1

Establishing a Comprehensive School Physical Activity Program

Centers for Disease Control and Prevention

&

Georgia State University

2012 Seed Award Program for Social and Behavioral Science Research

Final Report Submitted by Michael W. Metzler

September 25, 2015

Co-Principal Investigators:

(CDC) Seraphine Pitt Barnes, PhD, MPH, CHES (GSU) Michael W. Metzler, PhD

Health Scientist, Division of Population Health Professor, Kinesiology & Health

Co-Investigators (CDC):

Allison J Nihiser, MPH Sarah M. Lee, PhD

Health Scientist Lead Health Scientist

Division of Population Health Division of Population Health

Co-Investigators (GSU):

Shannon Barrett-Williams, PhD Kari Hunt, M.Ed. Clinical Assistant Professor Doctoral Student

Kinesiology and Health Kinesiology and Health

Jenee Marquis, M.Ed. Margaret Trent, M.Ed. Doctoral Student Doctoral Student

Kinesiology and Health Kinesiology and Health

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

2

In the spring of 2012 a collaborative team of researchers at the Centers for Disease Control and

Prevention (CDC) and Georgia State University (GSU) were awarded a two-year CDC/GSU

Seed Award Grant. The grant allowed GSU to design, to implement and evaluate a

Comprehensive School Physical Activity Program (CSPAP) at Peachtree Charter Middle School

(PCMS) in DeKalb County, GA. CDC served in a technical advisory capacity for the project. A

CSPAP includes five components: 1) quality physical education; 2) physical activity during

school; 3) physical activity programs before- or after school; 4) staff involvement; and 5) parent

and community involvement (http://www.cdc.gov/healthyyouth/physicalactivity/cspap.htm;

http://eric.ed.gov/?id=EJ826304 ). The CSPAP model is recommended in CDC’s 2011 School

Health Guidelines to Promote Healthy Eating and Physical Activity; a similar concept (called

whole-of-school approach) was strongly endorsed by the Institute of Medicine in 2013.

The purpose of this study was to establish a two-year pilot CSPAP in an urban middle school

(PCMS) and conduct in-depth analysis of its design, implementation, feasibility, and efficacy in

achieving a series of CSPAP outcomes such as expanded teacher expertise, increased physical

activity by students, increased parental knowledge and involvement, and an overall improved

school environment that can contribute to the goal of every child being physically active for 60

minutes each day. The CSPAP plan designed for this study is based on the Health Optimizing

Physical Education (HOPE) curriculum model (Metzler et al., 2013a, 2013b) (See Appendix A).

This project was conducted at Peachtree Charter Middle School (PCMS) in DeKalb County.

PCMS is racially diverse, with 22% African-American, 22% Hispanic, 9% Asian, and 45%

White students. Nearly 35% of PCMS students qualify for free or reduced school meals.

Because this is a two-year study, only students in the sixth and seventh grades in fall of 2013

were included (current estimates: 450 6th graders and 400 7th graders).

Students at PCMS take health or physical education as an elective; neither are required by state

law or school district regulations. About 70% of PCMS students elect to take one or more 9-

week terms in health or physical education. Health and physical education classes are offered in

50-minute periods on a daily basis for those students who are enrolled in them.

The 2012-2013 school year was devoted to 1) securing IRB approvals at GSU and from DeKalb

County Schools Research Office; 2) establishing a working relationship between the GSU and

CDC researchers; and 3) planning for the implementation of the PCMS CSPAP in the 2013-2014

and 2014-2015 school years.

It should be noted that there existed a clear delineation in project roles and responsibilities

between the teams of researchers at CDC and GSU. CDC personnel served in a technical

advisory capacity regarding data collection plans and methods; GSU personnel served to provide

direct assistance to the six PCMS Health and Physical Education (HPE) staff for the

development and implementation of the CSPAP, and to complete the approved data collections

and analyses.

Appendix B provides an overview of the various activities undertaken and completed in Years 1

and 2.

Securing IRB Approvals

3

The Co-PI from GSU and other GSU researchers submitted a Study Application to the GSU IRB

in January of 2013. That application included a signed agreement from DeKalb County Schools

to allow the study to be conducted at PCMS for two years. Concurrent with that application, the

GSU research team submitted a request to the DeKalb County Schools Research Office for its

official approval. Both approvals were given in May of 2013, and the project began in earnest.

Planning and Training

GSU Research Staff meetings

The GSU research team includes two faculty, Michael Metzler (Co-PI) and Shannon Williams

(CO-Investigator), and three doctoral research assistants funded from a combination of the

project budget and research budget of the Kinesiology and Health Department.

That team met numerous times in Year 1 to:

1. Plan the CSPAP implementation at PCMS

2. Prepare the PCMS teacher trainings

3. Prepare resources for the PCMS teachers

4. Plan to complete the approved data collection schedule

5. Collate and analyze Year 1 data

That team met numerous times in Year 2 to:

1. Prepare the PCMS teacher trainings

2. Prepare resources for the PCMS teachers

3. Plan to complete the approved data collection schedule

4. Collate and analyze Year 2 data

Training and follow-up meetings at PCMS

The GSU staff met with the six PCMS HPE teachers over three days in June of 2013 to facilitate

their planning and implementation of the HOPE CSPAP in the 2013-2014 school year. It should

be emphasized that it was not the role of GSU staff to make decisions and plans for the PCMS

teachers; our role was to facilitate and support their efforts to establish the HOPE CSPAP

themselves and to provide needed resources in that effort. Two follow up meetings were held

during Year 1 to discuss the teachers’ perceptions of the implementation and to learn about

additional resources and support they needed.

The GSU staff met with the PCMS HPE teachers over two days in August of 2014. The purpose

of those meetings was to summarize the activities of the previous school year, and to make

updated plans for the 2014-2015 school year regarding program implementation and evaluation.

The GSU staff met with the PCMS teachers monthly on site during the 2014-2015 school year.

A sample agenda and minutes from a training meeting are presented in Appendix C.

4

Implementation of the CSPAP

Development of Technology Resources

To facilitate their efforts to establish their CSPAP, the GSU team developed internet-based

resources (e.g. high-Moderate to Vigorous Physical Activity [MVPA] unit and lesson plans on

Dropbox) and provided four iPads to PCMS HPE teachers to better track physical activity on

“CV Days.” CV Days took place on each Monday. Students completed a 15-minute run/walk,

attempting to meet or exceed their personal goals for distance covered in that time. Students

who achieved their personal goals were acknowledged on a public display board in the PCMS

gym. Following the timed run, students could choose from several options to remain in MVPA

time for the rest of the period.

Physical Education (MVPA in classes)

One purpose of the training meetings was to have the PCMS teachers discuss ways they could

provide more MVPA in their physical education classes. To accomplish this, they agreed to

make changes in class management routines (e.g., using ‘instant activities’ instead of sedentary

class starting plans, having students stretch and exercise while waiting turns in class), offer more

high-MVPA units during the year (e.g., Ultimate Frisbee) and to provide more MVPA time for

students on designated “CV Days.” The teachers were provided with SPARK-PE Middle School

Resource Kits, but they elected as a group not to implement a full SPARK-based curriculum.

Instead, they would use selected SPARK lesson plans in certain instructional units in place of

some current low-MVPA plans. The PCMS HPE staff decided to conduct “CV Choice Day” on

every other Friday (instead of each Friday), and to use student goal-setting and achievement as

the basis for grades on those days. (Previously, only students who met predetermined lap counts

could get high grades on CV Choice Days).

Before/After School Physical Activity (PA) Programming

The PCMS HPE teachers agreed to start a before/after school physical activity program in the

second 9-week term of the year. One teacher assumed the primary recruiting and instructional

responsibilities for the program. Some criteria were set for the conduct of the program: 1) it

would be open to any PCMS student who wished to participate (no exclusions); 2) it would be

voluntary—students could attend any time they chose, but had to indicate their plans one day

ahead to help with planning; 3) it would be not be competition-based or team-based (e.g., not a

team intramural league); and 4) Parental permission was required.

The before/after school PA program was announced in PE classes but no other formal

recruitment effort was made; the lead teacher wanted it to grow “by word of mouth” from

students who found value in it. Initial attendance was low, around 10 students each day. By the

end of the school year, daily attendance averaged over 60 students. The program offered

fitness/strength training, low-organization games (e.g., Ultimate Frisbee, basketball), and aerobic

activities.

5

Family Participation and Parent Education Events at PCMS

Two major events were offered each year as part of the CSPAP. The first was the “CV Classic”

run/walk event, open to all PCMS students, parents and families. The CV Classic is the annual

fitness promotional event planned by the HPE staff and sponsored by several local businesses

and community organizations. It takes place on a Saturday morning, and features a 3.1KM

walk/run fun event, and informational booths for physical activity, nutrition and health

monitoring (e.g., blood pressure). In order for a student to participate, he/she must be

accompanied by a parent or other adult family member.

The second event was a parent education program held at PCMS one evening in the springs of

2014 and 2015. The purpose of the event was to introduce parents to the PCMS PE program,

provide health-related information and screenings, and offer suggestions for whole-family

physical activity options in the community. The event included speakers from GSU, CDC, and

local community physical activity/health organizations, and class project displays from PCMS

6th graders on similar topics.

Measuring Outcomes in Years 1 and 2

All students at PCMS were eligible to participate in the Year 1 CSPAP, either by attending PE

for one or more 9-week terms, participating in the before/after school program, or by joining a

parent/s at one of the scheduled events described above. For logistical and budgetary reasons it

was not possible to collect outcomes data on every student in the school. Data collection

excluded 8th graders in 2013-2014 because they would not be at PCMS for the full two-year

implementation. A random sample of 150 6th and 7th graders were selected and recruited to

participate in the data collection part of the project. Of those, 109 (54 boys, 55 girls) returned

signed parent consent forms and personal assent forms to indicate their willingness to have data

collected on them in the project. Ninety-nine of those students were still attending PCMS in the

spring of 2014. Ninety of the sampled students were attending PCMS in the spring of 2015.

FITNESSGRAM Testing for Health-Related Fitness Indicators

All students who took physical education were required by state regulations to complete five

parts of the FITNESSGRAM testing battery: curl ups (abdominal strength), push ups (upper

body strength), sit and reach (flexibility), and a combination of PACER and BMI (from height

and weight) to determine an estimate of VO2MAX (aerobic capacity). The students in the

random sample were tested and recorded by the GSU research team, using the strictest

procedural and counting criteria; all other students were tested by the PCMS HPE staff. The

Baseline (fall 2013), End Year 1 (spring 2014) and End Year 2 (spring 2015) results are shown

in Table 1. Table 2 shows the percent of students who met HFZs each year.

6

Table 1: Healthy Fitness Zones on FITNESSGRAM

Test Baseline HFZ End Year 1 HFZ End Year 2 HFZ

BMI (5-85%tile) 70.0% 69.3% 73.0%

Curl Ups 80.2% 88.0% 92.9%

Push Ups 72.4% 77.8% 90.7%

Sit and Reach 60.2% 52.0% 70.5%

PACER Laps 68.8% 70.6% 63.3%

Aerobic Capacity 66.1% 69.7% 62.4%

Table 2: Summary of HFZ Achievement by Year

Tests in

HFZ

Baseline

End Year 1

End Year 2

6 28.0% 27.9% 47.5%

5 28.0% 27.9% 25.0%

4 17.2% 20.9% 6.3%

3 11.8% 8.1% 12.5%

2 6.5% 10.5% 6.3%

1 7.5% 2.3% 2.5%

0 1.1% 2.3% 0.0%

Mean of

Tests in HFZ

4.32

4.38

4.88

The difference between Baseline and the end of Year 1 was not significant [t(71) = 1.96, p. =

.054]. The difference between Baseline and the end of Year 2 was significant [t(69) = 3.29, p. =

.002].

Test of Knowledge of Physical Activity and Healthy Eating

A test of knowledge about physical activity and healthy eating was developed from a validated

set of questions in the PE Metrics question bank. The selected 22 questions were matched to the

major goals for the CSPAP: increased physical activity and healthier food choices. The

randomly selected students (n=109) took the test on-line, in the school’s media center in

September 2013. The media center was not available during the post-test period in May of 2014,

so students (n=86) completed the test on hard copy, using pencils. Similarly, students (n=73)

took the spring 2015 tests on hard copy, using pencils. All tests were administered and monitored

by the GSU research team. Table 2 shows the mean scores for all sampled students, by grade,

and by gender.

7

Table 3: Percent Correct on Test of PA and Healthy Eating Knowledge

Group Baseline mean

End Year 1 mean

(% Gain)

End Year 2 mean

(% Gain from Baseline)

All Sampled 51.8 56.3 (8.7%) 64.3 (24.1%)

Grade 6 50.4 53.4 (6.0%) 61.1 (21.2%)

Grade 7 53.5 60.4 (12.9%) 67.6 (26.4%)

Girls 50.1 57.1 (14.0%) 68.7 (37.1%)

Boys 53.1 55.4 (4.3%) 59.9(12.8%)

The difference between Baseline and the end of Year 1 for all sampled students was significant

[t(85) = 3.05, p. = .003], as was the difference between Baseline and the end of Year 2 [t(68) =

6.22, p. = .000].

Accelerometry in Physical Education Lessons

PCMS had three distinct types of PE lesson types: “typical” lessons on Tuesdays, Wednesdays

and Thursdays; “CV Day” on Mondays; and “Choice Day” on Fridays. In typical lessons, the

focus was on the development of sport and movement skills that addressed the majority of

learning outcomes in the school’s curriculum.

On CV Days students were required to complete a 1-mile walk/run, trying to improve on their

personal best time for that distance. The PCMS teachers used iPads to track each student’s

personal best time and to encourage them to beat that time on the current day. Students who

were able to beat their personal best time were recognized with their names being posted on a

bulletin board at the entrance of the gym. Once students completed the 1-mile walk/run they

were required to participate in one of several high-PA activities planned by the teachers, or they

could continue to walk/run for the remainder of the period.

On Choice Days students were allowed to select from 3-4 planned learning activities that

included team sports, recreational games, aerobic dance, stretching, and walking/running.

Students were not allowed to “sit out” on Choice Days and had to be fully participating

throughout the entire class period.

The randomly selected students were directed to wear accelerometers (Actigraph Gt3x) during

each type of PE lesson. The devices recorded multiple variables related to both the intensity and

duration of physical activity in class. The students returned the devices to the GSU research

team who then extracted the pertinent data; students were not allowed to self-record or self-

report the data from their assigned devices. The Baseline (fall 2013), end of Year 1 (spring

2014) and end of year 2 (spring 2015) results are shown in Table 4 for physical activity in typical

PE classes.

Table 4 shows the means number of class minutes and the percent of class time in MVPA on

typical lesson days.

8

Table 4: Physical Activity Time and Percentages in Typical PE Lessons

Category Baseline End Year 1 End Year 2

Mins/50 Percent Mins/50 Percent Mins/50 Percent

Sedentary 18.8 37.6 19.8 39.9 16.9 33.8

Light PA 18.8 37.6 16.5 33.1 18.6 37.2

Moderate PA 6.2 12.4 6.3 12.6 7.5 15.0

Vigorous PA 6.2 12.4 7.2 14.4 7.1 14.2

M+VPA 12.4 24.8 13.5 27.0 14.6 29.2

The mean number of recorded minutes in PE classes was 50 (“bell to bell” time). Based on that,

students accrued 12.4 minutes of MVPA in baseline classes and 13.5 minutes in classes at the

end of Year 1 and 14.6 minutes at the end of Year 2. The difference between Baseline and the

end of Year 1 was not significant [t(69) = 1.02, p. = .312]. The difference between Baseline and

the end of Year 2 was significant [t(59) = 2.67, p. = .010].

PA on CV Days and Choice Days was not measured in Baseline or at the end of Year 1, due to

time and weather constraints at PCMS. At the end of Year 2 the sampled students wore

accelerometers during one Choice Day and one CV Day. Table 5 shows the mean time and

percent of class time spent in MVPA at the end of Year 2 for typical lessons, CV Days and

Choice Days.

Table 5: Physical Activity in Three Lesson Types, End of Year 2

Category Typical PE Class CV Day Choice Day

Mins/50 Percent Mins/50 Percent Mins/50 Percent

Sedentary 16.9 33.8 13.1 26.2 12.9 25.8

Light PA 18.6 37.2 11.3 22.5 14.7 29.4

Moderate PA 7.5 15.0 10.6 21.2 8.8 17.6

Vigorous PA 7.1 14.2 15.0 30.1 13.6 27.2

M+VPA 14.6 29.2 25.6 51.3 22.4 44.4

The mean amount of MVPA time was significantly different between CV Day and typical

lessons [t(36) = 5.72, p. = .000] and between Choice Day and typical lessons [t(54) = 7.17, p. =

.000].

Accelerometry in 4-Day Measured Periods

The sampled students were directed to wear the accelerometers during all waking hours over a

consecutive 4-day period from the start of PE class on Monday to the start of PE class on Friday,

including all time in and out of school. The devices recorded multiple variables related to both

the intensity and duration of physical activity over the four days. The students returned the

devices to the GSU research team who then extracted the pertinent data; students were not

allowed to self-record or self-report the data from their assigned devices. Data were collected

during baseline (September, 2013), end of Year 1 (May 2014) and end of year 2 (May 2015).

9

Table 6 shows the mean total number of minutes/day students were engaged in MVPA and how

much of that MVPA occurred in typical PE lessons each day. MVPA outside of school is the

difference between total daily MVPA and PE MVPA (typical lesson).

Table 6: Daily (4 days) Physical Activity (mean mins/day)

Baseline End Year 1 End Year 2

MVPA Daily Total 50.1 35.9 31.7

MVPA in PE (typical) 12.4 13.5 14.6

MVPA outside of school 37.7 22.4 17.1

The mean number of daily MVPA minutes steadily declined over the course of the study. The

decrease in total daily MVPA from baseline to the end of Year 1 was statistically significant

[t(90) = 6.47, p. = .000] as was the difference between Baseline and the end of Year 2 [t(76) =

7.63, p. = .000].

Composite Analysis of MVPA

In the spring of 2015 additional MVPA data were collected on students who participated in the

after school program. It must be noted that this group of students included few of the sampled

students; any student who attended the after school program on data collection days was included

in this data collection. The students in the after school program had a mean of 25.1 MVPA

minutes/day, during an average 50-minute observation period.

It is possible to construct a composite of student physical activity by disaggregating the

accelerometry data into three separate times: PA in PE, PA in the after school program, and PA

outside of school (from 4 PM dismissal to 10PM). It is important to further disaggregate the

MVPA date by types of PE classes: typical, CV Day, and Choice Day due to the variability of

those classes relative to accrued MVPA.

Figure 1 shows this composite, constructed from the 2015 spring MVPA data sources. On

typical PE days, students accrued 49.8 total MVPA minutes/day. On CV Days in PE students

accrued 60.8 total MVPA minutes/day. On Choice Days in PE students accrued 57.6 total

MVPA minutes/day. Again, precautions must be taken because few of the students in the after

school program were from the study sample. Even with that precaution, the composites show

that it is possible the combining PE classes containing a high-PA emphasis, with an after school

PA program can provide sufficient opportunities for students to accrue the recommended 60

minutes/day of MVPA; minutes of MVPA in the evenings (e.g., sport, recreation, outside play)

can add to the daily total available in schools.

10

Figure 1: Composite of Total MVPA

Measures of CSPAP Implementation

It was also the purpose of this study to analyze measures beyond those related to student learning

outcomes. Several process measures were taken to determine the success in implementing the

CSPAP plan at PCMS.

Attendance in the After School Physical Activity Program

One member of the PCMS HPE staff started an after school physical activity (ASPA) program in

October of 2013, with an announcement posted in the school gym for students to read. The

program was designed to allow participation by any student who wished to attend on any given

day, be non-competitive, and provide a variety of high-PA offerings daily. Attending students

could select which activity they wished to participate in. The ASPA started with an average of

~10 students/day for the first few months. Early in 2014, the program saw rapidly growing

attendance, to more than 60 students/day. That attendance level required the addition of one

more HPE teacher each day, along with 2-3 rotating personnel from PCMS and the community.

Due to the need for extra personnel, the allocated budget was expended by early 2015.

Recognizing the demand for the CSAP program, and the contribution it was making to increased

PA in students’ days, the PCMS principal committed discretionary funding to the program until

the end of the 2014-2015 school year. It is our understanding that this funding will continue into

the 2015-2016 school year.

0

10

20

30

40

50

60

70

Total MVPA (w/typical PE) Total MVPA (w/CV Day) Total MVPA (w/Choice day)

Evenings

After school

Pe class

11

Attendance at PCMS CSPAP Events

Two annual events were held at PCMS as part of the CSPAP: the traditional CV Classic family

walk/run and fitness fair, and a new Health Fair for parents. The CV Classic also serves as a

fundraiser for the HPE Department at PCMS through nominal entry fees and local

business/community sponsorships. The 2014 CV Classic had 200 entrants, and raised over

$7,500. The 2015 event had 230 entrants and raised over $8,000.

The 2014 Health Fair event had to be rescheduled due to severe weather and as a result, some

guest speakers could not attend. Of the 150 attendees, 40 were parents. “Ticket Out The Door”

surveys showed that the parents appreciated the opportunity to learn more about their children’s

PE program and its teachers, and to learn from some of the guest speakers. However, there were

many comments about distractions made by the large number of students in attendance. The

2015 event had 30 attendees, all of whom were parents; students were not allowed to attend that

event, due to the disruptions in the previous year’s event. The “Ticket Out the Door” surveys

indicated that the attending parents found the Health Fair to be both informative and better

organized as a parent-only event.

Teacher Training for Classroom Activity Breaks (CAB)

One strand of the HOPE CSPAP model calls for increased opportunities for physical activity in

the school day, beyond those offered in the scheduled PE curriculum. The plan in this study was

to train PCMS classroom teachers to use the Take 10! program to provide short physical activity

breaks in their classroom during the school day. In November of 2014 GSU staff informed

PCMS teachers of a Take 10! training session to be conducted the next month. 36 PCMS

teachers responded to this announcement. Training was delayed because of the need to develop

subject-specific CAB instructions. The training day was held in January 2015, with only 6

teachers attending. Teachers expressed a willingness to conduct CABs and we have some

anecdotal evidence that some of them did so, but this part of the CSPAP was not formally

assessed.

Measures of CSPAP Feasibility

Another purpose of this study was to examine the resources needed for it implementation, and to

determine it feasibility and transferability to other school settings beyond PCMS. Two data

sources were used for this analysis: weekly time logs completed by PCMS and GSU staff to

report the amount of time they spent on CSPAP-related activities, and a budget review.

PCMS HPE staff devoted nearly 20 hours/week to the CSPAP, beyond their regular time

for physical education instruction. That is an average of about 2.5 hours/week per

teacher. The weekly averages were highly variable, with the majority of time spent in

annual pre-planning, the after school physical activity program, the CV Classic, and the

Health Fair.

The GSU support team included two faculty and three doctoral students. In total, they

devoted about 1,000 hours to the project each year. That time was used for PCMS staff

development (~15%), training (~10%), technical support (~5%), data collection (~50%),

and data analysis/reporting (~20%).

12

Over two years, the program cost approximately $75,000 to implement and evaluate.

Implementation included annual trainings for the PCMS HPE teachers, technology

resources, promotional items, and costs to attend professional conferences and provide

substitute teachers. Those activities accounted for about one-third of the total project

costs. About two-thirds of the total cost of the project came from GSU personnel needed

for training, support and evaluation (primarily data collection and analysis).

13

Summary of Findings

1. A CSPAP plan, with its multidimensional approach can lead to improvements on certain

indicators of health-related physical fitness, and allow more students to reach age/gender

targets in the Health Fitness Zones on more tests. We were not able to determine

specifically how any single CSPAP component, or multiple components together

promoted this outcome.

2. A concerted effort to provide more lesson content in health and physical education about

physical activity and healthy eating can increase students’ knowledge in this important

foundation to changing relevant behaviors.

3. The CSPAP plan did not improve the amount of total daily MVPA accrued by students in

this study. In fact, there was a significant decrease in total daily MVPA over the two

years of the study. Two related factors may have contributed to this finding. First, the

daily MVPA in baseline were taken in September, when many youth participate in more

organized high-activity sport opportunities, such as football and soccer. The daily

MVPA data at the end of Years 1 and 2 were taken in April and May, before youth sport

seasons had begun. This created a comparative imbalance across the three data collection

periods. The collection of daily MVPA data at the end of Year 1 occurred during an

extended period of inclement weather that reduced students’ opportunity to be active

outdoors. Similar to that, the collection of daily MVPA data at the end of Year 2 had to

be postponed for inclement weather and was then conducted during the scheduled

required academic testing period, likely limiting both opportunity and motivation for

students to seek physical activity in the evenings.

4. It is possible to provide students with increased amounts of MVPA in physical education

by offering PA-promoting lessons, rather than traditional skill-based and sport-based

instruction. Students averaged less than 15 minutes of MVPA in “typical” PE lessons.

However, when the lesson focus was directly on the accrual of physical activity (CV

Days and Choice Days), students had more than a 50% increase in MVPA over typical

lessons.

5. The after school physical activity (ASPA) program provided attending students with

more than 25 minutes of MVPA each time. This volunteer, informal, and focused

program grew to an average daily attendance of over 60 students by the spring of 2015.

6. From a composite analysis, it was evident that the key to students accumulating the 60

minutes of daily physical activity centered on the offerings and opportunities at the

school--not outside of the school. That is, in physical education classes and in the after

school program. PA-focused physical education lessons can provide nearly half of those

minutes, as can an after school program. This is encouraging because those programs are

under the direct control of the HPE staff and the school administration and site-based

decisions can be made to promote more physical activity in physical education and higher

attendance in the after school program (more staffing, transportation, etc.).

14

7. Even with questions of data collection time periods after Baseline, it was evident in this

study that the CSPAP had negligible effects on student physical activity outside of the

school setting. Further study is needed to examine this relationship further. However, if

this relationship cannot be demonstrated, it reinforces the need to provide more MVPA

content in physical education, and to find ways to greatly expand the after school

physical activity program—both of which are in direct control at the site level.

8. The CSPAP plan is plausible, at least as it was implemented at one middle school. All

eight of the HOPE CSPAP strands were implemented at PCMS, even if not all of them

fully (e.g., Classroom Activity Breaks). This implementation was completed primarily

by the HPE teachers at PCMS, and supported strongly by the PCMS principal—both key

factors in this program.

9. It was the strategy in this project for GSU personnel to serve primarily as support

providers for the PCMS HPE teachers who would plan and implement almost all of the

HOPE CSPAP strands. And GSU personnel planned and conducted all components of

the project evaluation. In retrospect, it may have been more beneficial for GSU

personnel to be more directly involved with the daily and weekly implementation of the

HOPE CSPAP, while still leaving the PCMS teachers in the leadership role. This would

have led to a more consistent implementation of the HOPE CSPAP and have allowed

GSU personnel to be in better position to provide even added support to the PCMS

teachers where it mattered most—in carrying out the changes in the PE instructional

program to promote higher levels of MVPA in classes.

10. Questions are raised about the feasibility and transferability of the HOPE CSPAP plan.

While PCMS personnel carried almost all of the implementation, they received

significant planning and assessment support by GSU staff, along with funding support

from the CDC/GSU Seed Grant. That direct funding support to PCMS included the

staffing of the after school physical activity program, teacher attendance at conferences

for professional development and needed substitutes, iPads for tracking students for goal

setting on CV Days, and some promotional materials. It should also be noted that PCMS

had 6 HPE teachers in Year 1 and 7 HPE teachers in Year 2, providing sufficient

personnel for the after school program, the CV Classic, and the parent Health Fairs.

Given the total resources available to plan, implement, and assess the HOPE CSPAP at

Peachtree Charter Middle School, this model raises questions about its feasibility and

sustainability (i.e., can it be sustained at PCMS without CDC/GSU Grant support?), and

the ability to transfer this model to the vast majority of schools in the US with far fewer

resources and external support than were available in this project.

15

Appendix A: PCMS HOPE Program Strands 2013-2015

Strand

Learning

Outcome/s

Intervention

Strategies

Evaluation Before/During/After

school extended PA

programming

Promote high rates of MVPA and health-

related knowledge to supplement the

scheduled PE program

-Before/after school PA program

-Student attendance

-PA during after school program

-Teacher time logs

Sport, games, dance,

and other movement

forms

To learn sport, games dance and other

movement forms as a source of lifelong

participation in PA.

-Teacher staff development from GSU

-Analysis and revision of current PE curriculum

and instruction to include more PA

-New instant activity plans for lessons

-Goal setting for “CV Days” in PE

-“Choice Days” in PE

-PA during PE (typical days)

-PA during PE (CV Days)

-PA during PE (Choice days)

Family/home

education,

To teach parents, guardians, and other family

members to promote PA, better diet, etc. at

home.

-CV Classic Day for parents and students

-Open house evening for HPE program

-Announcements in school e-newsletter

-Events attendance

-“Tickets out the door”

-Teacher time logs

Community-based PA

programming

To promote PA opportunities for children in

community settings

-Announcements in school e-newsletter and

postings around school for PA

opportunities/events in the community

-Not evaluated

Health-related fitness

To promote weekly MVPA according to

national standards

To promote individual achievement to

“Healthy Fitness Zone”

-Increased content time for knowledge of PA in

health and PE

-Annual fitness assessments

-Percent of students in Healthy

Fitness Zones on FITNESSGRAM

test components and BMI

Diet and nutrition for

physical activity

To learn and demonstrate knowledge of diet

and nutrition that enhances PA

-Units on diet and nutrition for PA in health

-Student projects for Open House

-Test of knowledge on PA and

nutrition

Physical Activity

Literacy

To acquire knowledge and appreciation that

can increase and enhance participation and

enjoyment of PA

-PA health fair at school

-Guest speakers from community advocacy

Organizations

-Information in school e-newsletter

-Test of knowledge on PA and

nutrition

Integration of HOPE

across all school

subjects (including

recess)

To increase (non-PE) teachers’, school

administrators’ and school staff’s knowledge

of and support for children’s PA and

improved dietary habits

-Teacher training for Classroom Activity Breaks

(Take10!)

-Not evaluated

16

Appendix B

CDC/GSU Seed Award Grant Project Activity

May 2013 – June 2014

May

2013

June

2013

July

2013

Aug

2013

Sep

2013

Oct

2013

Nov

2013

Dec.

2013

Jan

2014

Feb

2014

Mar

2014

Apr

2014

May

2014

June

2014

1.0 Securing IRB approvals

2.0 Planning and Training

2.1 Research staff meetings at GSU

2.2 Training and follow up

meetings at PCMS

2.3 Meetings and communications

between CDC and GSU

personnel

3.0 Implementation of the CSPAP

3.1 Development of technology

resources for PCMS

3.2 MVPA implementation in PE

3.3 Before/After school PA

Program

3.4 Parent Events at PCMS

(CV Classic and Open House)

4.0 Measuring outcomes in Year 1

4.1 FITNESSGRAM testing for

health related fitness

4.2 Test of knowledge of PA and

healthy eating

4.3 Accelerometry in PE classes

and for 4-day periods

17

CDC/GSU Seed Award Grant Project Activity

August 2014 – September 2015

Aug

2014

Sept

2014

Oct

2014

Nov

2014

Dec

2014

Jan

2015

Feb

2015

Mar

2015

Apr

2015

May

2015

June

2015

July

2015

Aug

2015

Sept

2015

2.0 Planning and Training

2.1 Research staff meetings at GSU

2.2 Training and follow up

meetings at PCMS

2.3 Meetings and communications

between CDC and GSU

personnel

3.0 Implementation of the CSPAP

3.1 Teacher training for Classroom

Activity Breaks

3.2 MVPA implementation in PE

3.3 Before/After school PA

3.4 Parent Events at PCMS

(CV Classic and Open House)

3.5 Announcements in PCMS

e-newsletter

4.0 Measuring outcomes in Year 2

4.1 FITNESSGRAM testing for

health related fitness

4.2 Test of knowledge of PA and

healthy eating

4.4 Accelerometry in PE classes

and for 4-day periods

4.5 Accelerometry in after school

program

18

Appendix C

H.O.P.E. Planning Meeting Minutes 1/23/2015 I. Classroom Activity Breaks- Update

a. Mike and Shannon came out last week. Originally 36 expressed interest, but only 6 6th grade teachers showed up to be trained.

b. Available for feedback and additional training. II. Family Health Night

a. Monday, March 9 2015 in Cafeteria 6:30pm-8pm b. Caryn- point person c. Volleyball parents- promote this way? d. Stephanie Walsh (pediatrician)- potential speaker e. Charlie’s chiropractor- potential speaker f. Health projects to share g. Fitnessgram h. Promote through e-blast (flyer) and scrolling board

III. Diet and Nutrition a. Garden- B/A school has taken up most of the time. Hope to split time by the

spring to be able to do more work in the garden. IV. Before/After School Programming

a. Track, soccer, basketball, conditioning b. 40/50 students, can increase/decrease c. Attendance sheets for next payments (Nov-end of Jan). Last payments will be

Feb-May. V. Southern District

a. Feb. 21st- presentation is now at 10:45am. b. Terri, Caryn, and Staci c. 3 subs needed Thurs and 4 on Friday (7 total)

VI. Data Collection Schedule a. PA in PE (end of April) b. Weekly PA (end of April) c. PA Knowledge Tests (paper based) d. Fitness Test Date (week of March 9?)

VII. Teacher Feedback/Perceptions of H.O.P.E. a. Project wrap up. We would like to sit down with PCMS staff and discuss how

they feel it went and if they think it’s improved the program as well as GSU interactions with PCMS. Perhaps the last meeting that we do. Questions would be sent ahead of time.

VIII. Other a. Hoops for Heart starts Feb. 3- promote in e-news b. K Kids begins first week in March through mid May

IX. Future Meetings a. February 27, March 27, April 24