Physical activity and academic achievement: an analysis of potential student- and school-level moderators.

BACKGROUND: Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement. METHODS: In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8-9) and at follow-up in Grade 4 (ages 9-10). Standardized test scores were not measured in Grade 5 (ages 10-11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship. RESULTS: Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (ß = -0.159 p < 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (ß = -0.128 (p < 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities. CONCLUSIONS: Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics. TRIAL REGISTRATION: This study was registered with the National Institutes of Health (NIH) ClinicalTrials.gov system, with ID NCT03765047 . Registered 05 December 2018-Retrospectively registered.

The longitudinal association between objectively-measured school-day physical activity and academic achievement in US elementary school students.

BACKGROUND: It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement. METHODS: In a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics. RESULTS: Cross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had ß = --0.066, ß = --0.063, ß = --0.066, and ß = --0.058 associations (p <  0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had ß = --0.206 and ß = --0.283 (p <  0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were - 1.666, - 1.638, and - 1.993 points lower respectively (p <  0.001). CONCLUSION: The cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA - which would constitute an approximately 300% increase from current levels - results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress. TRIAL REGISTRATION: ClinicalTrials.gov , NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03765047.

Nutrition Policies, Practices, and Environments in Low-Income Georgia Elementary Schools, United States, 2015-2017.

BACKGROUND: A nutritious diet can prevent obesity and chronic disease and improve academic performance, yet many children have energy-dense, nutrient-poor diets. The objective of this study was to assess nutrition policies, practices, and environments in Georgia Supplemental Nutrition Assistance Program Education (SNAP-Ed) elementary schools and compare them across school-level demographic characteristics. METHODS: We distributed a cross-sectional online survey to administrators, grade level chairs, and nutrition managers from 113 Georgia SNAP-Ed elementary schools during 2015-2017. Logistic regression, one-way ANOVA, and Tukey's tests were performed to assess differences by free and reduced-price lunch eligibility and percentage black. Fisher's exact and Rao-Scott chi-square tests were performed to assess differences by school size and geography. RESULTS: The majority of schools established wellness policies and committees, provided nutrition education, and offered fresh fruits and/or vegetables daily. Fewer schools had policies limiting sugar-sweetened foods within classrooms or had established a school garden. There were minimal significant differences in survey responses across school-level demographics. CONCLUSIONS: Georgia SNAP-Ed elementary schools are providing healthy nutrition settings for their students in a number of areas, and can further improve by establishing more comprehensive wellness policies, a committee to enforce them, and engaging children in hands-on nutrition education activities.

Health Empowers You: Impact of a School-Based Physical Activity Program in Elementary School Students, Georgia, 2015-2016.

BACKGROUND: Most youth in the United States do not meet the recommended 60 minutes of daily physical activity (PA). The school environment offers an opportunity to engage students in PA. The purpose of this study was to evaluate the impact of a comprehensive school-based physical activity program on student PA across student-level and school-level characteristics. METHODS: PA levels from 3294 fourth grade students in 24 intervention schools and 7 control schools in metropolitan Atlanta, Georgia were measured during the 2015-2016 academic year. PA measures included daily steps in school, steps taken in physical education class (PE), and percent of PE class time spent in moderate-to-vigorous physical activity (MVPA). Intervention effectiveness was assessed using generalized estimating equations adjusting for sex and school-level socioeconomic status (SES). RESULTS: After adjusting for sex and school-level SES, intervention students had significantly higher increases in average daily steps (p < .05), steps taken in PE (p < .01), and percent of PE class spent in MVPA (p < .01) than control students. CONCLUSIONS: Our findings demonstrate the effectiveness of CSPAPs in increasing PA. Further research using randomized controlled trials of large-scale implementations, longer follow-up periods, and more diverse student sample is warranted.

Elementary school physical activity opportunities and physical fitness of students: A statewide cross-sectional study of schools.

BACKGROUND: Using a cross-sectional design, we assessed the relationship between the time schools provide for physical activity and the proportion of students achieving a healthy aerobic capacity or body mass index. METHODS: In 2013-2014, physical education and grade-level teachers from 905 of 1,244 Georgia elementary schools provided survey data about the frequency and duration of physical activity opportunities offered before, during, and after school. Log-binomial models related the weekly physical activity minutes provided by schools to the proportion of children in the FitnessGram healthy fitness zone for aerobic capacity or body mass index while adjusting for school characteristics and demographics. RESULTS: During-school physical activity time was not associated with student fitness, but schools with before-school physical activity programs had a moderately higher prevalence of healthy aerobic capacity (prevalence ratio among girls: 1.06; 99% confidence interval: 1.00-1.13; prevalence ratio among boys: 1.03; 99% confidence interval: 0.99-1.08). Each additional 30 minutes of recess per week was associated with no more than a 3%-higher proportion of students with healthy body mass indexes (prevalence ratio among girls: 1.01; 99% confidence interval: 1.00-1.03; prevalence ratio among boys: 1.01; 99% confidence interval: 0.99-1.03). CONCLUSIONS: The amount of physical activity time provided by schools is not strongly associated with school-aggregated student fitness. Future studies should be designed to assess the importance of school-based physical activity time on student fitness, relative to physical activity type and quality.

Impact of an Elementary School-Based Intervention on Physical Activity Time and Aerobic Capacity, Georgia, 2013-2014.

OBJECTIVES: The objectives of this study were to (1) determine the impact of a 1-year elementary school physical activity intervention on changes in teacher-reported school-based physical activity time and (2) assess the relationship between these changes and changes in student aerobic capacity. METHODS: HealthMPowers, a nonprofit organization, provided a multicomponent physical activity intervention to 3479 students in 39 schools in Georgia during 2013-2014. HealthMPowers administered a survey to faculty members before (August 2013) and after (May 2014) the intervention to measure student physical activity times. The organization collected pre- and post-intervention Progressive Aerobic Cardiovascular Endurance Run (PACER) laps (a measure of aerobic capacity that awards 1 lap for each completed 20-meter lap) for 2342 fourth-grade students. We performed linear regression to determine the relationship between school-level changes in teacher-reported school-based physical activity time and student aerobic capacity. RESULTS: The weekly estimated teacher-reported time in physical activity increased by 39 minutes from pre- to post-intervention: 21 minutes for recess, 17 minutes for classroom, and 1 minute for physical education. The mean number of student PACER laps increased by 3 laps from pre- to post-intervention, and 1515 of 2342 (65%) students increased the number of PACER laps completed. We observed a positive association between school-level changes in school-based physical activity time and school-level changes in PACER laps ( r = 0.38; 95% confidence interval, 0.29-0.46). CONCLUSIONS: These findings highlight the need for more prospective research into multicomponent physical activity interventions. Rigorous testing, including randomized controlled trials of large-scale implementations, is needed to examine how these school-based interventions might be used to improve the physical activity and fitness of larger populations of children.