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Direct observation in high school physical education

ProQuest Dissertations and Theses, 2009
Dissertation
Author: Nicole J Smith
Abstract:
The purpose of this study was to analyze existing data collected using direct observation in a high school setting in order to understand more about the quality and contribution of physical education to public health goals. The System for Observing Fitness Instruction Time (SOFIT) was utilized to collect data related to student activity levels, lesson contexts, and teacher promotion of physical activity behavior. Two cross-sectional samples were observed in the spring 2005 and spring 2007 from seven high schools in a large urban school district in the eastern United States. In total, 164 lessons were observed yielding over 75 hours of observation. Descriptive statistics were calculated and logistic regression was utilized to determine the association between lesson contexts and student activity levels. The results showed the mean length of lessons was 29.1 minutes which translated to 32% shorter than scheduled. Students engaged in MVPA during 53% of the total intervals, however, only 13% were vigorous. Physical activity was not promoted 73% of the time, and, coincidently, a majority of the lessons did not meet public health guidelines (n = 93, 57%) and only engaged students in MVPA for 35% of the lesson length. "Skill practice" was the best predictor of MVPA (Odds Ratio = 1.7) and best source of vigorous physical activity, however was only observed in 4% of the total intervals. The dominant lesson contexts were "game play" (49%) followed by "fitness activity" (21%). Little time was spent in "knowledge" (4%). In this study environmental factors related to instructional goals (i.e., lack of knowledge, skill practice, and promotion of physical activity) and decreased lesson length diminished the quality and contribution of physical education to public health goals. The quality and contribution of high school physical education can be improved by increasing student participation in vigorous physical activity, modifying instructional goals to include more knowledge and skill related content, and increasing the promotion of physical activity. More studies should be conducted to examine the relationship between key environmental and policy influences (e.g., lesson length, time spent in contexts, professional development) on the quality and contribution of high school physical education to public health goals.

TABLE OF CONTENTS ABSTRACT.........................................................................................................iii LIST OF TABLES................................................................................................vii LIST OF FIGURES.............................................................................................viii ACKNOWLEDGMENTS......................................................................................ix CHAPTER ONE INTRODUCTION.......................................................1 Background .............................................................................................1 Research Problem.....................................................................................4 Statement of Purpose................................................................................5 Research Questions..................................................................................5 Significance .............................................................................................6 Limiting Factors.........................................................................................7 Scope .............................................................................................7 Assumptions...................................................................................7 Limitations.......................................................................................8 Operational Definitions...............................................................................9 CHAPTER TWO REVIEW OF THE LITERATURE.............................11 The Relevance of Studying Physical Activity Behavior............................12 Physical Activity and its Relationship to Health.............................12 Recommendations and Guidelines for Physical Activity................15 The Prevalence of Physical Inactivity Among Young People........17 Correlates and Determinants of Physical Activity Behavior...........18 Physical Activity and Physical Education.................................................20 Recommendations for Quality Physical Education........................21 Profile of School Physical Education and Physical Activity...........24 Enrollment Requirements in Physical Education................25 Content...............................................................................27 Staffing...............................................................................28 Other School Sources of Physical Activity..........................28 Measurement of Physical Activity in Physical Education.........................29 Surveillance..................................................................................30 Accelerometery.............................................................................31

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Pedometry.....................................................................................32 Direct Observation........................................................................32

CHAPTER THREE METHODS...............................................................35 Setting and Schools.................................................................................36 Data Collection........................................................................................38 SOFIT ...........................................................................................38 Observer Training...............................................................38 Observation Schedule........................................................39 Reliability Measures...........................................................39 Interobserver Agreement.........................................39 Data Analysis...........................................................................................40 RQ # 1-4.......................................................................................40 RQ# 5...........................................................................................41 RQ# 6 ...........................................................................................42 Human Subjects......................................................................................42

CHAPTER FOUR RESULTS................................................................43 Descriptives ...........................................................................................44 Student Activity Levels.............................................................................47 Lesson Contexts......................................................................................48 Teacher Promotion of Physical Activity....................................................51 Public Health Guidelines..........................................................................52 Lesson Contexts and Student Physical Activity Levels ...........................52

CHAPTER FIVE DISCUSSION..........................................................55 Quality of Physical Education..................................................................55 Student Physical Activity Levels....................................................55 Lesson Contexts...........................................................................57 Teacher Promotion of Physical Activity.........................................60 Contribution to Public Health Goals.........................................................62 Conclusion ...........................................................................................63

APPENDICES ...........................................................................................65 Appendix A Tables...............................................................................65 Appendix B Factors Influencing SOFIT Data.......................................67

REFERENCES...................................................................................................68 VITA...................................................................................................................80

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LIST OF TABLES Table 1 Days, Lessons, and Teachers Observed per School....................45 Table 2 Class size, Lesson Length, and Intervals Observed per School...46 Table 3 Percent MVPA in lessons that “Met” and “Did not meet” public health guidelines...........................................................................54 Table 4 Association between Lesson Context and MVPA.........................54 Table A1 Frequency and Time Engaged in each Physical Activity Level.....65 Table A2 Frequency and Time Engaged in each Lesson Context................65 Table A3 Frequency and Time Spent Promoting Physical Activity...............66 Table A4 Profile of Physical Activity during Lesson Contexts.......................66 Table A5 Proportion of Physical Activity Levels during Lesson Contexts.....66

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LIST OF FIGURES Figure 1 Average scheduled vs. average actual lesson length...................47 Figure 2 Proportion of student activity levels observed...............................48 Figure 3 Proportion of lesson contexts observed........................................49 Figure 4 Sedentary vs. MVPA behavior by lesson context..........................50 Figure 5 Moderate vs. vigorous behavior by lesson context........................51

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ACKNOWLEDGMENTS The data utilized in this study are a product of the Pittsburgh Obesity Prevention Initiative (POPI). Many thanks are owed to Highmark Blue Cross Blue Shield and the Grable Foundation for providing funds to conduct the POPI study, to SPARK for donating staff time and materials, and to the Pittsburgh Public Schools. Additional acknowledgment, appreciation, and thanks are due to Dr. Thomas McKenzie, Paul Rosengard and Julie Frank from the SPARK Programs, Inc., and to my committee including Dr. Monica Lounsbery (chair), Dr. Jerry Landwer, Dr. Timothy Bungum, and Dr. Martha Young who demonstrated unwavering patience and support throughout the experience and helped me to refine my ideas and improve the quality of my work. Many people have inspired my endeavors over the years including family and colleagues. However, none has inspired or supported me more than my graduate school advisor, mentor, and friend Dr. Monica Lounsbery. Words cannot express the tremendous gratitude I feel for her investment in my potential. I would have never attempted to do this work if not for her optimism and persistence. I offer a lifetime of gratitude for her vision and belief in my potential, and her patience to deal with my many shortcomings.

CHAPTER ONE

INTRODUCTION Background Physical activity is an important heal th behavior for people of all ages and backgrounds (USDHHS, 1996, 2002, 2008b). Physical activity occurs when body movement is produced by the contraction of skeletal muscles requiring energy to be expended in order for the movement to be sustained (Casperson, Powell, & Christenson, 1985; USDHHS, 1996). Physical activities are commonly characterized according to type (e.g., aerobic, anaerobic, resistance), intensity (e.g., sedentary, light, moderate, vigorous), and volume (e.g., sets, repetitions). Participation in regular moderate to vigorous physical activity (MVPA) is associated with numerous health benefits and is essential for young people. Regular participation is associated with healthy weight and reduced risk for chronic health conditions (USDHHS, 1996, 2002, 2004b). Unfortunately, decline in regular MVPA begins during childhood and by the time many young people reach high school they do not meet recommendations for daily participation (CDC, 2008; NCHS, 2008; USDHHS, 2004b, 2006). Decline in MVPA coincides with increases in sedentary activities (e.g., lying, sitting, standing) characterized by lack of movement and minimal energy expenditure. The consequences of sedentary lifestyle in youth are severe (Gortmaker, 1

Must, Perrin, Sobol, & Dietz, 1993). Decreases in energy expenditu re are associated with increased prevalence of overweight. Not only does being overweight in childhood have its own physical and psychological health problems, but overweight children are also likely to become overweight or obese adults of whom, are at increased risk for cardiovascular disease, diabetes, and cancer (Strong et al., 2005). Risk associations are similar for children and adults, so it is likely that risk for many future diseases can be reduced not only by children engaging regularly in physical activity but also by developing skills and habits that will permit them to have an active lifestyle as they grow older. The impact of physical inactivity is evident in the increased prevalence in overweight among young people. From 1980 to 2000 the prevalence of overweight among adolescents tripled (CDC, 2004; Ogden, Flegal, Carroll, & Johnson, 2002) and as a result, obesity is now the most prevalent chronic disease risk for children and adolescents in the United States. Today, nearly 20% of children in the United States are overweight (Hedley, et al., 2004; Dietz, 1998) and the prevalence of overweight continues to increase each year (Ogden et al., 2006; USDHHS, 2006). Furthermore, the prevalence of chronic health conditions such as atherosclerosis, hypertension, obesity, and osteoporosis are increasing among people of all ages. Such conditions are increasingly viewed as preventable degenerative processes that may be prevented or delayed with regular participation in recommended amounts of physical activity during childhood (Rowland, 2007). The majority of young people spend a significant amount of their childhood 2

and adolescent years in school. For this reason, schools are an important place where young people can participate in MVPA (CDC, 1997; Pate, et al., 2006). School physical education is strongly recommended for its potential to provide students with a significant opportunity to participate in daily MVPA, teach students generalizable movement skills (McKenzie, 2007), and contribute to public health goals (NASPE, 2005a; Sallis & McKenzie, 1991;Pate et al, 2006; USDHHS, 2000). In addition, public health leaders recognize physical activity as an important outcome of physical education and so establish a national objective to increase the number of students engaged in MVPA for at least half of every lesson (USDHHS, 2000, 2004b). However, in spite of the fact that high school physical education is mandated in most states and included among public health goals, very little is known about its effectiveness to provide students with a significant source of MVPA. Most of what is known about physical activity during high school physical education is derived from self-report surveys (e.g., YRBSS). Self-report surveys do not detect contextual or behavioral influences which are known to influence physical activity behavior (McKenzie, 2002b). Direct observation provides rich descriptive data on the physical activity participation and is essential to understanding the physical activity behavior of young people in order to understand if intervention is necessary (Sallis, Zakarian, Hovell, Hofstetter, 1996). For this reason, direct observation is the criterion standard for assessing physical activity (Sirard & Pate, 2001) in physical education settings. The System for Observing Fitness Instruction Time (SOFIT) is a valid and 3

reliable dire ct observation instrument that simultaneously assesses student activity levels, lesson contexts, and teacher interactions and is frequently cited in the study of physical activity outcomes in physical education (McKenzie, Sallis, & Nader, 1991). Although several studies of elementary and middle school physical education utilize direct observation to provide a rich description of these settings, few studies of high school physical education (Chow, McKenzie, & Louie, 2009) exist in the current literature. Therefore, the purpose of this study is to analyze existing data, collected using direct observation in a high school setting, in order to understand more about the quality and contribution of physical education to public health goals.

Research Problem The prevalence of overweight and obesity are increasing and are associated with chronic health problems, increased medical expenditures, and decreased quality of life (Finkelstein, Fiebelkorn, & Wang, 2003; USDHHS 2004b, 2006). Participation in regular physical activity is important because it is associated with health-related variables including healthy weight, lower risk for chronic health conditions, health status, quality of life, and longevity (USDHHS, 1996, 2002). Unfortunately, the prevalence of physical inactivity worsens as young children matriculate through school and by high school many do not engage in sufficient amounts (USDHHS, 2004b, 2006). Quality school physical education is often recommended and endorsed as a significant opportunity for young people to engage in MVPA and realize public health goals. However, the quality of high 4

school physical educ ation is often described using self-report data which may not be accurate. SOFIT is a valid and reliable direct observation instrument cited in many studies to describe the quality of elementary and middle school physical education. Importantly, few studies utilizing SOFIT to describe high school physical education lessons could be located.

Statement of Purpose The purpose of this study is to analyze existing data collected using direct observation in a high school setting in order to understand more about the quality and contribution of physical education to public health goals.

Research Questions The research questions that will be addressed specific to the sample of high school physical education lessons in this study are: 1. How active were high school students observed in the sample of high school lessons? 2. What proportion of time was spent in the lesson contexts of “management,” “knowledge,” “fitness activity,” “skill practice,” game play,” and “other” in the sample of high school lessons? 3. How active were students in the sample of lessons, during respective lesson contexts (i.e., “management,” “knowledge,” “fitness activity,” “skill practice,” game play,” and “other”)? 5

4. What is the frequency and nature (i.e., in and out of PE) of teacher physical activity promotion in the sample of high school lessons? 5. What proportion of lessons met public health guidelines (engaging students in MVPA for ≥ 50% of lesson length)? 6. What was the association between lesson context and student physical activity levels (i.e., sedentary vs. MVPA) in the sample of high school lessons?

Significance Physical education may be the only opportunity many high school students have to engage in regular sufficient physical activity and to learn generalizable movement skills necessary to lead a physically active lifestyle. High school physical education is mandated in most states; however, most of what is known about student physical activity levels is derived from self-report data which may prove unreliable. Student outcomes during physical education are influenced by many factors. For this reason, it is important to utilize direct observation to measure physical activity during physical education since it is the gold standard and considers contextual and behavioral influences on the physical activity behavior. Using direct observation will help researchers understand contribution of physical education to public health goals, describe how time during physical education lessons is spent, and learn more about the promotion of physical activity to young people. This information can be utilized to inform school policy, teacher preparation, and the development of interventions seeking to improve the 6

quality and quantity of physical education. The results can also be used to determine important variables such as energy expenditu re which may resonate well with public health leaders.

Limiting Factors Scope The scope of this study is to evaluate a sample of high school physical education lessons collected during the Pittsburgh Obesity Prevention Initiative (POPI). In this manner only student physical activity levels, lesson contexts, and teacher interactions in terms of promotion of physical activity in or out of physical education are included as focal points of the research. Assumptions The assumptions of the study are as follows: 1. Student activity levels, lesson contexts, and teacher interactions were validly operationalized. 2. Data collectors interpreted and recorded the observed behaviors reliably. 3. Lying down, sitting, and standing are sedentary behaviors. 4. Walking and vigorous activities each contributed to moderate-vigorous physical activity. 5. Logistic regression can sufficiently measure the strength of association between lesson contexts and student activity levels in order to predict the likelihood of a specific activity level occurring. 7

Limitations

The use of existing data to describe student activity levels, lesson contexts, and the promotion of physical activity are limited as follows: 1. The results of this study are limited to SOFIT observations of 165 physical education lessons from 7 high schools in the Pittsburgh Public Schools. The System for Observing Fitness Instruction Time (SOFIT) a direct observation instrument measures student activity levels, lesson contexts, and teacher promotion of physical activity. No other measure of student physical activity levels, lesson contexts, or teacher interactions was used. The total number of SOFIT observations is limited by time and resources. SOFIT is a time intensive method of collecting data. 2. SOFIT data are limited to what can be seen or heard (McKenzie, 1991). In addition, direct observation utilizes momentary time sampling to record observations in 20 second intervals. Therefore, the SOFIT observations are limited to what is seen in heard during each momentary time sample and are not continuous type data 3. The results of SOFIT are further limited by instructional goals, class characteristics, and environmental conditions (McKenzie, 2002a). For example, the type of unit and the lesson placement in the unit limit the outcomes. In addition, the size and diversity of classes are known to influence the outcomes of SOFIT. Finally, the size and location of the space, the ratio of equipment for each student, and the weather also influence the outcomes of SOFIT. 8

4. The results of SOFIT observations may be influenced by subject reactivity to observers. Reactivity may have a positive or negative influence on all subjects. In this case, students and teachers may increase or decrease observed behaviors upon recognizing obs ervers are coding behaviors and in spite of the fact they are unaware of the specific behaviors being observed.

Operational Definitions 1. Health- Health is characterized by the absence of disease or infirmity and is also characterized by as a state of complete physical, mental, and social well-being. 2. Physical activity- Physical activity occurs when body movement is produced by the contraction of skeletal muscles requiring energy to be expended in order for the movement to be sustained. 3. Sedentary physical activity- Sedentary physical activity includes activities that involve energy expenditure at the level of 1.0-1.5 metabolic equivalent units (METs). (One MET is the energy cost of resting quietly, often defined in terms of oxygen uptake as 3.5 mL·kg -1 ·min -1 ). 4. MVPA- Moderate to vigorous physical activity, includes physical activity that expends 3.0 to 5.9 METs (moderate) and > 5.9 (vigorous) activity. On the SOFIT scale MVPA is calculated by combining all walking (4) and very active (5) scores to make a new variable (MVPA). 9

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5. MET- metabolic equivalent - 1 MET is the rate of energy expenditure while sitting at rest. It is taken by convention to be an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. Physical activities frequently are classified by their intensity using the MET as a reference. 6. Physical Activity Guidelines- Describe the types and amounts of physical activity that offer substantial health benefits for young people, adults, and seniors of all abilities and backgrounds. 7. Morbidity- Illness, disease; Can refer to the number of individuals in poor health during a given time period (the incidence rate) or the number who currently have that disease (the prevalence rate), scaled to the size of the population. 8. Mortality –Death; Mortality rate is typically expressed in units of deaths per 1000 individuals per year; thus, a mortality rate of 9.5 in a population of 100,000 would mean 950 deaths per year in that entire population. 9. Overweight among children- Overweight is defined as a BMI at or above the 85th percentile and lower than the 95th percentile among children. 10. Obesity among children- Obesity is defined as a BMI at or above the 95th percentile for children of the same age and sex. 11. Overweight among adults-An adult who has a BMI between 25 and 29.9 is considered overweight. 12. Obesity among adults- An adult who has a BMI of 30 or higher is considered obese.

CHAPTE R TWO

REVIEW OF LITERATURE Physical activity is an important health behavior and young people should engage in at least 60 minutes every day. Unfortunately, decline in physical activity begins during childhood and by the time many young people reach high school age they reportedly do not engage in sufficient amounts (NCHS, 2008). However, most of what is known about the physical activity behavior of high school-aged youth is generated from self-report data (e.g., YRBSS) and even though high school physical education is mandated in most states, very little is known about how much physical activity it provides. Therefore, the purpose of this study was to analyze existing data collected using direct observation in a high school setting in order to understand more about the quality and contribution of physical education to public health goals. The purpose of this review is to provide literary support for the importance of studying student physical activity levels during high school physical education using direct observation. For organizational purposes this chapter is divided into the three sections: (a) the relevance of studying the physical activity behavior, (b) physical activity during physical education and (c) measurement of physical activity during physical education. Each section is organized into sub-sections. What follows next is the introduction to section one, the relevance of studying the 11

physical activity behavior of young people.

The Releva nce of Studying Physical Activity Behavior The study of physical activity behavior of young people is important for several reasons. Foremost, physical activity is related to health and therefore, in the first sub-section the relationship between physical activity and health is presented. Second, because physical activity is associated with good health it is often recommended as a preventive health behavior. In the second sub-section, an overview of the national guidelines and recommendations for regular and sufficient participation in physical activity are presented. Finally, physical activity behavior is influenced by many factors and in spite of the fact it is commonly recommended for good health, a large number of people do not engage in sufficient amounts. In sub-section three the prevalence of physical inactivity among young people today is described and the correlates and determinants of physical activity behavior are presented. Physical Activity and Its Relationship to Health According to the World Health Organization (WHO) good health is characterized by the absence of disease or infirmity and is described as a state of complete physical, mental, and social well-being (as cited in Bouchard, Blair, & Haskell, 2007). Unfortunately, the number of young people living in poor health is increasing annually (Aronne, Brown, & Isoldi, 2007; USDHHS, 2006) and coincides with increasing morbidities and mortality associated with chronic conditions in adulthood. The impact of morbidity, mortality, and medical 12

expenditures associated with physical inactiv ity are a detriment to society (Aronne, et al., 2007). Physical inactivity is believed to be the leading behavioral cause of death in the United States (Mokdad, Marks, Stroup, & Gerberding, 2004) and today sedentary lifestyle is recognized as a world-wide public health problem (WHO, 2002). The relationship between physical inactivity, overweight, and obesity has been well-documented (e.g., USDHHS, 1996, 2002, 2004b; USDHHS & USDA, 2005). The conditions of overweight and/or obesity increase the risk of high blood pressure, high cholesterol, type 2 diabetes, heart disease, stroke, gall bladder disease, arthritis, sleep disturbances, breathing problems and certain types of cancers (CDC, 1997; Sinha et al., 2002; National Center for Health Statistics, 2008, USDHHS, 2000, 2004b, 2007) The costs and consequences of physical inactivity are enormous and growing (Finkelstein et al., 2003; Finkelstein, Fiebelkorn, & Wang, 2004). Today, over 430 billion dollars is spent each year due the direct and indirect costs of cardiovascular disease and 92.6 billion dollars alone are spent on overweight and obesity annually (Arrone, et al., 2007). For this reason, many believe that increasing participation in physical activity among young people is important because it could help reduce the burden of chronic health problems on society (Luepker, 1999) by decreasing costs associated with morbidity and mortality (Hahn, Teutsch, Rothenberg, & Marks, 1990; USDHHS, 2002). The importance of physical activity in the reduction of the nation’s mortality and morbidity has been clearly established through decades of epidemiological 13

research (USDHHS, 1996). In particular, studies have shown that participation in physical activity is associated with lo wer prevalence of metabolic syndrome (Alexander, Landsman & Grundy, 2008; Chen, Roberts & Barnard, 2006; Chen, Srinivasan & Berenson, 2008; Ekeland, et al., 2005; Sui, et al., 2007; Irwin, et al., 2002; Jurca, et al., 2004), reduced occurrences of back pain and fractures (Malina, Bouchard, & Bar-Or, 2004) and improved psychological health and mood (Biddle, Fox, & Boutcher, 2000; Glassa et al., 2004). More is known about the health benefits of physical activity in adults than in young people (USDHHS, 1996), however, childhood physical activity tracks into adulthood (Malina, 1996; Trudeau, Laurencelle, & Shephard, 2004) and there are some known immediate benefits (Gidding, et al., 2006; Strong, et al., 2005).

For example, children’s habitual physical activity is positively associated with most health-related fitness components and increases in physical activity and fitness are related to improved measures of health (Strong, et al., 2005). In addition, reviews of the scientific literature indicate that physical activity reduces risk of cardiovascular disease, overweight, and Type 2 diabetes, and vigorous activity helps increase the strength and density of bones (Sothern, Loftin, Suskind, Udall, & Blecker, 1999). Improvements in flexibility, muscular strength, and bone health not only advance movement and sport related performances, but are also are thought to be related to reduced back pain and fractures in adulthood (Malina, et al., 2004).

Vigorous physical activity may also help improve psychological health and mood, and can assist in reducing blood pressure and increasing HDL-cholesterol among high-risk youths (Strong, et al., 2005). 14

The benefit s of physical activity for young people include health-related, social, psychological, and cognitive benefits (USDHHS, 1996; Rowland, 2007). The health benefits for young people include better weight status, lower blood pressure, greater levels of good cholesterol (HDL), and lower risk for type II diabetes mellitus and some cancers (Rowland, 2007; Sothern, et al., 1999). In addition, many young people who participate in regular physical activity feel greater self-esteem and manage stress more efficiently (USDHHS, 1996). Further, participation in physical activity may have cognitive benefits (Sibley & Etnier, 2003) associated with executive functions such as planning, abstract thinking, rule acquisition, initiating or inhibiting appropriate actions, and selecting relevant sensory information (Tomporowski, Davis, Miller, & Naglieri, 2007; Hillman, Castelli, & Buck, 2005). Recommendations and Guidelines for Physical Activity Recommendations and guidelines for physical activity are mounting as society becomes more reliant on technology, participation in physical activity declines, and the prevalence and cost of chronic health problems continue to grow exponentially (NCHS, 2008). Recently, the United States Government released its first ever 2008 Guidelines for Physical Activity for Americans (USDHHS, 2008b). The 2008 Guidelines recommend that young people engage in at least 60 minutes of moderate or vigorous physical activity every day. The guidelines also suggest young people participate in a variety of developmentally appropriate activities including vigorous, muscle strengthening, and bone 15

strengthening activities at least 3 days of every week (USDHHS, 2008b). The guidelines verify and extend previous recommendations for children and adolescents to participate in at three sessions of at least 20 minutes of moderate intense phy sical activity per week and preferably daily (CDC, 1997). The guidelines support previous recommendations that children and youths should participate in a variety of physical activities that are developmentally appropriate and enjoyable (CDC, 1997; Strong, et al., 2005) and clarifies the types (e.g., vigorous, muscle and bone strengthening) of physical activities that are recommended. Prior to the 2008 Guidelines, governmental recommendations for participation in regular physical activity are evident from a number of sources. The 1996 Surgeon General’s Report on Physical Activity and Health is a landmark review of the relationship between physical activity and health (USDHHS, 1996). One of the major findings of the report is that physical activity is good for all people regardless of age. The report is a milestone because it represents the first time; the Surgeon General recognizes physical inactivity is a serious public health problem. The Healthy People initiative establishes health objectives for the nation and includes physical activity as one of ten leading health indicators which reflect major health issues in the United States (USDHHS, 2000). For each leading health indicator, measurable objectives are identified that, if accomplished, would improve the health and well-being and reduce health disparities among all Americans. Several of the Healthy People objectives for physical activity target 16

improvement of the physical activity behavior of young people (USDHHS, 2000). The goals for physical activity include specific objectives for participation in vigorous ph ysical activity (VPA) and MVPA, daily physical education, and also include a target goal for students to engage in MVPA during physical education classes. The 60-minute per day goal for young people is also reflected in the 2005 Dietary Guidelines for Americans (USDHHS & USDA, 2005) which also recommended activity can be accumulated throughout the day and in various settings. The United States Dietary Guidelines for Americans provides important information on good dietary habits and include physical activity in the discussion since energy expenditure is related to energy consumption. Further, the guidelines purport that adequate physical activity provides protection against chronic diseases and helps to balance energy expenditure and intake. The Prevalence of Physical Inactivity Among Young People Unfortunately, many do not engage in sufficient physical activity due to a myriad of personal, social, and environmental barriers. Despite the many documented benefits of physical activity, numerous reports suggest that all segments of the population, including children and youths, do not engage in sufficient activity for health purposes (Ogden, et al., 2002; Pate, et al., 2006; Strong, et al., 2005; USDHHS, 2006).

Full document contains 91 pages
Abstract: The purpose of this study was to analyze existing data collected using direct observation in a high school setting in order to understand more about the quality and contribution of physical education to public health goals. The System for Observing Fitness Instruction Time (SOFIT) was utilized to collect data related to student activity levels, lesson contexts, and teacher promotion of physical activity behavior. Two cross-sectional samples were observed in the spring 2005 and spring 2007 from seven high schools in a large urban school district in the eastern United States. In total, 164 lessons were observed yielding over 75 hours of observation. Descriptive statistics were calculated and logistic regression was utilized to determine the association between lesson contexts and student activity levels. The results showed the mean length of lessons was 29.1 minutes which translated to 32% shorter than scheduled. Students engaged in MVPA during 53% of the total intervals, however, only 13% were vigorous. Physical activity was not promoted 73% of the time, and, coincidently, a majority of the lessons did not meet public health guidelines (n = 93, 57%) and only engaged students in MVPA for 35% of the lesson length. "Skill practice" was the best predictor of MVPA (Odds Ratio = 1.7) and best source of vigorous physical activity, however was only observed in 4% of the total intervals. The dominant lesson contexts were "game play" (49%) followed by "fitness activity" (21%). Little time was spent in "knowledge" (4%). In this study environmental factors related to instructional goals (i.e., lack of knowledge, skill practice, and promotion of physical activity) and decreased lesson length diminished the quality and contribution of physical education to public health goals. The quality and contribution of high school physical education can be improved by increasing student participation in vigorous physical activity, modifying instructional goals to include more knowledge and skill related content, and increasing the promotion of physical activity. More studies should be conducted to examine the relationship between key environmental and policy influences (e.g., lesson length, time spent in contexts, professional development) on the quality and contribution of high school physical education to public health goals.