Translating School Physical Education and Activity Policies into Practice: A Case Study.

BACKGROUND: Public health experts recommend school-based policies as a population based approach to increase youth physical activity. The purpose of this case study is to describe one, largely rural, state's efforts to translate this recommendation into practice. Details about the genesis, implementation and evolution of two state level policies (physical education and physical activity), as well as in-house efforts of a State Department of Education to monitor policy compliance and challenges encountered are described. Two specific years are highlighted, due to policy and monitoring enhancements made during those particular time periods. METHODS: Data for this paper come from the West Virginia Department of Education for two time periods: 2013-2014 and 2014-2015 (n=369 elementary schools). Descriptive statistics for quantitative data and content analysis for qualitative data were used to document school level compliance and provide context for implementation challenges. RESULTS: Greater than 70% of school principals reported achievement of physical education and physical activity policy expectations for each year. Limited staff was the predominant explanation for nonfulfillment of physical education expectations, followed by lack of time and facilities. Recess and classroom-based physical activity were the primary strategies used to comply with the physical activity expectations. PE and PA policy compliance varied significantly by certain school characteristics in each school year studied. CONCLUSIONS: Further investigation is warranted on how states translate public health policy recommendations into practice, including how physical education and physical activity policies are developed and monitored at the state level and how to support states and schools with monitoring and implementation challenges.

Challenges and Lessons Learned From a Prevention Research Center Partnership.

For more than a decade, the West Virginia Prevention Research Center, Mid-Ohio Valley Health Department, and the Wood County Schools have built and sustained a partnership to reduce health disparities and promote population health. Specifically, this partnership has contributed significantly to the peer-reviewed literature on children's physical activity, fitness, and academic achievement, as well as identifying possible areas for physical activity interventions (within the school and community settings) that would improve health and academic outcomes. This case study describes the partnership among a University Prevention Research Center, a local health department, and a local school system. In the description of the partnership, this paper sequentially explores characteristics of the partnership that were advantageous or challenging over time. It details the interface among state and local partner interest, resources, and goals all directed toward enhancing children's physical activity, fitness, cardiovascular risk, and academic improvement. The paper concludes with lessons learned that may contribute to the science and practice of multilevel collaborations in child health.

Observing anthropometric and acanthosis nigrican changes among children over time.

This study assessed the anthropometrics and acanthosis nigricans (AN) in a sample of 7,337 children at two assessments. Four groups of children were identified based on the presence of AN at both time points: those who never had the marker, those who gained the marker, those who lost the marker, and those who maintained the marker. Group differences in height, weight, body composition, and the amount of change in these variables over time were explored. Our findings demonstrated that children who maintain or gain the AN marker had the greatest height, weight, and body composition changes over time. It is apparent that the AN marker does disappear in some children and that this is associated with lower weight gain and body composition loss. If interventions can be developed targeting children who present with the marker, it is likely that their risk of developing type 2 diabetes could be reduced.

Children's aerobic fitness and academic achievement: a longitudinal examination of students during their fifth and seventh grade years.

OBJECTIVES: We assessed children's potential differences in academic achievement based on aerobic fitness over a 2-year period. METHODS: The longitudinal study sample included 3 cohorts of students (n = 1725; 50.1% male) enrolled in a West Virginia public school system. Students received baseline fitness and academic assessments as fifth graders and at a 2-year follow-up assessment. We used FitnessGram to assess fitness in aerobic capacity and WESTEST, a criterion-based assessment, for academic performance. RESULTS: Students who stayed in the healthy fitness zone (HFZ) had significantly higher WESTEST scores than did students who stayed in the needs improvement zone (NIZ). Students who moved into or out of the HFZ occasionally had significantly higher WESTEST scores than did students who stayed in the NIZ, but they were rarely significantly lower than those of students who stayed in the HFZ. CONCLUSIONS: Students' aerobic capacity is associated with greater academic achievement as defined by standardized test scores. This advantage appears to be maintained over time, especially if the student stays in the HFZ.

L.I.F.E.: a school-based heart-health screening and intervention program.

This article describes the development and growth of Lifestyle Improvements in the Family Environment (L.I.F.E.), a school-based heart-health screening and intervention program. The primary goals of L.I.F.E. through three rounds of grant funding remained constant: (a) to identify cardiovascular risk factors in students and their families and (b) to provide counseling, education, and opportunities to change lifestyle routines that contribute to those risk factors. The program began with direct ties to a university-based research program and grew with evidence-based successes and development of community partnerships. Waves of growth were influenced by capacity-building efforts, partnership development, and resource availability. School nurses managed the screening component and partnered with appropriate others in the intervention programming. School nurses are appropriately positioned to assist families as well as school and community partners in decreasing the incidence of obesity and promoting healthy lifestyle behaviors.

The extended relationship between child cardiovascular risks and academic performance measures.

OBJECTIVE: To examine the relationship between children's overweight status and other cardiovascular risk fitness factors and academic performance among fifth-grade students. RESEARCH METHODS AND PROCEDURES: Using a sample of 968 fifth-grade students (50.7% boys; mean age = 10.6 years), children's cardiovascular risks (BMI, blood pressure, acanthosis nigricans) and fitness measures were compared with their mean group performance scores across four subscales (mathematics, reading/language arts, science, and social studies) of a statewide standardized academic performance test. RESULTS: Of this sample, 39% were either at risk for being overweight or were already overweight; slightly over one half were of normal weight. Initial findings revealed a significant relationship between children's weight category and their reading/language arts, mathematics, and science test scores even after controlling for a proxy of socioeconomic status. When additional cardiovascular risk and fitness measures were included in the model, however, children's BMI status had no association. Instead, a composite fitness index, children's blood pressure, sex, and proxy of socioeconomic status were significantly associated with children's academic test scores. DISCUSSION: This study expanded our understanding of the connection between children's overweight risks and academic performance by examining the impact of other cardiovascular risk factors such as high blood pressure and measures of fitness. These findings support the development and implementation of childhood cardiovascular risk surveillance programs that evaluate not only children's overweight risks but also their fitness, risk for type 2 diabetes, and/or high blood pressure by showing a relationship between some of these risks and children's academic test performance.