Assessing sustainability of Lifestyle Education for Activity Program (LEAP).

Sustained intervention effects are needed for positive health impacts in populations; however, few published examples illustrate methods for assessing sustainability in health promotion programs. This paper describes the methods for assessing sustainability of the Lifestyle Education for Activity Program (LEAP). LEAP was a comprehensive school-based intervention that targeted change in instructional practices and the school environment to promote physical activity (PA) in high school girls. Previous reports indicated that significantly more girls in the intervention compared with control schools reported engaging in vigorous PA, and positive long-term effects on vigorous PA also were observed for girls in schools that most fully implemented and maintained the intervention 3 years following the active intervention. In this paper, the seven steps used to assess sustainability in LEAP are presented; these steps provide a model for assessing sustainability in health promotion programs in other settings. Unique features of the LEAP sustainability model include assessing sustainability of changes in instructional practices and the environment, basing assessment on an essential element framework that defined complete and acceptable delivery at the beginning of the project, using multiple data sources to assess sustainability, and assessing implementation longitudinally.

Implementation of a school environment intervention to increase physical activity in high school girls.

Physical activity levels begin to decline in childhood and continue falling throughout adolescence, with girls being at greatest risk for inactivity. Schools are ideal settings for helping girls develop and maintain a physically active lifestyle. This paper describes the design and implementation of 'Lifestyle Education for Activity Program', or LEAP. LEAP used a health team approach with participatory strategies to provide training and support, instructional capacity building and opportunities to adapt school instructional program and environmental supports to local needs. The social-ecological model, based on social cognitive theory, served as the organizing framework for the LEAP intervention and elements of the coordinated school health program model as intervention channels. For the 12 intervention schools, LEAP staff documented 191 visits and interactions with 850 individuals over the 2-year period. Teachers reported successful implementation of most components of the intervention and demonstrated optimism for sustainability. These results indicate that a facilitative approach to intervention implementation can be used successfully to engage school personnel, and to change instructional programs and school environments to increase the physical activity level of high school girls.

Effects of the CATCH physical education intervention: teacher type and lesson location.

BACKGROUND: Substantial differences exist in how and where physical education (PE) is conducted in elementary schools throughout the United States. Few effectiveness studies of large-scale interventions to improve PE have been reported. DESIGN: Multicenter randomized trial. SETTING/ PARTICIPANTS: The Child and Adolescent Trial for Cardiovascular Health (CATCH) was implemented in PE classes in 96 schools (56 intervention, 40 control) in four study centers: California, Louisiana, Minnesota, and Texas. INTERVENTION: The 2.5-year PE intervention consisted of professional development sessions, curricula, and follow-up consultations. MAIN OUTCOME MEASURES: Intervention effects on student physical activity and lesson context in PE were examined by teacher type (PE specialists and classroom teachers) and lesson location (indoors and outdoors). RESULTS: Differential effects by teacher type and lesson location were evidenced for both physical activity and lesson context. Observations of 2016 lessons showed that intervention schools provided more moderate-to-vigorous physical activity (p=0.002) and vigorous physical activity (p=0.02) than controls. Classroom teachers improved physical activity relatively more than PE specialists, but PE specialists still provided longer lessons and more physical activity. Classroom teachers increased lesson length (p=0.02) and time for physical fitness (p=0.03). CONCLUSIONS: The intervention improved PE of both specialists' and classroom teachers' lessons. States and districts should ensure that the most qualified staff teaches PE. Interventions need to be tailored to meet local needs and conditions, including teacher type and location of lessons.

School physical education: effect of the Child and Adolescent Trial for Cardiovascular Health.

BACKGROUND: Physical inactivity is a risk behavior for cardiovascular and other diseases. Schools can promote public health objectives by increasing physical activity among youth. METHODS: The Child and Adolescent Trial for Cardiovascular Health (CATCH) was a multicenter, randomized trial to test the effectiveness of a cardiovascular health promotion program in 96 public schools in four states. A major component of CATCH was an innovative, health-related physical education (P+) program. For 2.5 years, randomly assigned schools received a standardized PE intervention, including curriculum, staff development, and follow-up. RESULTS: Systematic analysis of 2,096 PE lessons indicated students engaged in more moderate-to-vigorous physical activity (MVPA) in intervention than in control schools (P = 0.002). MVPA during lessons in intervention schools increased from 37.4% at baseline to 51.9%, thereby meeting the established Year 2000 objective of 50%. Intervention children reported 12 more min of daily vigorous physical activity (P = 0.003) and ran 18.6 yards more than control children on a 9-min run test of fitness (P = 0.21). CONCLUSIONS: The implementation of a standardized curriculum and staff development program increased children's MVPA in existing school PE classes in four geographic and ethnically diverse communities. CATCH PE provides a tested model for improving physical education in American schools.