Effects of a comprehensive physical activity program: Using school wellness policies to promote physical activity

Background: The WIC Reauthorization Act of 2004 recommends schools provide physical activity (PA) breaks, active recess, and classroom based PA for all students as a part of a school wellness policy. This study assessed Active & Healthy Schools (AHS), a PA program designed to implement these recommendations. Methods: Sixth grade students (11-12yrs) from three treatment schools (TS, 76 boys, 58 girls) and three control schools (CS, 104 boys, 93 girls) wore sealed pedometers for four school days (Walk4Life 2505). Baseline and post treatment steps and activity time were measured during school and outside the school day. The treatment consisted of activity breaks, semi-structured recess, and kinesthetic learning experiences in the classroom. Regression models, controlling for baseline values and clustering of students within classrooms, were computed for each post assessment variable, separately. Dummy variables for treatment status (1 = TS), gender (1 = boys), and the treatment-x-gender interaction were entered into the models. Results: TS engaged in more average daily steps (886.6steps, 95CI 6.0 to 1,767.2steps, P = .049), and more outside (10.4min, 1.5 to 19.3min, P = .024) and average daily activity time (17.7min, 2.8 to 32.6min, P = .022) than CS. Conclusions: While beneficial treatment effects were observed, high attrition rates (52.7% TS vs. 27.3% CS) suggest the fidelity of implementation of AHS is suspect. Future studies should examine teacher/school-related characteristics associated with implementation. Such findings can guide future pre-implementation preparation to ensure readiness for school-wide changes in PA offerings.