Physical Education/Physical Activity, Academic Performance, and Overweight/Obesity
Tracy S. Taylor
Overview
Recent attention has been given to childhood obesity and the role of schools and physical fitness.1 Childhood obesity can have adverse biological effects such as cardiovascular disease(s) and diabetes mellitus (DM), which can lead to increased anxiety and depression and decreased quality of life (QoL).2-4 Childhood obesity has become one of the biggest health concerns in the United States (US), and has been associated with orthopedic, neurological, pulmonary, gastroenterological, and endocrine conditions, as well as cognitive and psychosocial maladaptive behaviors.3, 4 Conversely, musculoskeletal and psychological functions, recreation, and QoL improve as a result of physical fitness.5 Between 1991 and 2003, the percentage of students enrolled in daily physical education (PE) dropped from 42% to 28%. Only 50% of elementary schools and 25% of middle schools nationwide require PE, and less than approximately 5% of US schools have daily PE.6 Less than 4% of US elementary schools and 8% of middle schools offer PE on a daily basis.7 Many US public schools’ funding is based on academic performance as measured by standardized test scores, possibly as a result of the No Child Left Behind Act.1 In the US, time spent in PE classes has decreased as a result of attempting to improve academic performance, and hence standardized testing has increased.8 As a result, physical education has been pushed aside in favor of core academics.1 Schools are slow to address student obesity and lack of physical fitness due to the premise that these health conditions are loosely related to academic performance and achievement. School boards are primarily interested in optimizing student academic achievement.9
For my Capstone project I wanted to determine if there was a positive relationship between the frequency of physical education (PE) and academic performance at the elementary school level, with the hope of disseminating the evidence to the Wake County School Health Advisory Council (Wake County SHAC). Wake County SHAC serves as advisories to the Wake County Public School System’s Board of Education on topics relating to student health and well-being. Additionally, the Wake County SHAC serves as the primary health advisory board for the Wake County Public School System and submits recommendations to the superintendent and Wake County school board members annually. This area of research is of particular interest to me because I have two elementary-aged children who have PE one day per week at a public school in Wake County. I am also concerned with the lack of physical activity in the public schools as well as the increased prevalence of overweight and obesity currently plaguing the children in the US. In the Evidence-Based Practice II course in the fall semester of my third year, I decided to look into the research regarding PE and academic performance at the elementary school level by asking the PICO question: For elementary school aged children (5-11 years), does participation in physical education five times per week demonstrate improved academic performance and reduction in obesity and overweight levels as measured through standardized testing compared to participation in physical education one time per week? Broader implications of this question that are of clinical importance to the physical therapist include treating children and hence adults with multiple comorbidities in addition to musculoskeletal and neuromuscular impairments for which they seek our services, thereby changing the manner in which we currently treat our patients.
Literature Review
The research for my Capstone project became slightly broader as I encountered more studies that included elementary, middle, and high school children. Questions that arose as part of the literature review included: What types of standardized academic tests are sufficient to demonstrate improved academic performance? What components of the academic standardized tests would be beneficial to demonstrate this change? What types of physical performance measures are sufficient to demonstrate a change in physical fitness and performance? What components of the Fitnessgram would be beneficial to demonstrate this change? What types of exercise (cardiovascular, muscular strength/endurance, flexibility) would be best and at what duration and frequency to demonstrate a positive relationship between physical activity, academic performance, and reduction in overweight and obesity incidence? I continued to explore the evidence further in the spring semester and critically analyzed sixteen studies, including a systematic review (consisting of 43 studies) and a meta-analysis (consisting of 59 studies). I compiled the research with an Evidence Table and wrote a Research Paper summarizing my findings.
Products
When my research was complete I learned about creating presentations by viewing the resources available to me through our program, and I created a Power Point presentation. I presented this evidence to the Wake County SHAC members on March 19, 2014, and I gave each participant a One Page Summary of my research conclusions based on my research paper. Following the presentation, I received a Presentation Feedback Survey from all participants regarding my ability to clearly present the information, how they felt they benefitted from this presentation, and suggestions for presentation improvement. A brief Presentation Feedback Survey Summary is provided regarding scores and comments from the 11 participants. Based on the feedback of 2 of my committee members, I decided to revise my Power Point Presentation to better reflect the information presented and discussed at the meeting. I also revised my one-page summary by redesigning it into a Fact Sheet with article references on the back of the page. Upon hearing my presentation, Wake County SHAC members were eager to include this evidence as part of their annual recommendations to the superintendent and Wake County school board members at the May, 2014 public School Board meeting.
Special Thanks and Feedback
I would like to thank the following people who have helped to make my Capstone project and presentation possible: my Capstone committee members Brian Glendenning, Larry Bauder, and Laurie Ray for their vital support and for having patience with me through all of my questions as we worked together through the development process. I would also like to thank Karen McCulloch for her guidance and feedback in helping me further define my Capstone project from its inception through the finished product.
Please use the “Comments” feature at the bottom of this page for additional feedback. I value your honesty as your comments will help me identify what is working well, and ways to improve the presentation and additional materials for future use. Thank you for visiting!
References:
- Van Dusen DP, Kelder SH, Kohl HW, Ranjit N, Perry CL. Associations of physical fitness and academic performance among schoolchildren. Journal of School Health. 2011;81(12):733-740.
- Hollar D, Messiah SE, Lopez-Mitnik G, Hollar L, Almon M. Effect of a two-year obesity prevention intervention on percentile changes in body mass index and academic performance in low-income elementary school children. Am J Public Health. 2010;100:646-653. doi:10.2105/AJPH.2009.165746.
- Datar A, Sturm R, Magnabosco JL. Childhood overweight and academic performance: National study of kindergartners and first-graders. Obesity Research. 2004;12(1):58-68.
- Vanhelst J, Beghin L, Fardy PAS, Bui-Xuan G, Mikulovic J. A conative educational model for an intervention program in obese youth. BMC Public Health. 2012:12:416-20.
- Eveland-Sayers BM, Farley RS, Fuller DK, Morgan DW, Caputo JL. Physical fitness and academic achievement in elementary school children. Journal of Physical Activity and Health. 2009;6:99-104.
- Fedewa AL, Ahn S. The effects of physical activity and physical fitness on children’s achievement and cognitive outcomes: A meta-analysis. RQES. 2011;82(3):521-35.
- Reed JA, Maslow AL, Long S, Hughey M. Examining the impact of 45 minutes of daily physical education on cognitive ability, fitness performance, and body composition of African American youth. Journal of Physical Activity and Health. 2013;10:185-197.
- Telford RD, Cunningham RB, Fitzgerald R, et al. Physical education, obesity, and academic achievement: A 2-year longitudinal investigation of Australian elementary school children. Am J Public Health. 2012;102(2):368-374.
- Roberts CK, Freed B, McCarthy W. Low aerobic fitness and obesity are associated with lower standardized test scores in children. J Pediatr. 2010;156(5):711-8. doi:10.1016/j.jpeds.2009.11.039.
7 Responses to “Physical Education/Physical Activity, Academic Performance, and Overweight/Obesity”
Tracy Taylor
Debbie and Karen –
The information will be presented at the Wake County School Board meeting on 5/6 by the Chairman of the Wake County SHAC. I plan on being there in case there are questions that the chairman feels would be best answered by me.
In regard to further presentation, I plan on asking for Laurie’s advice in terms of how it would be best to further distribute the information. She has extensive knowledge and experience in this area and hopefully we can find the best way to disseminate the information and affect change. I imagine this will be a long process, but I am in it for the long haul. Our children deserve it. 🙂
Karen, to answer your other question, there were several “new” faces at the meeting; I believe they were guests who are not SHAC members (this was my 3rd meeting). I believe this is why there was a wide range in scores as you referred to. I hope this answers your question!
Tracy
Karen
Hi Tracy,
Nice job organizing all of this information on your capstone site. It is clear that you’ve studied the literature. If you are able to move forward with this information to a larger audience, I think there would still be benefit to distilling the information further. As Debbie said, the sound byte concept is more what you want to aim for than the microfont and multiple superscript citations. Although the fact sheet is an improvement, I think you could still do more to make the information accessible. What are the “big take aways” from the lit review – can you organize the facts into a few categories and put a heading that encapsulates the main ideas? Busy people are much more likely to look at the big headings (and dig into more detail if they are interested) but few will have the time to read a densely packed document. Did you do readability statistics on your one pager or fact sheet? Would it help to add some images? You don’t need to do these things to meet the capstone requirements, but if you are planning to do more lobbying about this issue, I think considering the “health literacy” approach may really be helpful. We can talk more about this if you’re not clear what I mean.
Overall excellent work, however – and its clear that its an issue you’ll continue to advocate for in the future. Glad you found a “way in” -hopefully potential influence will continue!
Also, I’m interested in your perceptions of how the presentation went – sounds like it was an overall success, but scores ranged pretty widely – what would you attribute that to?
kmac
Debbie Thorpe
Hi Tracy
Great job on this project!! Lots of information. I would love to see you present this to the school board. As Cathy said, these are common sense results but using the hard facts is what it takes to influence policy. For a presentation to the “powers that be” try to condense into “sound bites”, that is how they operate. Will be a task but well worth it.
Again, very nice work!
Debbie
Beverly Knight
Tracy,
Great capstone! It is evident that you really did your research. It is unfortunate and sad that physical education has dwindled in schools, but hopefully that will change in the future. Your topic is worthy of being shared with the masses! I really hope that you continue to disseminate this information throughout NC!
Tracy Taylor
Hi Cathy and Larry,
Thank you for your comments! I am currently working on finding out how I can continue to disseminate this information across North Carolina, beginning with local area districts first. Cathy, I think the results are common sense to physical therapists, but not to everyone. If that were the case time spent in PE would not have been reduced. To answer your question, my guess would be that these results would apply to children with disabilities as well. The majority of the studies excluded children with disabilities however. After talking about my Capstone with several other students, it made sense to take the approach of finding these studies, since all children in public schools would be affected by new policy (children with disabilities are not to be excluded from receiving the same education as their peers). I’m not sure how PT’s could provide the same services as PE teachers without significant increase in cost to the school system, but I agree completely with you that this would be a great inroad for PT’s to promote health and wellness.
Tracy
Cathy Howes
Hi Tracy, Great job on your Capstone. Very interesting, but almost common sense results. I hope you make an impact and a change for good. Way to go on influencing policy! How do you think this applies to children with disabilities in the school system? Children with disabilities also have challenges with overweight and obesity. Do you think physical therapists have a role in providing any of these services for typically developing children or children with disabilities? I feel this would be a nice inroad for therapists to promote health and wellness. Curious to hear your thoughts. Cathy
PS: This got under a different category initially.
L Bauder
Tracy hit her target with the WCPSS SHAC. There are other School Policy Makers that should see this work.