum should span not only team sports, but also activities that require fewer participants, such as tennis and golf.

Students at all levels of instruction should have opportunities to develop their physical fitness , especially their aerobic endurance, muscular strength and flexibility.

What parents can do

Dozens, maybe hundreds, of online resources are devoted to keeping kids active and fit when they aren’t in school. However, I’ve found that few are backed by research and that most were not developed by professional PE educators.

Rather than scour the internet for ideas, parents of elementary students should play games with their children that incorporate fundamental motor skills. Throwing and catching a beanbag, striking a balloon with a paddle and kicking a ball are all helpful.

Encouraging children to dance and do some basic tumbling will help them improve their balance .

Parents of middle and high school students should encourage their kids to try activities they might enjoy and continue into adulthood, such as running, hiking, biking and – when facilities are available – racquetball. Try to encourage them by participating yourself and being a physically active role model.

Whenever possible, parents should support their children’s activity interests by assisting with transportation, buying equipment and planning family outings to parks and local events like fun runs.

Parents should also help their children learn to track and manage their personal fitness. Wearable fitness trackers like Fitbits are a helpful tool. Kids can use these to set daily step goals and monitor progress.

Families also can regularly try new activities that make fitness fun. For example, to work on aerobic endurance, try jumping rope or dancing. Instead of using weights to build muscular strength, go kayaking or rock climbing, or use resistance bands at home. Yoga, pilates and tai chi are great for developing flexibility.

Just remember this: Physical activity is a behavior and physical fitness is a condition. Neither are synonymous with physical education but a good PE program will help bring about both.

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Attitudes of High School Students toward Physical Education and Their Sport Activity Preferences

Problem statement: Identifying and understanding correlates of school children’s physical education activity participation are critical to promoting current and lifelong physical activity participation of children. Among other factors, children’s attitudes are considered to be a key element influencing physical activity participation. Children who have more positive attitudes toward physical activity are reported to be more likely to participate in physical activity outside of school and demonstrate higher physical activity amounts than those with less positive attitudes. Fostering children’s positive attitudes toward physical activity would be conducive to the promotion of current and lifelong physical activity participation of children. Aims at to examine high school students’ attitudes toward Physical Education Activity (ATPEA) and their sports activities preferences. Approach: Participants were 1,317 students in grades 9-12th (603 boys and 714 girls) from five urban public school districts. The Physical Education Activity Attitude Scale (PEAAS) adapted version was employed for data collection. One-way ANOVA revealed that the five highest scores were Items 2, 16, 11, 18 and 5 on the PEAAS. Results: The overall mean score (70.160±3.948) indicated positive ATPEA for the participants. The independent group ANOVAs identified significant (p Conclusion: The current ATPEA status of the participants appears to be positive. There are some crucial factors that structure the participants’ ATPEA. These factors are related to students’ perception, benefit, care and value about physical education programs and sports activities. 

How to Cite: Zeng, H. Z., Hipscher, M. & Leung, R. W. (2011). Attitudes of High School Students toward Physical Education and Their Sport Activity Preferences. Journal of Social Sciences , 7 (4), 529-537. https://doi.org/10.3844/jssp.2011.529.537

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• value of program
• aerobic exercise
• Physical Education (PE)
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• Attitudes Toward Physical Education Activity (ATPEA)

Promotion of Physical Activity and Health in the School Setting

• © 2024
• Antonio García-Hermoso   ORCID: https://orcid.org/0000-0002-1397-7182 0

Navarrabiomed, Hospital Universitario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain

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• Discusses new approaches to promote physical activity and sports in the school environment
• Presents activities to help children feel strong and enjoy lifelong physical activity
• Shows how to plan, implement, evaluate and monitor the promotion of physical activity of school children and adolescents

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About this book

This book is the first-known contributed volume focused exclusively on physical activity in the school setting. It describes the importance of regular physical activity for all preschoolers, children and adolescents, which contributes to preventing concerning public health problems such as childhood obesity and physical inactivity. 

Children and adolescents spend more time in school than anywhere else other than the home, making schools an excellent setting in which to offer quality physical activity education and possibilities for an active school day. Physical activity is associated with physiological, physical, and mental health benefits. School-based physical activity initiatives can also positively impact learning and classroom behavior. 

This book comprehensively reviews the latest research on physical activity and health in the school setting, presenting different perspectives from prestigious international authors representing 12 countries and involving 40 different researchers. It provides an in-depth description on how the school environment can be used to develop, implement, and evaluate strategies that promote physical activity and reduce sedentary behavior among these populations according to the educational stage (i.e., pre-primary, primary and secondary school). It also details how to implement each individual initiative based on successful investigations and how to plan, implement and evaluate a school policy. By implementing these strategies, schools can help create a culture of physical activity that promotes healthy habits and reduces the risk of chronic diseases.

The volume's 16 chapters are organized in three parts, providing an overview of current knowledge. The authors discuss advances in theory and research and demonstrate how they are using that evidence to improve professional practice and collaborate with families. 

• Part I: Movement Guidelines and Recommendations
• Part II: Monitoring and Evaluation in School Settings
• Part III: Physical Activity During School Hours

Promotion of Physical Activity and Health in the School Setting makes an important contribution to the youth physical activity field for scholars and practitioners. The book is essential reading for advanced students, researchers, practitioners, and policy-makers with an interest in physical activity, youth sport, public health, physical education, or child and adolescent development and education.

• Physical activity and sports in schools
• Healthy schools
• Active school evaluation
• HIIT (high-intensity interval training programs) at schools
• Health-related physical fitness assessment in schools
• Active travel to and from school
• Multi-component school-based physical activity programs
• Muscle-strengthening activities at schools
• Health promotion in the school setting
• School fitness tests
• Recess and recreation time
• Commuting to school
• Physical activity and health guidelines and recommendations
• School-aged children and adolescents
• Motor skill assessment
• Physical literacy assessment
• Active classrooms in school curricula
• Inclusive physical activity for youth with special needs
• Active school activities and breaks
• Active learning

Table of contents (16 chapters)

Front matter, movement guidelines and recommendations, physical activity and sedentary behavior in children and adolescents: recommendations and health impacts.

• Yang Liu, Danqing Zhang, Youzhi Ke, Yiping Yan, Yangyang Shen, Zhenghan Wang

Twenty-Four-Hour Movement Behaviors for School-Aged Children and Adolescents

• José Francisco López-Gil

Assessment and Evaluation of Physical Health and Skills in School Settings

Physical literacy assessment: a conceptualization and tools.

• Andreas Fröberg, Suzanne Lundvall

Assessment of Physical Activity in Children and Adolescents

• Jairo H. Migueles, Patricio Solis-Urra

Health-Related Physical Fitness Assessment in School Settings

• Kai Zhang, Cristina Cadenas-Sanchez, Brooklyn Fraser, Justin J. Lang

Motor Skill Assessment in Children and Adolescents

• Nadia Cristina Valentini

Physical Activity During School Hours

Physical activity and health through physical education.

• Adrià Muntaner-Mas

Active Travel to and from School

• Adilson Marques, Tiago Ribeiro, Miguel Peralta

Physical Activity Opportunities During School Recess

Antonio García-Hermoso

Active Classrooms in School Curricula and Active Breaks

• Abel Ruiz-Hermosa, David Sánchez-Oliva, Mairena Sánchez-López

Multicomponent School-Based Physical Activity Programs

• Collin A. Webster

School-Based Before-School Physical Activity Programs

• Michalis Stylianou, James Woodforde

School-Based After-School Physical Activity and Sports Programs

• Hyungsik Min, Donetta Cothran, Pamela Hodges Kulinna

Integrating High-Intensity Interval Training (HIIT) into the School Setting: Benefits, Criticisms, and Recommendations

• Angus A. Leahy, Jordan J. Smith, Narelle Eather, Nigel Harris, David R. Lubans

How Can Muscle-Strengthening Activities Be Promoted in School Settings?

Inclusive physical activity practices for disabled children and adolescents.

• Thi Nancy Huynh, Justin Haegele, Maeghan E. James, Kelly P. Arbour-Nicitopoulos

Editors and Affiliations

About the editor.

Antonio García-Hermoso, PhD, MSc , is a native of Plasencia, Spain, and a graduate of the University of Extremadura, Spain. Since 2019, Dr. García-Hermoso has been a member of the Navarrabiomed Research Center in Pamplona, Spain, where he serves as the head of the Physical Activity, Children, and Youth Unit. This unit is dedicated to analyzing the impact of exercise and physical activity on the physical and mental health of both ill and apparently healthy young people.

Dr. García-Hermoso has contributed to over 300 publications in peer-reviewed and PubMed-listed journals. He is a member of several international professional societies and serves on the editorial boards of Translational Pediatrics journal and The Scandinavian Journal of Medicine & Science in Sports .

Bibliographic Information

Book Title : Promotion of Physical Activity and Health in the School Setting

Editors : Antonio García-Hermoso

DOI : https://doi.org/10.1007/978-3-031-65595-1

Publisher : Springer Cham

eBook Packages : Medicine , Medicine (R0)

Copyright Information : The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2024

Hardcover ISBN : 978-3-031-65594-4 Published: 25 August 2024

Softcover ISBN : 978-3-031-65597-5 Due: 08 September 2025

eBook ISBN : 978-3-031-65595-1 Published: 24 August 2024

Edition Number : 1

Number of Pages : XV, 387

Number of Illustrations : 1 b/w illustrations, 18 illustrations in colour

Topics : Health Promotion and Disease Prevention , Sport Education and Didactics , Sport Science , Health Policy , Education, general

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Impact of extracurricular physical activity on achievement of the sustainable development goals and academic performance: mediating cognitive, psychological, and social factors.

1. Introduction

2. materials and methods, 2.1. search strategy and quality assessment of studies, 2.2. study selection criteria, 2.3. data extraction, quality assessment, 3.1. study selection, 3.2. quality assessment, 3.3. characteristics of the included studies, 3.4. physical activity and academic achievement results, 4. discussion, 4.1. key findings and sdg implications, 4.2. limitations and future research, 5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

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Zarazaga-Peláez, J.; Barrachina, V.; Gutiérrez-Logroño, A.; Villanueva-Guerrero, O.; Roso-Moliner, A.; Mainer-Pardos, E. Impact of Extracurricular Physical Activity on Achievement of the Sustainable Development Goals and Academic Performance: Mediating Cognitive, Psychological, and Social Factors. Sustainability 2024 , 16 , 7238. https://doi.org/10.3390/su16167238

Zarazaga-Peláez J, Barrachina V, Gutiérrez-Logroño A, Villanueva-Guerrero O, Roso-Moliner A, Mainer-Pardos E. Impact of Extracurricular Physical Activity on Achievement of the Sustainable Development Goals and Academic Performance: Mediating Cognitive, Psychological, and Social Factors. Sustainability . 2024; 16(16):7238. https://doi.org/10.3390/su16167238

Zarazaga-Peláez, Jorge, Valentina Barrachina, Alejandra Gutiérrez-Logroño, Oscar Villanueva-Guerrero, Alberto Roso-Moliner, and Elena Mainer-Pardos. 2024. "Impact of Extracurricular Physical Activity on Achievement of the Sustainable Development Goals and Academic Performance: Mediating Cognitive, Psychological, and Social Factors" Sustainability 16, no. 16: 7238. https://doi.org/10.3390/su16167238

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Study shows physical education teachers influence students' attitudes about physical activity later in life

Thu, 09/07/2023.

Mike Krings

LAWRENCE — Everyone who has gone through high school probably remembers gym class, for better or worse, and the influence their teachers had on the class environment.

A study from the University of Kansas shows that physical education teachers greatly influence students’ perception of the class and its purpose and also influence how likely they are to remain physically active later in life.

Research has long shown that as students get older, their physical activity level drops. Thus, high school can be the last chance to encourage students to be physically active and encourage a healthy lifestyle.

The current study found that physical education teachers greatly influence how students perceive the class, its purpose and that the teachers’ style influences whether they enjoy physical activity. Thus, teachers should focus on providing a positive, fun experience in PE classes instead of simply having students compete or complete rote physical tasks, students indicated.

“My thing is always, ‘Let’s ask the students.’ We should be shaping physical education around what they want and need, along with what we want to be teaching content-wise to our students,” said Ken Murfay, assistant teaching professor of health, sport & exercise science at KU and lead author of the study. “The more we can give PE meaning for students, the better it will be long-term. Students want it to be both fun and meaningful.”

Study authors conducted focus group interviews with 25 students entering high school. The school was chosen because its primary physical education teacher had a reputation as an effective educator and students entered the school via a lottery system, ensuring a diverse cross section of participants. The results showed the students understood the purpose of physical education was to provide them a time to be physically active and teach them ways they could continue to have activity throughout their lives.

To that theme, the students indicated they preferred a variety of activities to an overemphasis on certain sports or to simply understand the rules or scoring of a particular sport, such as basketball.

Students also indicated they felt PE should be a fun experience to be meaningful. Those who reported enjoying the class also indicated the class had purpose and taught them ways to be active. Those who had negative experiences reported the class was simply a way to take up an hour of their school day or that they were instructed to move with little guidance or had an overemphasis placed on competition.

Perhaps the most significant theme was that students reported the influence the teacher had on their experience. A teacher’s style and the experiences they designed and provided largely shaped how students viewed the class, the sport or activity they were taking part in and their attitudes toward activity itself.

“Definitely a noticeable effect if you have a strict hardcore gym teacher who’s like, ‘You have to do this perfectly.’ It’s going to make the gym experience less enjoyable, and then you’re going to probably not really try to stay as active because now you have a negative experience in that field,” one student said. “You’re like, ‘I don’t really feel like doing this anymore.’ And especially in gym class when you have to be there for an hour and it’s required. You have no way out of it. You have a teacher that’s just yelling at you all day, like commands and stuff. It definitely changes the experience entirely.”

Murfay and colleagues examine physical education through social cognitive theory. The theory holds that human thoughts and actions are based on personal, behavioral and environmental factors. PE as taught in school is an environmental factor that can influence personal factors like self-efficacy. Teachers’ social persuasion through words and actions can also influence student perceptions of physical education and activity, and the curriculum they choose to implement — whether only team sports or a variety of activities — can shape how students view physical activity throughout life.

The study, published in the journal European Physical Education Review, was co-written with Aaron Beighle, Heather Erwin and Erin Aiello of the University of Kentucky.

Previous research has shown perceptions of PE are mixed, with negative attitudes increasing with age. A better understanding of the role teachers play in those perceptions can both help improve the experience for students at a crucial time in their lives and educations as well as encourage teachers to use more effective approaches. Results showing students prefer a fun, positively motivating experience with a variety of activity options can help encourage better PE curriculum, Murfay said.

A former K-8 physical education teacher, he said the goal of his research is to continually improve physical education, as studies have shown physical activity has a wide range of benefits throughout life, both physical and mental. As physical education can often be overlooked or its importance not fully understood, illustrating the importance of good PE teachers as crucial.

“How a teacher frames physical education is very important in how the student interprets it,” he said. “The environment a teacher creates affects how they view activity and sport in general, and perceptions are influenced by experience. If they get a teacher who is passionate and lets students control their physical activity, it can make a big difference.”

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• Published: 26 August 2024

The effect of physical activity on the subjective well-being of rural left-behind children: the mediating role of discrimination perceptions and loneliness

• Fazhao Feng 1   na1 ,
• Huanyu Li 1 &
• Ting Zhang 2   na1  

BMC Psychology volume  12 , Article number:  455 ( 2024 ) Cite this article

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This study explored the mediating role of perceptions of discrimination and loneliness on the relationship between physical exercise and subjective well-being in rural left-behind children.

A package of surveys were administered to junior high school students and senior primary school students ( n  = 592) in the countryside, which including the scale of the Physical Activity Behavior Scale , Subjective Well-Being Scale , Perceived Discrimination Scale , and Loneliness Scale. Structural Equation Modeling and Bootstrap were used to analyze the data to investigate the chain mediating effect of perceived discrimination and loneliness.

(1) There was a positive correlation between physical activity and subjective well-being, and the direct prediction of subjective well-being was significant. (2) Physical activity negatively predicted perceptions of discrimination, and perceptions of discrimination positively predicted loneliness and negatively predicted subjective well-being, and loneliness could negatively predict subjective well-being. (3) Perception of discrimination and loneliness significantly mediated the relationship between physical activity and subjective well-being. The mediating effect consisted of indirect effects generated by 2 paths, one was that physical exercise indirectly affected subjective well-being by affecting discrimination perception, and the other was that physical exercise further acted on subjective well-being through the chain mediating effect from discrimination perception to loneliness.

Physical exercise can directly affect the subjective well-being of rural left-behind children. Physical exercise can indirectly affect left-behind children’s subjective well-being through discrimination perceptions, and it can also indirectly affect left-behind children’s subjective well-being through the chain mediating effect of discrimination perceptions and loneliness.

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Introduction

The problem of left-behind children has been in the public eye in recent years. In recent years, with the advancement of reform and opening up in China, urbanization has been accelerating in many places, with a large number of rural laborers flowing into the cities, but due to a series of practical problems, such as labor treatment, family economic situation, and family choices, a large number of children of migrant workers are forced to stay in the countryside [ 1 ]. Some studies have shown that left-behind children are significantly lower than non-left-behind children in terms of satisfaction with family, schooling, freedom, environment, and overall life satisfaction [ 2 ]. In terms of emotional experience, some studies have shown that left-behind children experience more negative emotions compared to the average student [ 3 ]. Therefore, it is of theoretical and practical significance to explore the influencing factors and mechanisms of left-behind children’s subjective well-being and then to adopt effective strategies to improve their subjective well-being, to help left-behind children cope with stressful events in their lives and maintain their psychological health.

Among the many factors affecting subjective well-being, physical exercise, as a common activity of leisure and recreation in modern society, can produce many positive psychological benefits, and its impact on subjective well-being has attracted much attention from scholars [ 4 ]. However, there are few studies at home and abroad on whether the subjective well-being of left-behind children can be regulated by physical exercise. Based on the psychological problems of left-behind children, this paper focuses on explaining how physical exercise regulates the negative emotions of left-behind children and improves their subjective well-being at the same time, to provide ideas for improving the well-being of left-behind children.

The definition of left-behind children has been explained by many scholars and relevant State departments. In 2014, the Ministry of Education of China issued the 2014 National Education Development Statistics Bulletin, which pointed out that rural left-behind children refer to children of school age who are under the custody of their fathers, mothers, or other relatives, who are left behind in their hometowns, where their parents have gone out to work for more than three consecutive months, and who are under the supervision of their fathers, mothers or other relatives, and who are subjected to compulsory education [ 5 ]. China’s State Council pointed out in the Opinions on Strengthening the Care and Protection of Rural Left-behind Children that left-behind children refer to minors under the age of sixteen who are not capable of being supervised by both of their parents going out to work or by one of the parents going out to work [ 6 ]. Therefore, the definition of left-behind children in rural areas in this paper is: in the compulsory education stage of adolescents in rural areas, because one or both parents go out to work and are left behind in the rural household registration area, the time left behind is more than three consecutive months, and children under the age of sixteen years old are raised and educated by a single parent or relatives.

Subjective well-being is a holistic assessment of the assessor’s quality of life based on self-defined criteria, which is a comprehensive psychological indicator of the quality of life of an individual, reflecting the subject’s social functioning and adaptive state [ 7 ], and at the same time, subjective well-being is also a cognitively and emotionally subjective evaluation of an individual’s own life [ 8 ]. As the recipients of rural education, the subjective well-being of rural left-behind children is an important factor in promoting rural construction as well as stabilizing urban and rural development. Since subjective well-being is not only genetically controlled but also depends largely on an individual’s choice of meaningful activities, choosing meaningful activities regularly is important for “pursuing” and “maintaining” long-term subjective well-being [ 9 ]. Currently, there is less literature that directly describes the extent and percentage of Chinese adolescents’ overall subjective well-being. Most studies have concluded that Chinese adolescents’ subjective well-being is high overall, but there are significant regional and individual differences. For example, adolescents in the eastern region generally have higher levels of subjective well-being than those in the central and western regions, and adolescents in urban areas have higher levels of subjective well-being than those in rural areas. In addition, there are differences in subjective well-being among adolescent students of different genders, grades, and family economic statuses [ 10 ].

Physical exercise is a conscious activity in which people take the initiative to transform and improve the subject themselves, and the activities of physical exercise include fitness and bodybuilding exercise, entertainment and leisure exercise, health care and rehabilitation exercise, and psychological intelligence exercise [ 11 ]. Physical exercise can reduce the ability of negative emotions such as depression and loneliness while obtaining psychological pleasure, which in turn has an impact on subjective well-being [ 12 ]. Studies have shown that physical activity induces changes in brain structure and function, with effects on cognitive function and subjective well-being [ 13 ]. Existing studies have shown that appropriate physical activity affects subjective well-being [ 14 ], while physical activity can also affect subjective well-being through different mediating variables [ 15 ]. Physical activity was found to be positively associated with positive affect and life satisfaction [ 16 ]. Currently, studies have shown that there are obvious regional and grade-level differences in Chinese adolescents’ choice of after-school activities, daily exercise plans, homework time consumption, in-school and out-of-school time disposal, and arrangements for weekend and holiday activities, etc.; economic factors, policy factors, awareness and methods, habit formation, external conditions, and classroom pressures are constraints hindering adolescents’ participation in extracurricular physical activity; the most important factors affecting adolescents’ participation in physical activity are exercise interest, exercise motivation, different grade levels, sports awards, school sports characteristics, fitness awareness, applicability of fitness methods, and rigor of fitness tests. The most important factors affecting adolescents’ participation in physical activity are interest in exercise, motivation for exercise, different grades, sports awards, school sports characteristics, awareness of fitness, applicability of fitness methods, and rigor of physical fitness tests [ 17 ].

Accordingly, Hypothesis 1: There is a positive effect of physical activity on subjective well-being.

Some studies have shown that physical activity can increase positive emotional experiences and decrease negative emotional experiences [ 18 ], and physical activity input of secondary school students is significantly positively correlated with life satisfaction and positive emotion in subjective well-being, and significantly negatively correlated with negative emotion [ 19 ]. Discrimination perception refers to the individual or the group to which the individual or the group belongs to be treated differently or unfairly, which can be divided into individual discrimination perception and group discrimination perception [ 20 ]. Due to the lack of parental care, left-behind children are ridiculed as “unwanted children”, which leads to the perception of individual discrimination [ 21 ]; while the media’s increased exposure of some cases strengthens the public’s negative impression of them, and they are regarded as “problem children”, which leads to the perception of group discrimination. The media’s increased exposure of some cases reinforces the public’s negative impression of them as “problem children”, leading to the perception of group discrimination [ 22 ]. It has been suggested that physical activity is an adaptive coping strategy to prevent negative mental and physical health problems caused by stressful events such as discrimination [ 23 ] and that discrimination has a detrimental effect on subjective well-being [ 24 ].

Accordingly, Hypothesis 2 is proposed: discrimination perceptions play a mediating role in the positive effect of physical activity on subjective well-being.

Loneliness is the subjective experience of an individual who feels dissatisfied with social relationships and life [ 25 ]. Harris et al. found that loneliness during childhood is closely associated with sleep disorders, depression, and health problems during adolescence [ 26 ], and is accompanied by poor academic performance, high dropout rates, and high crime rates [ 27 ]. Some studies have shown that physical activity has a significant negative effect on loneliness, such as when the amount of physical activity of college students is higher, their loneliness level is lower [ 28 ], in addition, some studies have suggested that loneliness correlates with life satisfaction, such as with the increase of loneliness, life satisfaction decreases [ 29 ]; at the same time, with the decrease of positive emotional experience and the increase of negative emotions, loneliness also increases [ 30 ].

Accordingly, Hypothesis 3 is proposed: loneliness plays a mediating role in the positive effect of physical activity on subjective well-being.

There was a significant positive predictive relationship between discrimination perception and loneliness for both two-parent out-of-home adolescents and father out-of-home pro-adolescents, suggesting that the level of discrimination perception is a significant risk factor for loneliness among left-behind adolescents [ 31 ]. One study confirmed that discrimination perceptions among long-term migrant children were significantly and positively associated with loneliness, social anxiety, and depression, with discrimination having the greatest impact on loneliness [ 32 ]. Perception of discrimination is thus an important predictor of children’s loneliness, and discrimination perceptions are likely to have a detrimental effect on children’s loneliness. Therefore, hypotheses 1–3 are synthesized, and it is believed that there may be a chain mediation path of “physical exercise → discrimination perception → loneliness → subjective well-being”, and that the internal mechanism of physical exercise empowering left-behind children’s subjective well-being may be as follows: Participation in physical exercise promotes left-behind children’s elimination of discrimination, better integration into the group, and then elimination of loneliness and improvement of left-behind children’s subjective well-being. The intrinsic mechanism of improving left-behind children’s subjective well-being may be as follows: participation in physical exercise can help them eliminate discrimination, better integrate into the group, and thus eliminate their sense of loneliness.

Accordingly, Hypothesis 4 was proposed; discrimination perceptions and loneliness play a mediating role in the positive effect of physical activity on subjective well-being.

The overall purpose of this paper is to explore whether physical exercise can effectively enhance the subjective well-being of rural left-behind children and to analyze in depth the chain-mediated roles of discrimination perceptions and loneliness in this context. Theoretically, it is to find out whether left-behind children have negative psychological experiences due to discrimination and loneliness, and whether physical activity can indirectly enhance their subjective well-being by alleviating and decreasing perceptions of discrimination and loneliness. In addition, the study examines whether physical activity first affects perceptions of discrimination, then affects loneliness through perceptions of discrimination, and ultimately affects subjective well-being. From a practical point of view, targeted policy and practice recommendations are proposed to promote the active participation of rural left-behind children in physical exercise, reduce the perception of discrimination and loneliness, improve the mental health of left-behind children, and promote the development of their positive psychological qualities.

Research methods

Sample and data collection procedure.

This study used a stratified whole cluster random sampling method to survey 592 upper primary and middle school students from 2 rural general elementary schools and 1 rural general secondary school in 3 townships of Xiaogan City, Hubei Province, from December 1 to December 15, 2022, by distributing paper questionnaires. It should be noted that while the city’s resident population at the end of 2023 in Xiaogan City was 4,172,000 people, the city’s total household population at the end of 2023 was 4,973,000 people. This means that a large portion of the city’s population is working outside of the city, which is bound to result in the creation of left-behind children. At the same time, the city has 429 general elementary schools and 227 general secondary schools (including schools in the city). The student enrollment in the three schools sampled in this paper is geared towards rural children, most of whom have parents who work outside the city all year round.

A total of 592 scales were distributed and 592 were returned. Four criteria were used to eliminate invalid scales: (1) more than 20% of the questions on the paper-based scales were omitted; (2) the proportion of the same number appearing in the fill-in answers of a single scale was more than 70%; (3) Z-values were calculated between each dimension, and those with standardized values of more than ± 3 were excluded; (4) missing values were filled in using the serial mean based on the first three items, and a Pearson correlation analysis, and found that there was no significant correlation between the amount of exercise and discrimination, eliminating the regularity of answers between scales of different dimensions. In this article, left-behind children were defined as children under 16 years of age who were separated from both or one parent for more than three consecutive months when both parents went out to work, or one parent went out to work, and they were taken care of by their grandparents, relatives or friends [ 33 ]. Five hundred and ninety-two scales were recovered, and finally, 476 were scales that met the conditions of the subjects, with a total of 73 invalid scales being excluded, resulting in 403 valid scales, with an effective recovery rate of 84.66%.

Among them (Table  1 ), 205 (50.9%) were boys and 198 (49.1%) were girls; 75 (18.6%) were fifth-grade students, 76 (18.9%) were sixth-grade students, 95 (23.6%) were Middle 1 students, 80 (19.9%) were Middle 2 students, and 77 (19.1%) were Middle 3 students. The average age of the sample was 13.17 ± 1.46, the average age of the fifth grade was 11.41 ± 0.52, the average age of the sixth grade was 12.03 ± 0.33, the average age of the first grade was 13.04 ± 0.62, the average age of the second grade was 14.10 ± 0.59, and the average grade level of the third grade was 15.21 ± 0.71. It is important to note that China’s school system is one in which a child starts at age six and entering elementary school begins with a six-year school system for elementary school, a three-year school system for junior high school, and a three-year school system for senior high school.

Measurement tools

Measurement of physical activity behavior.

Subjects’ physical activity intensity, time, and frequency were investigated using the Physical Activity Rating Scale revised by [ 34 ]. Physical activity = intensity × (time-1) × frequency, intensity, time, and frequency were divided into ‘5’ grades, which were scored from 1 to 5, with a maximum score of 100 and a minimum score of 0, respectively.

Subjective well-being measurement

To evaluate subjective well-being more comprehensively, life satisfaction and positive scales were used as evaluation indicators of subjective well-being. The subjective well-being questionnaire developed by Diener et al. [ 35 ]and Bradburn’s Positive and Negative Affective Scale [ 36 ] were used, and the Chinese translations translated by Ms. Feng Xia from Central China Normal University in her master’s thesis and by Chen Wenfeng were partially selected for this study. The questionnaire included overall life satisfaction (‘5’ questions) and a positive affective scale (‘7’ questions). Life satisfaction was scored on a 7-point scale from “strongly oppose” to “strongly favor”; the positive scale was scored on a 4-point scale from “do not have” to “often have”. The positive scale was rated on a 4-point scale from “not at all” to “often”. In this study, the two scales were combined to form a first-order two-factor model for specific research analysis. The study concluded that the Cronbach’s alpha coefficient of the subjective well-being scale was 0.886, the measurement model fit X²/df = 2.718, CFI = 0.963, TLI = 0.954, RMSEA = 0.065, and SRMR = 0.037, and the structural validity of the scales was good. The factor loadings for the five questions of the Life Satisfaction Scale were 0.766, 0.782, 0.843, 0.740, 0.407; and for the Positive Affect Scale, 0.765, 0.749, 0.808, 0.704, 0.703, 0.727, 0.720. The factor loadings for life satisfaction and positive emotions were 0.770 and 0.969. Comrey (2013) argued that it is recommended to use a series of more detailed cutoffs to assess factor loading quality, specifically 0.32 (poor), 0.45 (fair), 0.55 (good), 0.63 (very good), and 0.71 (excellent) [ 37 ]. The fifth question on Life Satisfaction was in the middle of poor and fair and was not removed because it did not affect the structural validity of the CFA.

Measurement of perceived discrimination scale for left-behind children

The Perceived Discrimination Scale developed by Shen Jiliang et al. (2009) was used [ 21 ], which contained ‘six’ questions, three of which examined individual perceived discrimination and the other three examined group perceived discrimination, and was scored on a 5-point scale, with higher scores representing higher levels of perceived discrimination. Since the first three questions and the last three questions examined different perspectives, the same two dimensions constitute a first-order two-factor model way to conduct specific research. The Cronbach’s alpha coefficient of the Perceived Discrimination Scale for Left-behind Children was found to be as follows with a Cronbach’s alpha coefficient of 0.831, measurement model fit X²/df = 3.652, CFI = 0.977, TLI = 0.957, RMSEA = 0.081, SRMR = 0.027, The factor loadings for the six questions of the scale were 0.733, 0.810, 0.668, 0.825, 0.762, and 0.737. The factor loadings for individual perceived discrimination and group perceived discrimination were 0.826 and 0.819. And good structural validity of the scale.

Measurement of students’ loneliness scale

Students’ loneliness dimensions selected from the Zhang Kuo Loneliness Scale (CLS) [ 38 ] were used, which consisted of 6 questions with a 5-point scale, ranging from “completely meets” to “does not meet at all”, with reverse scoring. In this study, the Cronbach’s alpha coefficient of the Student Loneliness Scale was 0.916, the measurement model fit was X²/df = 10.24, CFI = 0.951, TLI = 0.919, RMSEA = 0.154, and SRMR = 0.034, which indicates that the structural validity of the scale is good. The factor loadings for the six questions of the scale were 0.714, 0.848, 0.838, 0.869, 0.892, 0.649. The structural validity of the scale was fair, and it was speculated that the fit was poor due to the loneliness dimension being affected by extreme values.

Statistical methods

IBM SPSS Statistics 27 software was used for descriptive statistics, correlation analysis, reliability and validity tests of the scale, and Mplus 8.3 software was used for structural equation modeling to test model fit and mediation effects. The bootstrap method was used to estimate the chained mediation effect to ensure the statistical effect.

Kline suggests that an absolute value of less than 3 for skewness and less than 10 for kurtosis are acceptable criteria. [ 39 ] Therefore, the main variables in this paper conform to normal distribution (see Table  2 ).

Common variance bias test

The data used in the study were all from paper questionnaire tests, and there is a possibility of a common method bias problem. Harman’s one-factor modeling method was used to test the common method bias problem, and the results showed that the exploratory factor analysis extracted a total of six factors with eigenvalues greater than 1, and the explained variance of the first factor was 36.40, which was lower than the critical value of 40, indicating that there was no common method bias problem.

Correlation matrix of each variable

As can be seen from Table  3 , there is a significant positive correlation between Physical Activity (PA) and Life Satisfaction (LS) and Positive Emotion (PE), and a significant negative correlation between physical activity and Discrimination Perceptions (DP) and Loneliness (L), and the correlation coefficients of each variable are significant, which provides support for further construction of structural equation modeling.

Hypothesized Model Testing

To effectively control the measurement error, the structural equation modeling method was used to conduct the chain mediation effect test to detect the fit of the overall model when subjective well-being was used as the dependent variable. The model was set up and tested in Mplus software, and the results showed that the total effect of physical activity affecting subjective well-being was significant, with a total effect of 0.257 ( P  < 0.05), and the direct effect of physical activity affecting subjective well-being was 0.145 ( P  < 0.05). The strengths and weaknesses of the model were judged using the model fit indicators provided by the Mplus software, chi-square/degrees of freedom (the smaller, the better) comparative fit indicators CFI (> 0.9), Tucker-Lewis index TLI (> 0.9), root mean square of approximation RMSEA (< 0.05 or 0.08), standardized root mean square residual SRMR (< 0.08). The model was judged to be well fitted by the above criteria: χ2/df = 2.357, CFI = 0.936, TLI = 0.927, RMSEA = 0.058, SRMR = 0.047 (see Fig.  1 ).

A mediating model of the influence of physical exercise on subjective well-being of left-behind children. * p  < 0.05, ** p  < 0.01, *** P  < 0.001

The Bootstrap method was used to test the significance of each variable between physical activity and subjective well-being as a way of determining which paths may have indirect effects (See Table  4 ). The Bootstrap was set to sample 3,000 times to estimate the total and indirect effects. As shown in Table  4 , the β-value between physical activity and subjective well-being was 0.134 (95% CI = [0.060,0.213]); the β-value between physical activity and discrimination was − 0.155(95%CI= [-0.264,-0.033]); and the β-value between discrimination and subjective well-being was − 0.213 (95% CI = [-0.368,- 0.051]); the beta between physical activity and loneliness was − 0.051 (95% CI = [-0.147,0.052]); the beta between loneliness and subjective well-being was − 0.557 (95% CI = [-0.698,-0.401]); and the beta between discrimination and loneliness was 0.600 (95% CI = [0.478, 0.717]). Accordingly, it can be hypothesized that the direct effect is significant in this model, the indirect effect mediated by discrimination is significant, the indirect effect mediated by loneliness is not significant, and the chain-mediated indirect effect of discrimination and loneliness is significant.

Bootstrap method was used to test the mediating effect between physical activity and subjective well-being, setting Bootstrap sampling 3000 times to estimate the total and indirect effects. As seen in Table  5 , the indirect effect mediated by discrimination was 0.033 (95% CI = [0.006,0.083]), the indirect effect mediated by loneliness was 0.029 (95% CI = [-0.025,0.088]), and the indirect effect mediated by both discrimination and loneliness was 0.052 (95% CI = [0.014,0.100]), with the total indirect effect was 0.113 (95% CI = [0.044,0.183]). MacKinnon has noted in his work that there is evidence to support an indirect effect when the confidence interval excludes the value 0 [ 40 ]. The results showed that the mediating role of discrimination in physical activity - discrimination - subjective well-being was significant, loneliness in physical activity - loneliness -subjective well-being, discrimination and loneliness in physical activity - discrimination - loneliness - subjective well-being, the mediating role of the chain was significant, physical activity - discrimination - loneliness - subjective well-being, and loneliness - subjective well-being. -subjective well-being, the chain mediating role of physical activity was significant, and physical activity was significant in the direct role of physical activity-subjective well-being.

The enhancement of rural left-behind children’s subjective well-being is of great significance in promoting their physical and mental health, maintaining a good state of mind, and reducing negative emotions, which is closely related to their adherence to an appropriate amount of physical exercise. There are many cases in the existing literature on the study of “physical activity affects subjective well-being”, but there is a lack of evidence and accumulation of analysis of the specific effects and the existence of mediating and moderating effects. In this paper, from the perspective of left-behind children in rural areas, we choose the perception of discrimination and loneliness in the group of left-behind children and use negative emotion as a mediating variable to explore the potential mechanism of physical exercise affecting the subjective well-being of left-behind children in rural areas.

This study showed that the beta value between physical activity and subjective well-being of the left-behind children was 0.134 (95% CI = [0.060, 0.213]), indicating that physical activity positively affects subjective well-being.

Relationship between physical exercise and subjective well-being

Previous observational and experimental studies on the relationship between physical exercise and subjective well-being have provided evidence of a positive correlation between the two, and the results of this study indicate that the direct effect of physical exercise and subjective well-being of rural left-behind children is significant, and hypothesis 1 is valid that participation in physical exercise can improve the well-being of the general population [ 41 ]. Previous studies have looked at physical activity and mood and found that regular participation in physical activity produces a positive mood [ 42 , 43 , 44 ]. There are also studies demonstrating the important link between physical activity and life satisfaction, i.e., participation in physical activity can lead to higher quality of life and life satisfaction [ 45 ]. This is consistent with the results of this paper. In addition, physical activity can have an impact on subjective well-being through mediating variables such as physical self-esteem, interpersonal relationships, and personality, in addition to direct subjective well-being [ 46 ].

The mediating role of discrimination perception

Discrimination perception can mediate the relationship between physical activity and subjective well-being, its mediating effect value was 0.033 (95% CI = [0.006, 0.083]), which indicates that discrimination perception may be a risk factor for subjective well-being, which is consistent with the findings of previous research on the influencing factors of subjective well-being, and Hypothesis 2 is established. Goffman considers discrimination as a social attribute or characteristic that brings a sense of humiliation to a person, which is specifically manifested in looking down on the abilities and origins of him or her, such as meanness in attitude, psychological rejection, and behavioral alienation [ 47 ]. While rural left-behind children seem to be similarly labeled by the outside world, left-behind children when faced with the lack of family structure in most cases, the difficulties will encounter in terms of learning, psychology, health, and safety, as well as the presence of external pressures and questions, the discriminatory pressures may affect the health through silence, which equips them with a high level of threat assessment and vigilance, which can lead to a stressful reaction [ 48 ]. Being part of a social group but suffering special treatment means that higher levels of depression, higher levels of distress, and lower levels of self-esteem happen to them [ 49 ]. On the one hand, higher levels of individual discrimination are associated with lower levels of state self-esteem [ 50 ], on the other hand, self-esteem and affect are important components of the subjective evaluation of the quality of life in youth and these factors may be positively influenced by physical activity and cognitive-emotional factors [ 51 ]. In conclusion, physical exercise is an indirect way to increase the subjective well-being of rural left-behind children by enhancing their self-esteem and lowering their stress to contribute to making discrimination less influential on them.

Mediating role of loneliness

Page & Tucker (1994) found that loneliness was associated with lower levels of physical activity among elementary (grades 1–6), high school (grades 9–12), and college students [ 52 ]. Previous research on the relationship between loneliness and physical activity has had mixed results, with several studies finding no association [ 53 , 54 , 55 ]. Mishra et al.‘s study of female seniors showed that female seniors with high levels of loneliness had lower subjective well-being [ 56 ]. In this study, loneliness had a significant − 0.557 (95% CI = [-0.698, -0.401]) beta with subjective well-being, whereas physical activity had a non-significant − 0.051 (95% CI = [-0.147, 0.052]) beta with loneliness, the regression paths between physical activity and loneliness were not significant, which resulted in the fact that loneliness did not directly mediate between physical activity and subjective well-being, and Hypothesis 3 was not valid. The reason for this is hypothesized that discrimination perception plays a fully mediating role between physical activity and loneliness in the model, resulting in loneliness not playing a direct mediating role between physical activity and subjective well-being. It is hypothesized that discrimination perceptions are more likely to induce negative emotions in left-behind children than loneliness in rural left-behind children, thus affecting subjective well-being.

Chain mediating role of physical activity in positively predicting subjective well-being

This study showed that discrimination perceptions mediated between physical activity and loneliness in the chain mediation pathway between physical activity and subjective well-being. Perception of discrimination is significantly and positively related to the beta value of loneliness 0.600 (95% CI = [0.478, 0.717]), which is consistent with the study by Zhang Yihan et al., indicating that discrimination perception as a prominent psychological problem plays an inescapable role in the formation and promotion of loneliness, and loneliness is more likely to occur in the presence of discrimination, which is a risk factor for loneliness. Research shows that in the chain mediation path between physical exercise and subjective well-being, loneliness does not play a direct mediating role between physical exercise and subjective well-being, but plays an indirect mediating role between physical exercise and subjective well-being, and some scholars have pointed out that when an individual perceives discrimination from his peers or the outside world, he will be hesitant to socialize with other people, which will lead to the formation of the emotional experience of loneliness [ 25 ], and when left-behind children have discrimination from peers or the outside world, they will be more likely to develop loneliness. On the other hand, when left-behind children have a discrimination perception from the surrounding environment, the long-distance, long-term non-face-to-face parent-child communication makes parents unable to detect adolescents’ inner troubles promptly, which makes adolescents’ important psychological resources to cope with the pressure of external discrimination are missing or reduced, and thus more feelings of loneliness will be generated [ 57 ]. In summary, it can be seen that discrimination perception is an important risk factor for loneliness, and the creation of discrimination perception is more capable of triggering negative emotions such as loneliness.

The chain mediating role of discrimination perception and loneliness in the positive effect of physical activity on subjective well-being was verified by the Bootstrap method, and hypothesis 4 was established. The constructed chain mediation model provides a new perspective for further advancing and understanding the relationship between physical activity and subjective well-being in the future. Physical activity can either directly positively affect subjective well-being or indirectly affect subjective well-being through discrimination perceptions and loneliness. The results support the psychological elasticity theory [ 58 ], indicating that physical activity can stimulate the psychological elasticity of rural left-behind children, bring energy to the left-behind children, enable the left-behind children to cope with the adaptive problems due to the lack of parental accompaniment more effectively and reduce the emergence of the negative emotions such as discrimination perception and loneliness, which will then weaken the negative impact on the subjective well-being. Left-behind children can bring about healthy physical gains through physical exercise, which enhances their physical fitness and contributes to their physical growth and development in adolescence; on the other hand, physical exercise can cultivate left-behind children’s interest in physical exercise, reduce the negative impacts of perceptions of discrimination and loneliness, and help them better integrate into their classmates, thus improving their sense of well-being.

Research implications

How to enhance the subjective well-being of rural left-behind children and eliminate more negative emotions is a long way to go for rural educators in China. This study suggests that physical exercise can empower rural left-behind children to enhance their subjective sense of well-being and to effectively improve and take into account the psychology of left-behind children, to shape a healthy and complete personality for left-behind children, we should pay attention to the diversified value of the physical exercise.

In terms of practical implications: (1) The findings of this paper can provide a reference direction for rural schools on how to design physical education programs to more effectively improve the subjective well-being of rural left-behind children. For example, more interactive and interesting physical activities can be designed to reduce their sense of isolation while enhancing their social skills and teamwork. (2) The results of the study emphasize the importance of physical exercise in improving the mental health of rural left-behind children, which provides new ideas for rural schools to carry out mental health education. Schools can incorporate mental health elements into physical education courses to help children correctly understand and deal with their negative emotions and improve their emotional regulation ability. (3) In addition, schools and families should strengthen communication and pay joint attention to the mental health of left-behind children to provide them with a healthier and more harmonious growing environment.

In terms of policy implications: (4) It can provide a direction for the government’s future policy designation to encourage schools to carry out colorful sports activities to enhance the subjective well-being of rural left-behind children. For example, financial support can be provided to help schools build and optimize sports facilities and venues, and bring in sports teachers and coaches. (5) The government can also optimize the allocation of educational resources to ensure that left-behind children can enjoy the same educational resources and opportunities as urban children. At the same time, it can increase the investment in education in rural schools, raise teachers’ salaries, and improve the teaching environment. (6) The government can promote the popularization of mental health education so that more people will understand and pay attention to the mental health problems of left-behind children. Organize experts to conduct mental health lectures to improve schools’ and parents’ understanding of and ability to deal with left-behind children’s mental health problems. (7) The government can further improve its policy of caring for left-behind children and provide them with more support and assistance. It can strengthen economic assistance to their families, provide more social resources and public services, and reduce their economic pressure and psychological burden.

Limitations

This study has some limitations that need to be stated. First, this paper adopts a cross-sectional design of research, which cannot prove causality. Second, as a source of data for the study of rural left-behind children, this study relied solely on self-report questionnaires, which means that the data are more likely to have subjective judgments. Future research will use more objective measurements or collect data several more times to study the lag effect and causality more clearly.

This research is of great significance for the study of left-behind children. It reveals that physical exercise has a direct influence on the subjective well-being of rural left-behind children and also discovers that it has an indirect effect through influencing discrimination perception, loneliness and the chain mediation of both. Except for the path through loneliness, which is not significant, the others are all significant. This research provides key basis and direction for improving the psychological conditions of left-behind children, highlights the importance of physical exercise, contributes to the formulation of relevant policies and practical guidance, and is of great practical significance for enhancing the well-being of left-behind children.

Data availability

In this study, the original data can be further consulted to the corresponding author.

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Acknowledgements

We are grateful to the participants and their school for the cooperation and participation in this study.

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F-Z.Feng, T Zhang: Conceptualization, Data curation, Funding acquisition, Investigation, Methodology, Writing—original draft; H-Y.Li: Formal analysis, Supervision,. All authors have read and agreed to the published version of the manuscript.

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Feng, F., Li, H. & Zhang, T. The effect of physical activity on the subjective well-being of rural left-behind children: the mediating role of discrimination perceptions and loneliness. BMC Psychol 12 , 455 (2024). https://doi.org/10.1186/s40359-024-01950-z

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Daily School Physical Activity Improves Academic Performance

Physical activity (PA) may improve brain development, cognition, concentration and academic performance. In this prospective controlled intervention study, we increased the level of PA in 338 children aged 6–8 years at study start, from the Swedish standard of 60 min per week to 200 min per week (40 min daily). The intervention continued in all nine compulsory school years until the students graduated between 2007–2012. All other 689,881 Swedish children who graduated the same years were included as a control group. We registered at graduation eligibility rate for upper secondary school and the final grade score (from 0 to 320 grade points). We also registered the same end points in the 295 students in the index school and in all other 471,926 Swedish students who graduated in 2003–2006, that is, those who graduated before the intervention study started. Before the intervention, academic performance was similar among children in the index school as for all other Swedish boys and girls. With the intervention, the eligibility rate increased for boys in the index school by 7.3 percentage points and the mean grade scores by 13.3 points. This should be compared with a decrease of 0.8 percentage points in eligibility rate and an increase by 2.7 points in grade score in other Swedish boys. No changes were seen for intervention girls, neither in eligibility rates or grade scores. By introducing daily school-based PA in compulsory school, more boys would probably reach the eligibility rate for higher education.

1. Introduction

Lifestyle habits in childhood tend to follow the individual into adulthood [ 1 , 2 , 3 ]. Therefore, it is important in early years to already influence children to adopt healthy lifestyle habits, such as a physically active lifestyle, good sleep and good dietary habits [ 2 ]. Such habits are supported in school in Sweden, for example throughout repeated general information sessions by school nurses and teachers, not only to the students but also to parents or guardians. Large observational studies have also found that individuals with higher education, such as a university degree, have healthier lifestyles, higher self-esteem, are less likely to suffer from chronic diseases and have lower mortality rates than individuals without such education [ 3 , 4 , 5 ]. Society ought, therefore, to raise the educational level in society.

The proportion of Swedish children who graduate from the 9th and final year of compulsory schooling without eligibility for upper secondary school programs has increased during recent decades [ 6 , 7 ]. The proportion of eligible students was only 86% in 2015, the lowest proportion since 1998 [ 6 ]. The decrease is a paradox since researchers claim that 100% of Swedish students have the potential and capacity to reach the goals required for a passing grade in all school subjects [ 8 ]. School results, with reading performance, mathematics and performance in science as end point variables, have in the Program for International Student Assessment (PISA) been reported to decrease in Western countries [ 9 ]. Declining academic school performance should, therefore, be considered an international issue and the question is how to change this. One approach may possibly be to increase the level of physical activity (PA), as high level of PA is associated with superior intellectual performance [ 10 , 11 ]. For example, one study showed that 2 extra weekly school PA classes of 30–45 min including ‘‘play and motion’’ activities was in girls associated with higher likelihood to pass national tests in Swedish (odds ratio 5.7) and Mathematics (odds ratio 3.2) [ 11 ]. Another study showed that among 1271 students from urban Santiago, Chile, 4 hours per week of scheduled exercise was associated with having System for the Assessment of Educational Quality (SIMCE) composite z-scores ≥50th percentile (odds ratio 2.3) and ≥75th percentile (odds ratio 2.1) [ 10 ]. Despite this knowledge, there has been a tendency to reduce physical education (PE) during recent decades in favor of academic subjects [ 12 ]. Some reports have, therefore, postulated that the decrease seen in school results could at least partly be referred to the lower exposure to PA [ 13 , 14 ].

Hypothetically, increasing PE in school may, therefore, reverse the negative trend of school performance [ 13 , 15 ]. Recently this has been shown in a smaller pilot study at a regional level in southern Sweden [ 15 ]. The study found that daily physical activity during the nine compulsory school years was associated with a higher grade score. To our knowledge, no other prospective population-based intervention study has addressed the question by including all children within a country as control cohort. It has also been postulated that boys and girls could respond differently to such an intervention, since boys and girls respond differently to PA during growth [ 10 ] and since boys have a greater potential to improve, with their school results lower compared to girls [ 16 ]. Few studies have addressed this hypothesis and have either included small samples, been short-term, used specific groups or used different surrogate end points for academic performance [ 17 , 18 , 19 , 20 , 21 ], possibly explaining the divergent conclusions and lack of consensus on the effect of increased PA on academic school performance. A systematic review from 2018 describes a strong need for high-quality evidence with adequate control groups and end points [ 22 ]. Previous studies have shown increased PE to have positive effects on bone mass, muscle strength and fracture risk [ 4 , 23 ], but a positive effect on academic performance and thereby increased proportion of students eligible for higher education may have an even larger impact on overall health.

Therefore, we conducted a sex specific 9 year, population-based, prospective controlled, PA intervention study during growth. Our aim was to evaluate if daily school PA induced higher eligibility rate and higher final grade score than having school PA 1–2 sessions per week. Our hypothesis was that daily physical activity would be associated with increased eligibility rate and higher final grade score than having 1–2 sessions per, but with more obvious effect in boys than in girls, as boys have lower eligibility and lower grade scores than girls, and by this greater potential for improvement.

2. Materials and Methods

2.1. the malmo pediatric osteoporosis prevention (pop) study.

The Malmo Pediatric Osteoporosis Prevention (POP) study is a prospective controlled PA intervention study that evaluates the effects of increased school-based physical education (PE) on health and school performance. The study design has previously been presented in detail [ 15 , 24 ]. In summary, one school (index school) was invited to increase PE from 1–2 lessons per week to one daily lesson per school week. We chose to conduct the intervention in school since this is the only arena that reaches all children and PE is a compulsory school subject in all Swedish schools, and all children thus had to participate. The children were 6–8 years old at study start [ 24 ] and in this report we followed the children for nine years (the entire compulsory Swedish elementary school) until they were 15–17 years old. At that time, we evaluated school performance by eligibility rate to upper secondary school and overall grade score. The study was approved by the ethics committee of Lund University (LU 453-98; 1998-09-15), conducted according to the Declaration of Helsinki and was registered as a clinical trial (ClinicalTrials.gov.NCT00633828). Both oral and written signed consents were collected from parents or guardians and students before study start.

From school start in the index school, we increased the amount of PE per week from the Swedish standard of 60 min to 200 min given as one lesson of 40 min per school day. These lessons were scheduled as all other lessons and were given within the regular school curriculum. The PA included moderate to intense activities from the regular Swedish PE curriculum, such as gymnastics, team sports, dancing, running, jumping, and playing activities. We did not register types of activities included in the school PE. We did not measure the PA level that each student used at the PE lessons, only the duration of the activity. However, all students participated at least with the minimal required level, since all students received a passing grade in the subject PE. The intervention was ongoing in all children who started school during the years 1998–2003 and throughout all nine compulsory school years until they finished 9th grade in the years 2007–2012. The PE classes were led by the regular teachers and followed the regular PE curriculum. This curriculum included activities such as ball games, running, jumping, and playing, on a moderate to vigorous intensity. There were no extra PE classes during weekends or during the 15 weeks of annual school holidays. The school followed the regular national school curriculum in all other subjects.

2.2. Probands

All 234 boys and 190 girls who started grade one in the index school years 1998–2003 were included in the intervention from grade 1. The children (49 boys and 37 girls) who left the index school during the study period (and thus did not complete all nine years of intervention) , in almost all cases due to relocation of the family to another region in the city, another part of the country or abroad, were excluded. Since there at baseline were no differences in age, gender, weight, or body mass index when comparing those who left with those who stayed, the risk of selection bias seems minor (data not shown). Thus, 185 boys and 153 girls remained in the intervention group in this report.

To be able to identify any changes within the index school from the period before the intervention was initiated and after the intervention was initiated (the study period), we registered the same end points in children who started grade one in the index school during years 1994–1997 (175 boys and 181 girls). We excluded 25 boys and 41 girls who left the index school before graduation in 2003–2006, in almost all cases also due to relocation of the family. Thus, 155 boys and 140 girls remained in this group and graduated just before the intervention was initiated.

As controls we used all other Swedish students (not a sample) who finished 9th grade during the years 2003–2006 (n = 471,926; 241,089 boys and 230,837 girls) and the years 2007–2012 (n = 689,881; 353,439 boys and 336,442 girls). The mean duration of PE per school week in Sweden is 60 min, provided in 1–2 lessons. We must acknowledge, that this duration and frequency in controls are the mean values in Swedish schools, and there could during the nine compulsory school year be differences within the same school between the different grades, between different semesters and also between different schools within the same grades.

2.3. End Point Variables—School Grades and Eligibility to Higher Education

Schools in Sweden have to retain grade data for all students for at least 15 years. We collected final elementary grade score card data for each student through the archive of the index school and also registered whether each student was eligible for national upper secondary school or not. The 9th and final elementary school leaving grade report in Sweden includes 16 compulsory school subjects where every subject is graded with the grades Failed (0 points), Passed (10 points), Passed with Distinction (15 points) or Passed with Special Distinction (20 points). The final grade points of these 16 subjects may thus vary from 0 points (p) (no subject with an accepted grade) to 320 p (the highest grade in all subjects). To qualify for national upper secondary school programs the grade Passed is required in each of the subjects Swedish, English and Mathematics. For all other Swedish students the same end point data were retrieved from the Swedish National Agency of Education (Skolverket) [ 16 ].

2.4. Statistics

We used IBM SPSS Statistics® version 20 for statistical analyses (version 20, IBM, New York, NY, USA). Data are reported as absolute numbers (n), percentages (%), percentage points (pp) or means with 95% confidence intervals (95% CI). No measurement of dispersion is given for national data as these are not based on a sample but include all Swedish children (true values). Group differences were evaluated by Pearson’s chi-square test for eligibility rate, when comparing students in the intervention school graduating 2007–2012 (with the intervention) with students graduating in the same school 2003–2016 (before the intervention) as well as with all Swedish students graduating 2007–2012. We used Student’s unpaired two sample t -test when comparing for final grade score means in the two samples of students, those graduating in the intervention school 2007–2012 (with the intervention) with students graduating in the same school 2003–2016 (before the intervention). We finally used Student’s unpaired one sample t -test when comparing final grade score means in students in the intervention school graduating 2007–2012 with all Swedish students graduating 2007–2012. We considered p < 0.05 to represent a statistically significant difference.

3.1. Comparison between the Index School and All Other Swedish Children Graduating 2003–2006

Before the intervention was initiated a slightly higher proportion of both boys and girls were eligible for upper secondary school in the index school compared to overall Swedish boys and girls ( Table 1 ).

Numbers and proportion of students who reached eligibility for upper secondary school among boys and girls in the index school and the country of Sweden during years 2003–2006 (before initiation of the intervention in the index school) and 2007–2012 (with intervention in the index school). In Sweden, 241,089 boys and 230,837 girls left grade nine 2003–2006, and 353,439 boys and 336,442 girls 2007–2012.

Data are presented as absolute numbers (n), percentages (%), percentage points (pp) and means with 95% confidence intervals (95% CI). The p -value represent the comparison in eligibility rates in the two samples of children from the index school, those that graduated in 2003–2006 with those children that graduated in 2007–2012. Statistically significant group differences are bolded.

In boys the overall grade points were similar in the intervention and control groups, while girls in the intervention group had significantly higher grades (+21.8 points) then Swedish girls overall ( Table 2 ).

Summarized grade scores for boys and girls in the index school and the country of Sweden during years 2003–2006 (before initiation of the intervention in the index school) and 2007–2012 (with intervention in the index school). In Sweden, 241,089 boys and 230,837 girls left grade nine 2003–2006, and 353,439 boys and 336,442 girls 2007–2012.

Data are presented as absolute numbers (n), means with 95% confidence intervals (95% CI) and for country data the actual mean value without 95% CI (since this is not a sample). The p -value represents the comparison of summarized grade scores in the two samples of children from the index school, those who graduated in 2003–2006 with those children who graduated in 2007–2012. Statistically significant group differences are bolded.

3.2. Changes within Groups from 2003–2006 to 2007–2012

Before being compared to after the initiation of the intervention, the proportion of boys eligible for upper secondary school increased in the index school by 7.3 (1.4, 13.2) pp. During the same time frame this proportion decreased in Swedish boys overall by 0.8 pp ( Table 1 ). Among boys, the overall grade points also increased in the index school by 13.3 (3.1, 23.5) points and in Swedish overall boys by 2.7 points ( Table 2 ). In girls, the eligibility rate ( Table 1 ) and overall grades ( Table 2 ) were similar in the two periods both in the index school and overall in Sweden.

3.3. Comparison between the Index School and All Other Swedish Children Graduating 2007–2012

With the intervention, both the eligibility rate (+8.3 pp) ( Table 1 ) and the overall grade points (+12.6 points) ( Table 2 ) were higher in boys in the index school compared to all other Swedish children. Among girls, both the eligibility rate (+5.9 pp) ( Table 1 ) and overall grade points (+12.7 points) ( Table 2 ) remained higher in the index school than in all female Swedish students.

It should also be noted that since the proportion of qualified students (both in boys and girls) decreased in Sweden from 2003–2006 to 2007–2012, the difference between the children in the index school and all other Swedish children increased further with the intervention ( Table 1 ).

4. Discussion

In this study we show that boys who had 40 min daily school PA during all nine compulsory school years had higher summarized school grade points and higher qualification rate to upper secondary school than boys who during the nine years had 60 min school PA per week (provided in 1–2 PE lessons). Our results support previous research that suggests that PA is associated with beneficial cognitive achievement [ 5 , 11 , 15 , 25 , 26 , 27 , 28 ]. The association between daily PA and an increase by 7.3 percentage points in qualification rate to higher education between 2003–2006 and 2007–2012 is even more impressive, in the perspective that the eligibility rate in Swedish boys has decreased between these two periods.

Some previous research has suggested that there may be need of high intensity PA to improve academic achievement [ 19 ]. The cited study promoted 90 min/week of moderate to vigorous physically active academic lessons (3.0 to 6.0 metabolic equivalents (METS), ~10 min each) delivered intermittently throughout the school day. Lessons were usually delivered in the classroom, but were also delivered in school locations such as hallways and outdoors [ 19 ]. However, the authors also state in the same article that it is difficult to conclude which exercise dose is required to influence cognitive function and academic achievement [ 19 ]. That PA, even at a lower level, also may be beneficial for academic achievement, is supported by data that infer that daily moderate to intense intense PA with activities within the regular school physical education (PE) curriculum, provided as 40 min daily PE classes, was associated with beneficial academic achievement [ 15 ]. Since we exposed all children within a school (not only those who chose to participate) to PA activities that were possible for every child to take part in, our study indicates that increased PA is a feasible strategy to improve academic school results in boys on a population-based level.

There are numerous potential hypotheses that may explain the association between increased PA and improved school achievement [ 15 , 29 , 30 ]. Some studies infer that PA may have direct positive effects on the nervous system by increasing brain volume, blood flow to the brain, synaptic plasticity, as well as promoting formation of nerve cells, all involved in different aspects of perception, cognition, memory, and attention [ 31 , 32 , 33 , 34 ]. Other studies suggest that PA has positive effects on psychological parameters such as self-esteem, motivation, social engagement, and communication [ 12 ], all of importance for learning outcomes. There are even studies suggesting that inferior motor skills might lead to negative effects in these psychological parameters and delay cognitive development [ 35 , 36 ]. Reports also show an association between higher levels of PA and attention, ability to concentrate in the classroom, and academic achievements [ 29 , 37 ]. We must also emphasize that there could have been other changes, apart from increased PA, during the examination period, changes that we did not register but that still could influence time trends in academic performance. Examples of such changes could be that parents became more aware of the beneficial effects of PA, thereby increasing support to their children to cycle to school and friends, and spend more time with physical activities in their spare time.

Study strengths include the population-based controlled study design, the long-term intervention and the use of endpoint variables relevant to students, parents, teachers and society. Limitations include the low number of individuals in the intervention group, increasing the risk of a type II error, and the absence of comprehensive background data since academic achievement may be affected by other variables such as demographics, motivation, attitudes, extra-curricular activities, access to green spaces, level of spare time PA, socioeconomic status, ethnicity, and parental education. It should be noted that before the intervention was initiated, girls in the intervention school had higher summarized grade points and higher eligibility rate for higher education than Swedish girls in general. The reason for this cannot be explained with our study design, but with this high performance we speculate that the potential to improve was lower in girls than boys. Also, a randomization of the children to the intervention and control groups would have been preferred, but was not accepted by the teachers and parents. Another weakness is that the pre-intervention grades and eligibility to upper secondary school was collected during other years than the data from the intervention cohort. That is, general time trends in grades and eligibility rates not associated with PA may obscure the inferences and our conclusions regarding the effect of daily school physical activity. It would also have been advantageous to have not only data on duration but also the intensity during the PE classes, both on group and individual level, and also how much the children spent on non-organized physical activities.

Finally, we cannot draw any conclusions as regard causality, since there may be a variety of factors associated with the increased physical activity that influenced the school results.

5. Conclusions

We conclude that increasing school PA from 60 min per week to 40 min per school day during the nine compulsory school years in boys is associated with improved grade score and higher eligibility rate to secondary school in grade 9. We found no differences in grades or eligibility rates in girls with the intervention. We recommend schools introduce daily PA.

Acknowledgments

We would like to thank the children and teachers for their efforts with the study and Per Gärdsell and Christian Lindén who participated in the initiation of the POP study.

Author Contributions

J.F. collected the data, did all calculations, interpreted the data, drafted the initial manuscript and approved the final manuscript as submitted. M.E.C. collected the data, participated in interpretation of the data, drafting of the manuscript and approved the final manuscript as submitted. B.E.R. participated in the design of the study, interpretation of the data and the calculations and approved the final manuscript as submitted. C.K. participated in interpretation of the data and the calculations, drafting of the manuscript and approved the final manuscript as submitted. M.K.K. designed the study, collected data, supervised all work and approved final manuscript as submitted. All authors have read and agreed to the published version of the manuscript.

This research was funded by the Centre for Athletic Research, the Herman Järnhardt Foundation, Skåne Regional Foundations and ALF Foundations.

Conflicts of Interest

The authors declare no conflict of interest.

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Education | Colorado might ease SAT graduation requirement after big drops in high school math scores

Without such a change, it’s possible graduation rates could drop for the Class of 2025, Colorado Department of Education officials told the State Board of Education on Thursday.

To graduate from high school in Colorado, students must show proficiency in English and math. Using SAT scores is the most common way that districts offer students to meet that requirement, since the test is already administered to students in their junior year; ninth and 10th graders take the PSAT. But officials couldn’t say how many students were relying on the test result to meet the graduation requirements this year.

The proposed change the State Board is considering would lower the minimum passing score on the math portion of the SAT from 500 to 480. Without that change, officials say the percentage of students who can use their SAT score to meet graduation requirements will drop from 45% in 2023 to 39% with these results. That means about 3,400 students might be looking for a last-minute alternative to meet graduation requirements before May.

Read more at Chalkbeat Colorado .

Chalkbeat Colorado is a nonprofit news organization covering education issues. For more, visit chalkbeat.org/co .

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