Childhood obesity in the US is a serious public health problem. Today, there are nearly twice as many overweight children and almost three times as many overweight adolescents as there were in 1980 (5). Roughly 9 million youth older than 6 yr are considered overweight (4). It is an epidemic affecting youth, regardless of socioeconomic class, ethnicity, or geographic residence (3). The health, learning, and economic consequences of childhood obesity are already apparent (1-3). Strategies and interventions combating childhood obesity are plentiful but are often developed without the inclusion of key players who have direct contact with youth, such as physical education (PE) teachers, and this effort is fruitless.
On October 15, 2005, 23 school teachers, pedagogy researchers, and other public health professionals met at a Roundtable to discuss factors related to childhood physically active patterns of engagement. The Roundtable was organized in conjunction with a major international conference entitled "Walking for Health" that was held at the University of Illinois at Urbana-Champaign. The participation of the teachers in the conference and the Roundtable was made possible through the generous support of the Robert Wood Johnson Foundation and the American College of Sports Medicine. Teachers were chosen for this program through a selection process in which applications were solicited through the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD; national and state levels), listservs serving PE teachers, and other outlets that would reach PE teachers in September 2007. Interested PE teachers submitted an application providing information about their school, the percentage of their schools' students participating in the free lunch/breakfast program, and a 500- to 1000-word statement of how attending the walking conference will help them promote physical activity in school settings.
The response to the marketing effort was very positive. A total of 68 viable applications from all over the country were submitted. The applications were read, rated, and rank-ordered by the research project coordinator in Weimo Zhu's Kinesmetrics Laboratory using a 7-point rating with a focus on the following five areas:
- overall quality of the application;
2. likelihood that this teacher will start making changes in his/her school by attending the conference;
3. likelihood that this teacher will help us to understand challenges in promoting physical activities in school settings;
4. likelihood that this teacher will help create some innovative and effective approaches to promote physical activities in school settings;
5. likelihood that this teacher will have a significant impact on children with higher health risks (obese, low-SES group, etc.).
Zhu then went over the ratings and ranking, and the final selection was based on the following three criteria: (a) the schools were from a low-SES area (% of the students who participated free or reduced lunch program were ≥30%); (b) a state from different regions; and (c) the highest scores within a state. The 12 teachers selected were from Connecticut, Florida, Georgia, Illinois, Kansas, Maine, South Carolina, Texas, Virginia, Washington, West Virginia, and Wisconsin and consisted of 5 elementary, 5 middle, and 1 high school teacher and 1 roving PE teacher in charge of the PE curriculum and instruction development for her school district.
The primary goal of the Roundtable was to initiate a dialog between practicing school teachers and a group of researchers in pedagogy and public health to identify practical and effective strategies for increasing physical activity, particularly walking, in the school setting. Discussions were organized on the following major themes: 1) promoting physical activity, 2) barriers for physical activity promotion in children, and 3) integrating physical activity with other health behaviors in the curriculum. The 23 Roundtable participants were divided into three focus groups. Each group was facilitated by a university professor with significant research expertise in the area of PE and pedagogy. The facilitators led open-ended discussions structured by open-ended prompts related to the three themes previously listed. Each group provided a summary of their discussions to the total group at the end of the Roundtable.
Focus groups were asked to consider the role that PE teachers, other teachers, the school, and the local community could play in promoting physical activity in the school setting. Below, we summarize the thematic responses provided by the focus groups.
Theme 1: Promoting Physical Activity in the School Setting
- The Role of the PE Specialist. The following themes emerged as the key methods for promoting physical activity in the school setting by PE specialist teachers:
The Role of the Nonspecialist Teacher. The following themes emerged as the key methods for promoting physical activity in the school setting by nonspecialist teachers:
- PE specialists should serve as role models for both students and teacher colleagues.
- PE specialists should advocate for curricular revisions that encourage increased levels of physical activity in the classroom.
- PE teachers should emphasize the link between physical activity and academic performance.
- PE specialists should identify mechanisms to provide rewards and incentives to students who are regularly physically active (e.g., the President's Challenge Awards).
- PE specialists should encourage use of motivational devices such as pedometers, activity logs, group goals, etc.
The Role of the Individual School and School District. The following themes emerged as the key methods by which the individual school and school district can promote physical activity in the school setting:
- Work with PE teachers to develop strategies to increase physical activity in all aspects of the curriculum.
- Support student participation in sports clubs and other physical activity opportunities.
- Integrate regular physical activity breaks into most classes.
- Encourage the adoption of an integrated curriculum focusing on wellness and health.
The Role of the Community. The following themes emerged as the key methods by which the local comimunty can promote physical activity in the school setting:
- Identify links between the aims and objectives of PE programs and the broader goals and objectives of the school and school district.
- Provide incentives to teachers to participate in Continuing Education opportunities related to physical activity and health.
- Open the school facilities to students and community before and after school (gym, pool, playground, etc.).
- Provide administrators with information about health benefits of activity and information about increases in obesity and inactivity-related disorders among children.
- Provide in-service training to educate non-PE teachers how to build activity into the curriculum.
- Build collaborations beyond the classroom with other teachers, parents, business partners, and professional associations.
- Lead promotion and advocacy efforts through contacts with local media.
- Educate community partners about innovative new approaches to the promotion of physical activity both within the school setting and beyond.
- Organize an annual health fair or physical activity event that emphasizes the importance of physically active lifestyles for people of all ages.
Theme 2: Barriers for Physical Activity Promotion in Children
- Barriers to Physical Activity. The following barriers to physical activity promotion were identified by the Roundtable participants:
Strategies to Overcome Barriers to Physical Activity. The following strategies to overcome barriers to physical activity promotion were identified by the Roundtable participants:
- Lack of funding for PE and physical activity programming in the school setting.
- Lack of safe and affordable opportunities for after-school physical activity.
- Poor communication between the school and parents, and between the school and local community partners.
- Environmental constraints that limit physical activity such as lack of sidewalks, traffic, unsafe conditions, lack of equipment, and inadequate/improper facilities.
- Build collaborations between school, parents, and community partners.
- Demand accountability from all partners including students, teachers, the school, and the community.
- Facilitate information exchange through Web sites, media, newsletters, etc.
- Identify safe walking routes and promote walking to and from school when safe and appropriate.
- Address with state boards of education the importance of daily physical activity.
Theme 3: Integrating Physical Activity with Other Health Behaviors
- The Role of the PE Teacher. The following mechanisms were identified by which the PE teacher can contribute to promoting other healthy behaviors:
Integrating Physical Activity into Other Health Promotion Strategies. The following mechanisms were identified for integrating physical activity into other health promotion strategies:
- Integrate nutrition education and substance abuse messages throughout the PE curriculum.
- Ensure that PE and sports clubs and other extra curricular groups provide healthy snacks and promote safe behaviors.
- Develop innovative curriculum opportunities that use team-taught, daylong student conferences and workshops focused on integrative health promotion themes.
- Serve on community boards that promote physical activity and healthy behaviors.
- Develop a school wellness policy that integrates physical activity into other health promotion goals.
- Include information about healthy eating in school cafeteria menus; provide information about calories and the amount of exercise needed to burn calories.
- Develop a network of posters and message boards that disseminate information about healthy lifestyles.
SUMMARY AND CONCLUSIONS
The Roundtable identified many barriers and challenges that limit the degree to which physical activity is presently integrated into the lives of most schoolchildren. A wide variety of strategies were identified to help overcome these barriers and provide opportunities for schoolchildren to increase their activity levels. It is clear that the successful implementation of these strategies will require significant effort from all those involved including schoolchildren, PE teachers, other teachers, school administrators, ands local community members. Although many of the strategies identified will require the allocation of resources, many can be implemented without additional cost. The extent to which progress is made with respect to the implementation of these strategies will depend on the infrastructure of support can be built for the excellent recommendations provided by the Roundtable focus groups.
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