Chriqui, Jamie F. PhD, MHS; Eyler, Amy PhD; Carnoske, Cheryl MPH, RD; Slater, Sandy PhD, MS
The National Physical Activity Guidelines and Healthy People 2020 recommend that children and youth get at least 60 minutes of moderate-to-vigorous physical activity daily (MVPA).1,2 Yet, most youth do not achieve this level of physical activity (PA).3
Given that children spend approximately 30 to 35 hours per week in school for at least 9 months a year, schools provide a unique opportunity to engage children and youth in PA. Yet, given the emphasis on subjects such as reading, writing, and arithmetic, many school districts and schools do not prioritize PA and/or physical education (PE) during the school day.4 While the provision of PE is fairly commonplace, the duration, frequency, and quality of PE varies tremendously.3,5,6 A recent consensus statement concluded that increasing PE frequency and duration, increasing the amount of MVPA time in PE, and providing trained teachers to implement PE are keys to increasing in-school PA.7
States laws and district policies govern PE in schools.8,9 Most state laws have been on the books for a number of years and have not changed substantially since 2003.8 And, although not required, many districts incorporated PE provisions into their congressionally mandated school district wellness policy.9 (See the Supplemental Digital Content Table, available at: http://links.lww.com/JPHMP/A23, that illustrates the nationwide prevalence of state laws and district policies governing PE time and MVPA time.)
Research on the relationship between state and/or district PE laws and policies, respectively, is emerging. Taber and colleagues10 illustrated that district policies are stronger in states with strong PE laws, indicative of top-down policy making.11 Yet, Eyler and colleagues12 documented the relative lack of evidence-based elements in state PE laws, with only 16% and 11% of all such laws enacted between 2001 and 2007 containing language governing PE time or activity time, respectively. Several studies have found a relationship between specific PE time requirements and elementary school (ES) and/or middle school (MS) PE time practices.13–15 Cawley and colleagues16 found that state laws were associated with more student time in PE and, in a California study, state PE mandates were associated with district-level compliance and student fitness levels.17 Kim18 found no relationship between state PE laws and school-level PE, children's PA, or obesity. And, Evenson and colleagues19 found that a North Carolina statewide PE and recess policy change was associated with increased PA participation, awareness of healthy habits, student focus on studies, alertness and enjoyment, and higher staff involvement. Although literature in this area is growing, we are unaware of any study to examine the relationship between state laws, district policies, and district-level PE practices. This study seeks to fill this gap by illustrating the extent to which state and/or district PE time and MVPA time laws and policies, respectively, are being implemented in practice in districts nationwide and to highlight policy opportunities.
State laws for each of the 50 states were compiled by Bridging the Gap researchers at the University of Illinois at Chicago.20 The state laws, effective as of the beginning of September of school year 2010-2011, were identified through key word searches of the full-text, tables of contents, and indices of codified state statutory and administrative laws commercially available from Westlaw (www.westlaw.com) and Lexis-Nexis (www.lexis.com). Codified state statutory laws include legislation, whereas codified administrative laws include all rules/regulations promulgated by state Boards of Education. “Informal,” noncodified policies adopted by state Boards of Education were excluded from this study. The codified state laws were validated against secondary sources.8,21,22
The district sample was developed at the University of Michigan's Institute for Survey Research, using sampling frames based on the National Center for Education Statistics' Common Core of Data files. Districts from all contiguous US states were eligible.
“On-the-books” district policies effective as of the beginning of the 2010-2011 school year were obtained from 581 districts (98% policy collection rate9) in 47 states through Internet research with telephone and electronic mail follow-up.9 District policies were defined broadly to include: the district-approved wellness policy, any associated district regulation, and any state or district policies embedded by reference in the wellness policy/regulation (ie, PE policies). The University of Illinois at Chicago's institutional review board declared the district policy collection “not human subjects research.”
District sample and survey
Each district with a policy was contacted to confirm the PE coordinator and to obtain the coordinators' contact information. Physical education was coordinated either at the district level (78%) or at the school level (22%). Since this study sought to assess district-level implementation of state laws and district policies, the survey was restricted to the 444 districts (located in 45 states) with district-level PE coordination. (The 2 other states included in the original district sample did not have any sampled districts with district-level PE coordination.) District PE coordinator responsibilities ranged from PE curriculum coordinators, to health/wellness specialists, to athletic/fitness coordinators. Compared with excluded districts, included districts were more high and less mid socioeconomic status (SES), less small and more medium-sized, and more suburban and less rural.
An Internet survey of district PE practices, approved by the Washington University's institutional review board, was conducted between February and May 2011 with the district PE coordinators. This analysis focused on the survey items related to PE frequency and duration and percentage of PE time spent doing MVPA at the ES and MS levels.
Third grade was the ES referent category, with 3 relevant questions asked. First, “On average, how many days (range, 1-5) per week is PE required for third-grade students?” Second, an open-ended numeric question asked, “On average, how many minutes per week of PE do students in third-grade receive”? The third question asked, “What percentage of time do third-grade students spend engaged in active PE, that is, activity that will elevate their heart rates such as running, jumping jacks, etc”? Ordinal response options ranged from 0% to 100%. All questions included a “do not know” option.
Eighth grade was the MS referent category. Given the variability in MS scheduling, options to assess block scheduling were included to account for longer class periods and fewer days per week associated with block scheduling. PE coordinators were first asked, “What type of scheduling is used for eighth-grade within the district?” Response options were as follows: 1, block scheduling only; 2, standard scheduling only; and 3, both block and standard scheduling. “Block only” or “both block and standard scheduling” respondents were asked an open-ended numeric question: “On average, how long is each block of time allotted for PE?” This question was followed by “On average, how many blocks per week of PE do eighth-grade students receive?” Response options ranged from 1 to 5, with options for “every other day” and “it varies.” Respondents indicating that they used “standard scheduling only” were asked an open-ended numeric question: “How many days per week is PE required for eighth-grade students?” Standard scheduling-only districts were not asked the length of each PE session. Instead, researchers at Washington University collected the information via Internet research with electronic mail and telephone follow-up. A question on percent time in MVPA, akin to the question asked for third grade, was also asked for the eighth-grade level of applicability. All questions included a “do not know” option.
The survey was pilot tested to determine completion time and question wording. Washington University researchers e-mailed the survey to each PE coordinator through Qualtrics Online Survey Software (Qualtrics Labs Inc, Provo, Utah) along with an introductory e-mail explaining the survey purpose and offering an opportunity to be entered into a raffle for a $25 gift card for survey completion. Three follow-up electronic mail messages were sent.
Policy predictors (independent variables)
All state laws and district policies were double-coded by 2 trained coders, using a reliable and valid ordinal coding scheme.23 Coding agreement was high (ranging from 94% to 97%), and discrepancies were resolved through discussion among the coders and the lead author. The original PE time policy coding schemes ranged from a strong policy that met the National Association for Sport and Physical Education recommendation of 150 minutes of PE per week (ES) and 225 minutes of PE per week (MS) (level 2 code),24 a lesser requirement or only a suggested time standard (level 1 code), to no law/policy (level 0 code). The MVPA laws/policies were coded as follows: 2, requirement that at least 50% of PE time be spent in MVPA; 1, requirement that less than 50% of PE time be spent in MPVA or encouraged that PE time be spent in MVPA; and 0, no MVPA-related law/policy.
Because of a limited number of survey-responding districts being located in a state and/or district with a strong (level 2) state law and/or district policy for either topic, dichotomous variables (1, any law/policy; 0, no law/policy) were created for each item by grade level of applicability. The state and district variables were cross-tabulated to create a variable (one for each grade level of applicability), with 4 mutually exclusive and exhaustive categories to indicate policy jurisdiction: none (neither district nor state); district only; state only; or both district and state. Each of the latter categories was compared against “none” (referent).
District practices (outcome variables)
Elementary school items
Responses greater than zero for the third-grade minutes per week were received from all but 19 districts requiring PE. All but 13 districts responded to the question regarding the number of days of third-grade PE. And, 147 districts responded to the active time in PE question for third grade.
Middle school items
Response rates also varied for the MS items. Forty-six of the 53 districts with block scheduling responded to the number of blocks offered per week. For the standard scheduling districts, data on the number of minutes per session were obtained from 115 of the 130 standard scheduling districts. Responses were received from 145 districts on the number of days of PE required per week for eighth grade. Missing data for all ES and MS items were replaced with the item mean.
To standardize responses across standard and block scheduling districts, 2 new variables, “PE_TIMES” and “PE_MINWEEK,” were computed. PE_TIMES reflected the number of days per week that PE was offered in eighth grade and was based on the number of days of PE per week for standard schedule districts and the number of blocks per week for block districts. PE_MINWEEK was calculated by multiplying the minutes per session by the number of days per week for standard scheduling districts and the minutes per block times the number of blocks per week for block scheduling districts.
District-level contextual controls
District-level characteristics were obtained from National Center for Education Statistics' 2009-2010 Common Core of Data (data for school year 2010-2011 were not available at the time of this analysis). For each district, data were obtained on the total number of students (school size, collapsed into tertiles based on the data distribution of small, medium, and large [referent] districts based on student enrollment); US census region (South [referent], West, Midwest, and Northeast); and locale (city [referent], suburb, township, or rural). The percentage of students eligible for free or reduced price lunch was used as a proxy for SES, divided into 3 groups on the basis of free or reduced price lunch distribution: higher SES (referent), medium SES, or lower SES. School racial/ethnic composition was coded as 1 of 4 exhaustive and mutually exclusive categories: majority white (referent); majority Hispanic; majority black; and diverse (no majority). (Table 1 provides the cutoffs for each of the categorical variables.)
Analyses were conducted using Stata/SE v.12.1.25 Because of the nonnormal distribution of the outcome measures, Poisson regressions were used with robust standard errors and state clustering to account for the lack of heterogeneity in state laws for multiple districts within each state. In addition, to ease interpretation, predicted margins and marginal effects were computed. The predicted margins equal the adjusted outcome (eg, days of PE per week) within each policy category, controlling for covariates. The marginal effects represent the average difference in the outcome (eg, days of PE per week) associated with the state and/or district policies as compared with districts in states/districts without the given law/policy.
Completed surveys were received from 195 unique districts (44% response rate) located in 42 states. Respondent districts were not statistically different from nonresponders on any characteristics. Table 1 presents the responder characteristics. Physical education time policies were more common at the state level, whereas MVPA policies were more common at the district level. Districts reported an average of 2.5 and 3.7 days of PE per week at the ES and MS levels, respectively, and an average of 82.9 (ES) and 189.6 minutes (MS) of PE per week. And, districts reported a high percentage of MVPA time—64.4 (ES) and 65.7 (MS) percent time. Districts were distributed across regions and locales. Districts were majority white, predominantly medium or large in size, and more than 43% had low free or reduced price lunch participation rates (high SES).
As indicated in Table 2, both state laws and district policies were positively associated with more minutes and days of PE per week. At the ES level, districts located in states with a PE time law offered PE 0.63 more days per week (2.78 vs 2.15 days) and districts in both states and districts with PE time laws/policies offered PE 0.67 more days per week than those with no such laws/policies (2.82 vs 2.15 days). Similarly, districts in states with PE time laws offered PE for 18.07 minutes more per week than districts located in a state without such a law (93 vs 74.93 minutes per week). At the MS level, state PE time laws were significantly associated with the number of days of PE offered per week—0.73 more days per week than districts located in a state without such a law (4.18 vs 3.44 days per week).
State laws and district policies addressing MVPA time were not positively associated with district reports of MVPA time (Table 3); however, with 2 exceptions, neither state laws nor district policies were statistically related to such practices. The exceptions were that district PE coordinators reported that 4.69% and 7.24% less PE time was spent in MVPA at the ES and MS levels, respectively, when the district had an MVPA policy than districts where such a policy did not exist. State laws were not significantly associated with district MVPA time.
This study illustrated the extent to which public school districts are implementing state and/or district PE time and MVPA time laws and policies. Consistent with prior research, this study illustrates that state laws, in particular, have been influential in affecting district-wide practices regarding PE time.17,19 District policies were associated only with increased PE time when the state also had such a law, indicative of top-down policy making,11 and not surprising given that district PE policies are stronger in states with stronger PE laws.10
While the relationship between the state laws and district policies with district PE practices is encouraging, it is important to note that they all fell well below the National Association for Sport and Physical Education–recommended amount of PE time. Clearly, more efforts are needed to find ways (from both a competing demand and a resource standpoint) to enable districts to offer more PE time.
Neither state laws nor district policies positively influenced the amount of MVPA time in PE. It is possible that the district respondents overreported the amount of MVPA time (∼64%) as compared with prior observational research that found that only 35% to 38% of PE time was for MVPA26–29 and therefore one would not be able to correctly interpret the outcome. In addition, as indicated in Supplemental Digital Content Table (available at: http://links.lww.com/JPHMP/A23), most states and districts do not address this issue in their laws and policies and, when they do, districts are more likely than states-only to address the issue, thus policy opportunities exist to continue to enhance and oversee implementation of laws in this area.9,12,30
As always, the findings are subject to several limitations. First, this was a study of association and not causation. Second, the district practices were self-reported by district PE coordinators and thus are subject to reporting error and/or bias based on the extent of the respondents' knowledge regarding district-wide practices regarding PE time and MVPA time. While we attempted to reach the district official most knowledgeable about PE practices, respondent knowledge about actual practices may be limited to what they believe as opposed to what actually is happening in practice. Third, we were unable to assess the relationship between laws and policies and school-level practices or student time spent in PE or MVPA time in PE. Future research would be well served to explore the relationship between state laws, district policies, and student-level PE time and MVPA time in PE. Finally, survey responders primarily represented larger, predominantly white and high-SES districts nationwide; thus, the results may not be generalized to all districts nationwide.
In conclusion, state laws and district policies have the potential to influence PE time at the ES and MS levels; however, state laws clearly seem to be driving district PE time practices. Interestingly, although the laws and policies in this area were not “strong” (ie, they did not meet the National Association for Sport and Physical Education–recommended standards), the results of this study indicated that even “weaker” policies with lesser time standards are associated with increased PE time. Given that most state laws and district policies in this area do not change frequently9,10 and given that states and districts are constantly navigating the competing demands for time during the school day as well as resource limitations, policy changes in this area will be challenging, but the results of this study suggest that PE time laws/policies can influence district PE time practices. Given these challenges, districts would be well served to engage in cross-sectoral collaborations such as those recommended by the both the National Physical Activity Plan31 and the Institute of Medicine32 with the education sector working with other groups such as parks/recreation, transportation, health care, etc, to facilitate increased PA time among school-aged children.
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30. Carlson JA, Sallis JF, Chriqui JF, Schneider LM, Cox L, Agron P. State policies about physical activity minutes in physical education or during the school day. J Sch Health. 2013;83:150–156.
31. Pate RR. A national physical activity plan for the United States. J Phys Act Health. 2009;6(suppl 2):S157–S158.
32. Institute of Medicine Committee to Accelerate Progress in Obesity Prevention. Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. Washington, DC: The National Academies Press; 2012.
district wellness policies; physical activity; physical education; policy; state law
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