In-school physical activity opportunity and physical activity levels of elementary school-age children in the Mississippi Delta

INTRODUCTION: Many states have in-school physical activity (ISPA) policies; however, best practices that provide children with the opportunity for ISPA are unknown. METHODS: Eleven elementary schools, from three districts, within the Mississippi Delta participated in this investigation. Quantitative and qualitative data collection procedures were used. RESULTS: There were significant differences between School 6 and the following schools on the percent of time spent in moderate-to-vigorous physical activity (MVPA) during physical education (PE): School 3 (p = 0.001), School 4 (p = 0.003) and School 7 (p = 0.001). The majority of PE class time at School 6 was spent in class management (30.0% +15.8). There was a significant relationship between percent of PE class time spent in unstructured free play and time spent in MVPA (r = 0.56; p < 0.0005). The majority of PE class time at School 3 (38.8% +46.8), School 4 (59.0% +43.3) and School 7 (65.2% +42.1) was spent in unstructured play. There was a significant relationship between MVPA and children's BMI (r = 0.63; p < 0.05; school level analysis). CONCLUSION: Unstructured play is the most influential lesson context related to MVPA during PE. Ecological correlations reveal that schools with the most active children are also the schools with the most overweight children. This result reflects that students with limited opportunities for ISPA would like to be active and would be, if given the opportunity. A lack of policy implementation at the school level is apparent and more stringent evaluation of state policy is needed.