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Physical Education and Physical Activity: Results From the School Health Policies and Programs Study 2006

Posted on: Saturday, 22 December 2007, 06:00 CST

By Lee, Sarah M Burgeson, Charlene R; Fulton, Janet E; Spain, Christine G

ABSTRACT BACKGROUND: Comprehensive school-based physical activity programs consist of physical education and other physical activity opportunities including recess and other physical activity breaks, intramurals, interscholastic sports, and walk and bike to school initiatives. This article describes the characteristics of school physical education and physical activity policies and programs in the United States at the state, district, school, and classroom levels.

METHODS: The Centers for Disease Control and Prevention conducts the School Health Policies and Programs Study every 6 years. In 2006, computer-assisted telephone interviews or self-administered mail questionnaires were completed by state education agency personnel in all 50 states plus the District of Columbia and among a nationally representative sample of districts (n = 453). Computer- assisted personal interviews were conducted with personnel in a nationally representative sample of elementary, middle, and high schools (n = 988) and with a nationally representative sample of teachers of required physical education classes and courses (n = 1194).

RESULTS: Most states and districts had adopted a policy stating that schools will teach physical education; however, few schools provided daily physical education. Additionally, many states, districts, and schools allowed students to be exempt from participating in physical education. Most schools provided some opportunities for students to be physically active outside physical education. Staff development for physical education was offered by states and districts, but physical education teachers generally did not receive staff development on a variety of important topics.

CONCLUSIONS: To enhance physical education and physical activity in schools, a comprehensive approach at the state, district, school, and classroom levels is necessary. Policies, practices, and comprehensive staff development at the state and district levels might enable schools to improve opportunities for students to become physically active adults.

Keywords: physical education; physical activity; schools; school policy; surveys.

Citation: Lee SM, Burgeson CR, Fulton JE, Spain CG. Physical education and physical activity: results from the School Health Policies and Programs Study 2006. J Sch Health. 2007; 77: 435-463.

Regular physical activity can reduce risk for the development of chronic diseases among adults,1 including cardiovascular disease,2 cancer,3 and diabetes.4 Because participation in physical activity as a young person influences participation in physical activity as an adult, it can contribute to decreased risk for the development of such chronic diseases.3 Regular participation in physical activity as a young person contributes to healthy bone and muscle development, reduces feelings of depression and anxiety, and promotes psychological well-being.5 Further, regular physical activity reduces risk for the development of overweight among youth. In 2004, 18.8% of 6- to 11-year-olds and 17.4% of 12- to 19year- olds were considered obese, and an additional 20.4% of 6- to 11- year-olds and 15.3% of 12- to 19year-olds were considered overweight.6 (Note that these classifications of obese and overweight do not reflect the classifications used in the article cited but rather the June 2007 recommendations from the Expert Committee on the Assessment, Prevention, and Treatment of Child and Adolescent Overweight and Obesity convened by the American Medical Association [AMA] and co-funded by AMA in collaboration with the Health Resources and Services Administration and the Centers for Disease Control and Prevention [CDC].) Many youth become less active as they move from childhood into adolescence and adulthood.710

The US Dietary Guidelines for Americans recommend that young people (ages 6-19) participate in at least 60 minutes of moderate- to-vigorous physical activity on most, if not all, days of the week.11"13 A substantial percentage of each student's recommended amount of physical activity can be provided through a comprehensive school-based physical activity program. The Institute of Medicine's Preventing Childhood Obesity: Health in the Balance report recommends that students be given the opportunity to participate in at least 30 minutes of physical activity during the school day.13 In 1997, the CDC published research-based Guidelines for School and Community Programs to Promote Lifelong Physical Activity Among Young People}4 These guidelines outline a comprehensive school-based approach to promoting physical activity through quality, daily physical education and other physical activity opportunities including recess and other physical activity breaks, intramurals, and interscholastic sports.1415

Quality physical education provides the unique opportunity for students to obtain the knowledge and skills needed to establish and maintain physically active lifestyles throughout childhood, adolescence, and into adulthood. A quality physical education program meets the needs of and is an enjoyable experience for all students. Additionally, it keeps students active for most of physical education class time, teaches self-management as well as movement skills, and emphasizes knowledge and skills for a lifetime of physical activity.1617 Through a rigorous review of physical activity intervention research, the Task Force on Community Preventive Services recommended school-based physical education as 1 intervention strategy for increasing physical activity among youth.16 The interventions reviewed provided specific strategies to increase active time during physical education and improve physical fitness among students. These specific strategies include improving curriculum and instruction, making physical education classes longer, and incorporating fitness activities into physical education classes. Other components of a comprehensive school-based physical activity program (eg, recess and intramural programs) reinforce what is taught in physical education by providing additional opportunities to apply physical activity knowledge and skills.14,17,18

To support quality physical education, the National Association for Sport and Physical Education (NASPE) published the second edition of the National Standards for Physical Education in 2004.17 NASPE also has published other key documents on quality physical education, including Opportunity to Learn Standards and Appropriate Practices documents for physical education at the elementary, middle, and high school levels.19-24

The importance of physical education and activity among young people is also supported by the following Healthy People 2010 national health objectives:25

* Objective 15-31: Increase the proportion of public and private schools that require use of appropriate head, face, eye, and mouth protection for students participating in school-sponsored physical activities.

* Objective 22-6: Increase the proportion of adolescents who engage in moderate physical activity for at least 30 minutes on 5 or more of the previous 7 days.

* Objective 22-7: Increase the proportion of adolescents who engage in vigorous physical activity that promotes cardiorespiratory fitness 3 or more days per week for 20 or more minutes per occasion.

* Objective 22-8: Increase the proportion of public and private schools that require physical education for all students.

* Objective 22-10: Increase the proportion of adolescents who participate in daily school physical education.

* Objective 22-12: Increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours.

Selected Federal Support and Related Research

The CDC currently funds education and health agencies in 23 states to support coordinated school health programs that emphasize the prevention of health-risk behaviors, including physical inactivity, associated with chronic diseases. The CDC also funds health agencies in 28 states to prevent obesity and other chronic diseases through a variety of nutrition and physical activity strategies and settings, including schools. In 2001, Congress authorized the US Department of Education to administer the Physical Education for Progress program as part of Title X of the Elementary and secondary Education Act of 1965. Now titled the Carol M. White Physical Education Program (PEP), the program provides grants to local education agencies and community-based organizations to initiate, expand, and improve physical education for students in kindergarten through grade 12. The President's Council on Physical Fitness and Sport (PCPFS) serves as a catalyst to develop, implement, disseminate, and promote information and resources on physical activity, physical fitness, and sports programs for Americans of all ages and abilities. Following the 1996 launch of the Surgeon General's Report on Physical Activity and Health,5 the PCPFS added the Health Fitness Award (criterionreferenced standards) and Active Lifestyle Program (PALA) to the President's Challenge program, a presidential recognition program for physical activity and fitness that can be used within physical education settings. Finally, as part of the Child Nutrition and the Special Supplemental Food Program for Women, Infants, and Children (WIC) Reauthorization Act of 2004, school districts participating in the federal school meals program were required to develop local wellness policies.26 These policies must address physical activity as well as nutrition education and nutrition guidelines. In 1993, 1997, 2001, and 2006, NASPE conducted the Shape of the Nation Survey to examine the availability of and policies associated with physical education programs in each state.27 In the 2001 and 2006 Shape of the Nation Surveys, existing physical education practices were also described for each state. The School Health Policies and Programs Study (SHPPS) was previously conducted in 199428 and 2000.29 In 1994, SHPPS measured physical education and physical activity policies in kindergarten through grade 12 at the state and district levels and related practices in middle and high schools at the school and classroom levels. For SHPPS 2000, the study was expanded to include school- and classroom-level data from elementary schools. SHPPS 2006 expands the examination of school-based physical activity policies and practices outside physical education and recess, such as walk and bike to school programs and physical activity breaks.

This article describes for the first time findings from SHPPS 2006 about physical education at the state and district levels, including standards and guidelines, elementary school instruction, middle school instruction, high school instruction, physical education for students with disabilities, professional preparation, staffing and staff development, collaboration, evaluation, and physical education coordinators. The article also describes findings related to physical activity and interscholastic sports at the state and district levels, including elementary school recess, physical activity breaks, walk and bike to school programs, interscholastic sports coaches, and use of protective gear. At the school level, this article describes findings related to the following physical education topics: requirements, standards and guidelines, instruction, student assessment, physical education for students with disabilities, staffing and professional preparation, physical education coordinators, physical activity and discipline, and facilities. It also describes findings related to physical activity and interscholastic sports, including elementary school recess, physical activity breaks, walk and bike to school programs, intramural activities and physical activity clubs, interscholastic sports, and community use of facilities. At the classroom level, this article describes general course characteristics, teaching methods and topics, student assessment, physical education for students with disabilities, and staffing and staff development. In addition, it describes changes in key policies and practices from 2000 to 2006. While this article is primarily descriptive in nature, the CDC intends to conduct more detailed analyses and encourages others to conduct their own analyses using the questionnaires and publicuse data sets available at www.cdc.gov/shpps.

METHODS

Detailed information about SHPPS 2006 methods is provided in "Methods: School Health Policies and Programs Study 2006" elsewhere in this issue of the Journal of School Health. The following section provides a brief overview of SHPPS 2006 methods specific to the physical education and activity component of the study.

SHPPS 2006 assessed physical education and activity at the state, district, school, and classroom levels. State-level data were collected from education agencies in all 50 states plus the District of Columbia. District-level data were collected from a nationally representative sample of public school districts. School-level data were collected from a nationally representative sample of public and private elementary schools, middle schools, and high schools. Classroom-level data were collected from teachers of randomly selected classes in elementary schools and randomly selected required physical education courses in middle and high schools.

Questionnaires

The state-level questionnaire assessed school physical education policies and practices for grades K-12. Specifically, this questionnaire assessed school physical education standards and guidelines; required physical education instruction at the elementary, middle, and high school levels; elementary school recess; requirements for physical education for students with disabilities; student assessment; use of protective gear; use of physical activity for disciplinestaffing and staff development for physical education teachers and interscholastic sports coaches; collaboration; and the educational background and credentials of the person who oversees or coordinates school physical education.

Because the district-level questionnaire took longer than 20-30 minutes to complete and covered such a wide range of topics that a single respondent might not have sufficient knowledge to complete it, the questionnaire was divided into 5 modules: (1) standards and guidelines, (2) elementary school instruction, (3) middle/junior high school instruction, (4) high school instruction, and (5) students with disabilities, use of protective gear, physical activity and discipline, staffing and staff development, collaboration, promotion, evaluation, interscholastic sports coaches, and characteristics of physical education coordinators.

The school-level physical education questionnaire was also divided into 2 modules: (1) standards, guidelines, and objectives; required physical education; instructional content; student assessment; use of protective gear; physical activity and discipline; students with disabilities; facilities; staffing and staff development; collaboration and promotion; intramural activities and physical activity clubs; community use of school facilities; and characteristics of physical education coordinators and (2) interscholastic sports.

The classroom-level questionnaire assessed general characteristics of physical education classes and courses and specific content taught; time spent teaching specific physical activities; teaching and evaluation techniques; and the educational background, credentials, and recent staff development of physical education teachers.

Data Collection and Respondents

State- and district-level data were collected by computer- assisted telephone interviews or selfadministered mail questionnaires. Designated respondents for each of 7 school health program components (ie, health education, physical education and activity, health services, mental health and social services, nutrition services, healthy and safe school environment, and faculty and staff health promotion) completed the interviews or questionnaires. At the state level, the state-level contact designated a single respondent for each component. At the district level, the district-level contact could designate a different respondent for each module. All designated respondents had primary responsibility for, or were the most knowledgeable about, the policies and programs addressing the particular questionnaire or module.

After a state- or district-level contact identified respondents, each respondent was sent a letter of invitation and packet of study- related materials. Each packet contained a paper copy of the questionnaire, so that respondents could prepare for the interview(s), and provided a toll-free number and access code that respondents could use to initiate the interview. Respondents were told that the questionnaire^) could be used in preparation for their telephone interview or completed and returned if self- administration was preferred. One week after packets were mailed to respondents, trained interviewers from a call center placed calls to them to schedule and conduct telephone interviews. In April 2006, telephone interviewing ceased and most of the remaining state- and district-level data collection occurred via a mail survey. All remaining respondents were mailed paper questionnaires and return envelopes; however, interviewers remained available for any respondents who chose to contact the call center.

At the end of the data collection period (October 2006), 86% of the completed state-level physical education questionnaires had been completed via telephone interviews and 14% as paper questionnaires. For the completed district-level questionnaires, module 1 was completed via telephone interview 51% of the time; module 2, 53%; and modules 3, 4, and 5, 50%.

School- and classroom-level data were collected by computer- assisted personal interviews. During recruitment, the principal or another school-level contact designated a faculty or a staff respondent for each questionnaire or module, who had primary responsibility for or the most knowledge about the particular component. The most common respondents for module 1 were physical education teachers. The most common respondents for module 2 were physical education teachers and athletic directors.

At the classroom level, respondents to the computerassisted personal interviews were those physical education teachers whose elementary school class or middle or high school course was selected during the sampling process. All school- and classroomlevel interviews were completed between January and June 2006.

Response Rates

One hundred percent (n = 51) of the state education agencies completed the state-level physical education questionnaire. District eligibility for each module was determined prior to beginning the interview; 720 districts were eligible for module 1, 703 for module 2, 698 for module 3, 664 for module 4, and 719 for module 5. Of the 720 districts eligible to complete any physical education questionnaire module, 63% (n = 453) completed at least 1 module. School eligibility for each module was determined prior to beginning the interview; 1394 schools were eligible for module 1 and 1037 for module 2. Of the 1394 schools eligible to complete any physical education questionnaire module, 72% (n = 988) completed at least 1 module. At the classroom level, 1260 courses or classes were selected for the physical education interview; 95% (n = 1194) of teachers of these courses or classes completed the interview. Data Analysis

Data from state-level questionnaires are based on a census and are not weighted. District-, school-, and classroom-level data are based on representative samples and are weighted to produce national estimates. Two weights were constructed for analysis of classroom data. The first weight is appropriate for making inferences to schools nationwide based on the aggregation of classroom data within each school. The second weight is appropriate for making inferences to required elementary school classes or required middle and high school courses nationwide based on the data about the individual classes or courses.

Because of missing data, the denominators for each estimate vary slightly. Figures 4-6 in Appendix 1 of this issue of the Journal of School Health show the estimated standard error associated with an observed estimate from the district-, school-, and classroomlevel physical education questionnaires.

To analyze changes between SHPPS 2000 and SHPPS 2006, many variables from SHPPS 2000 were recalculated so that the denominators used for both years of data were defined identically. In most cases, this denominator included all states, districts, or schools, rather than a subset of states, districts, or schools. As a result of this recalculation, percentages previously reported for SHPPS 200029 might differ from those reported in this article. Only estimates from 2000 and 2006 based on this same denominator should be compared.

Because state-level data are based on a census, statistical tests for differences between 2000 and 2006 are not appropriate. Therefore, this article highlights changes over time, meeting at least 1 of 2 criteria: (1) the difference was greater than 10 percentage points or (2) the 2006 estimate increased by at least a factor of 2 or decreased by at least half as compared with the 2000 estimate. At the district, school, and classroom levels, t tests were used to compare SHPPS 2000 and SHPPS 2006 prevalence estimates. However, to account for multiple comparisons, this article only highlights changes over time, meeting at least 2 of 3 criteria: (1) a p value less than .01 from the t test, (2) a difference greater than 10 percentage points, or (3) the 2006 estimate increased by at least a factor of 2 or decreased by at least half as compared with the 2000 estimate. A p value less than .01 was used as the sole criterion for reporting on statistically significant differences based on means and medians between 2000 and 2006. Note that not all variables meeting these criteria are presented in this article.

RESULTS

Physical Education at the State and District Levels

Standards and Guidelines. Most (70.5%) states had adopted a policy stating that districts or schools will follow national or state physical education standards or guidelines. An additional 11.8% of states had adopted a policy encouraging districts or schools to follow national or state physical education standards or guidelines. Among all states, 76.0% required or encouraged districts or schools to follow physical education standards or guidelines based on NASPE's National Standards for Physical Education.17 To improve district or school compliance with any national or state standards or guidelines, 76.2% of the 42 states that required or encouraged standards or guidelines used staff development for physical education teachers, 48.8% included physical education when the state did onsite reviews in school districts for overall compliance with educational standards or guidelines, 31.0% used written reports from districts or schools to document compliance, and 7.1% included physical education in statewide assessments or testing.

Districts were more likely to require schools to follow physical education standards or guidelines. Nationwide, 81.4% of districts had adopted a policy stating that schools will follow national, state, or district physical education standards or guidelines. An additional 2.4% of districts had adopted a policy encouraging schools to follow national, state, or district physical education standards or guidelines. Among all districts, 55.1% required or encouraged schools to follow physical education standards or guidelines based on the National Standards for Physical Education.11 To improve school compliance with national, state, or district physical education standards or guidelines, 88.7% of the 83.8% of districts that required or encouraged schools to follow standards or guidelines used teacher evaluations or classroom monitoring, 79.8% used staff development for physical education teachers, 73.9% used teachers to mentor other teachers, and 51.4% used written reports from schools to document compliance.

Sixteen percent of states prohibited schools from using physical activity to punish students for bad behavior in physical education class, and 56.0% actively discouraged this practice. Only 6.0% of states prohibited but 54.0% discouraged schools from excluding students from all or part of physical education class as punishment for bad behavior in another class. Nationwide, 20.5% of districts prohibited schools from using physical activity to punish students for bad behavior in physical education class, and 45.1% actively discouraged this practice. In addition, 36.5% of districts prohibited and 33.9% discouraged schools from excluding students from all or part of physical education class as punishment for bad behavior in another class.

Elementary School Instruction. Nationwide, 76.5% of states and 81.9% of districts that provided elementary school instruction had adopted goals, objectives, or expected outcomes for elementary school physical education. More than two thirds of all states and more than three fourths of all districts had adopted goals and objectives that specifically addressed student outcomes from the National Standards for Physical Education17 (Table 1).

Nationwide, 80.4% of states and 93.3% of districts had adopted a policy stating that elementary schools will teach physical education. Thirty-six percent of all states and 75.8% of all districts specified time requirements (eg, minutes per week, hours per quarter, or hours per year) for elementary school physical education. In addition, 31.4% of all states and 24.5% of all districts had adopted a policy specifying a maximum student-to- teacher ratio for elementary school physical education.

Among the 80.4% of states that required elementary school physical education, 25.0% had adopted a policy describing reasons for which students could be exempted from physical education. The most common reasons for which students could be exempted from physical education requirements for 1 grading period or longer were long-term physical or medical disability and religious reasons (Table 2). Among the 93.3% of districts that required elementary school physical education, 45.7% had adopted a policy describing reasons for which elementary school students could be exempted from physical education. The most common reasons for which students could be exempted from physical education requirements were cognitive disability, long-term physical or medical disability, and religious reasons.

Only 7.8% of all states required and 3.9% recommended that districts or schools use 1 particular curriculum (defined as a written course of study that generally describes what students will know and be able to do by the end of a single grade or multiple grades and for a particular subject area; often presented through a detailed set of directions, strategies, and materials to facilitate student learning and teaching of content) for elementary school physical education. Curriculum requirements were more common at the district level. Among all districts, 29.5% required and 34.4% recommended that schools use 1 particular curriculum for elementary school physical education. The state education agency contributed to the development of this curriculum in 30.4% of the districts that had a requirement or recommendation. The district itself contributed to the development of this curriculum in 31.9% of the districts, academic institutions did so in 5.7%, a commercial company did so in 3.1%, and other state agencies did so in 3.1%.

Nationwide, 3.9% of states required and 37.3% recommended that elementary schools give written tests of students' knowledge related to physical education, 3.9% of states required and 43.1% recommended skill performance tests related to physical education, and 11.8% of states required and 35.3% recommended tests of students' fitness levels. Among all states, 29.4% required or recommended using the Fitnessgram for fitness testing, 21.6% required or recommended the Physical Fitness Test from the President's Challenge, 13.7% recommended the Health Fitness Test from the President's Challenge, and 2.0% recommended the Youth Fitness Test from the Young Men's Christian Association (YMCA).

Nationwide, 5.2% of districts required and 19.8% recommended that elementary schools give written tests of students' knowledge related to physical education, 20.9% of districts required and 33.6% recommended skill performance tests related to physical education, and 28.1% of districts required and 40.2% recommended tests of students' fitness levels. Among all districts, 53.6% required or recommended the Physical Fitness Test from the President's Challenge, 30.7% required or recommended the Health Fitness Test from the President's Challenge, 21.5% required or recommended using the Fitnessgram for fitness testing, and 5.0% required or recommended the Youth Fitness Test from the YMCA. During the 2 years preceding the study, states and districts provided a variety of information and materials for elementary school physical education. For example, 33.3% of states and 48.0% of districts provided a chart describing the scope and sequence of instruction, 21.6% of states and 55.4% of districts provided a physical education curriculum, 29.4% of states and 46.4% of districts provided a list of recommended physical education curricula, 39.2% of states and 50.0% of districts provided lesson plans or learning activities for physical education, and 51.0% of states and 46.4% of districts provided plans for how to assess or evaluate students in physical education.

Middle School Instruction. Nationwide, 78.4% of states and 78.6% of districts that provided middle school instruction had adopted goals, objectives, or expected outcomes for middle school physical education. More than two thirds of all states and districts had adopted goals and objectives that specifically addressed student outcomes from the National Standards for Physical Education17 (Table 1).

Nationwide, 78.4% of states and 89.5% of districts had adopted a policy stating that middle schools will teach physical education. In addition, 37.3% of all states and 76.0% of all districts specified time requirements (eg, minutes per week, hours per quarter, or hours per year) for middle school physical education. Further, 31.4% of all states and 26.0% of all districts had adopted a policy specifying a maximum student-to-teacher ratio for middle school physical education.

Among the 78.4% of states that required middle school physical education, 34.1 % had adopted a policy describing reasons for which students could be exempted from physical education. The most common reasons for which students could be exempted from physical education requirements for 1 grading period or longer were long-term physical or medical disability and religious reasons (Table 2). Among the 89.5% of districts that required middle school physical education, 50.8% had adopted a policy describing reasons for which middle school students could be exempted from physical education. The most common reasons for which they could be exempted from physical education requirements were cognitive disability, long-term physical or medical disability, participation in school activities other than sports (eg, band or chorus), participation in school sports, and religious reasons.

Only 9.8% of all states required and 5.9% recommended that districts or schools use 1 particular curriculum for middle school physical education. Curriculum requirements were more common at the district level. Among all districts that provided middle school instruction, 36.1% required and 22.6% recommended that schools use 1 particular curriculum for physical education. The district itself contributed to the development of this curriculum in 31.5% of the districts, and the state education agency did so in 32.5% of the districts.

Nationwide, 2.0% of states required and 39.2% recommended that middle schools give written tests of students' knowledge related to physical education, 2.0% of states required and 43.1% recommended skill performance tests related to physical education, and 13.7% of states required and 35.3% recommended tests of students' fitness levels. Among all states, 35.3% required or recommended using the Fitnessgram for fitness testing, 25.5% required or recommended the Physical Fitness Test from the President's Challenge, 17.6% recommended the Health Fitness Test from the President's Challenge, and 3.9% recommended the Youth Fitness Test from the YMCA.

Nationwide, 11.7% of districts required and 32.9% recommended that middle schools give written tests of students' knowledge related to physical education, 21.0% of districts required and 34.9% recommended skill performance tests related to physical education, and 26.1% of districts required and 39.0% recommended tests of students' fitness levels. Among all districts, 51.6% required or recommended the Physical Fitness Test from the President's Challenge, 29.3% required or recommended the Health Fitness Test from the President's Challenge, 24.1% required or recommended using the Fitnessgram for fitness testing, and 8.1% required or recommended the Youth Fitness Test from the YMCA.

During the 2 years preceding the study, states and districts provided a variety of information and materials for middle school physical education. For example, 31.4% of all states and 43.6% of all districts provided a chart describing the scope and sequence of instruction, 21.6% of states and 57.8% of districts provided a physical education curriculum, 25.5% of states and 45.0% of districts provided a list of recommended physical education curricula, 37.3% of states and 43.3% of districts provided lesson plans or learning activities for physical education, and 49.0% of states and 45.8% of districts provided plans for how to assess or evaluate students in physical education.

High School Instruction. Nationwide, 80.4% of states and 79.7% of districts that provided high school instruction had adopted goals, objectives, or expected outcomes for high school physical education. More than two thirds of all states and districts had adopted goals and objectives that specifically addressed student outcomes from the National Standards for Physical Education17 (Table 1).

Nationwide, 86.3% of states and 88.8% of districts had adopted a policy stating that high schools will teach physical education. Fifty-eight percent of all states and 81.0% of all districts specified time requirements (eg, minutes per week, hours per quarter, or hours per year) for high school physical education. In addition, 31.4% of all states and 31.1% of all districts had adopted a policy specifying a maximum student-to-teacher ratio for high school physical education. Among the 86.3% of states that required high school physical education, 25.0% had adopted a policy describing reasons for which students could be exempted from physical education. The most common reasons for which students could be exempted from physical education requirements for 1 grading period or longer were long-term physical or medical disability, participation in school activities other than sports, participation in school sports, and religious reasons (Table 2). Among the 88.8% of districts that required high school physical education, 59.6% had adopted a policy describing reasons for which high school students could be exempted from physical education. The most common reasons for which they could be exempted from physical education requirements were cognitive disability, long-term physical or medical disability, participation in school activities other than sports, participation in school sports, and religious reasons.

Only 13.7% of all states required and 2.0% recommended that districts or schools use 1 particular curriculum for high school physical education. Curriculum requirements were more common at the district level. Among all districts that provided high school instruction, 33.9% required and 27.2% recommended that schools use 1 particular curriculum for physical education. The district itself contributed to the development of this curriculum in 37.6% of the districts, and the state education agency did so in 31.4% of the districts.

Nationwide, 3.9% of states required and 39.2% recommended that high schools give written tests of students' knowledge related to physical education, 2.0% of states required and 43.1% recommended skill performance tests related to physical education, and 15.7% of states required and 33.3% recommended tests of students' fitness levels. Among all states, 31.4% required or recommended using the Fitnessgram for fitness testing, 25.5% required or recommended the Physical Fitness Test from the President's Challenge, 19.6% recommended the Health Fitness Test from the President's Challenge, and 3.9% recommended the Youth Fitness Test from the YMCA.

Nationwide, 21.7% of districts required and 37.6% recommended that high schools give written tests of students' knowledge related to physical education, 18.9% required and 43.6% recommended skill performance tests, and 24.6% of districts required and 41.9% recommended tests of students' fitness levels. Among all districts, 48.8% required or recommended the Physical Fitness Test from the President's Challenge, 29.7% required or recommended the Health Fitness Test from the President's Challenge, 21.2% required or recommended using the Fitnessgram for fitness testing, and 6.2% required or recommended the Youth Fitness Test from the YMCA.

During the 2 years preceding the study, states and districts provided a variety of information and materials for high school physical education. For example, 31.4% of all states and 43.5% of all districts provided a chart describing the scope and sequence of instruction, 19.6% of states and 55.8% of districts provided a physical education curriculum, 21.6% of states and 47.2% of districts provided a list of recommended physical education curricula, 41.2% of states and 43.9% of districts provided lesson plans or learning activities for physical education, and 49.0% of states and 43.5% of districts provided plans for how to assess or evaluate students in physical education.

Physical Education for Students With Disabilities. Most states required schools to implement measures to meet the physical education needs of students with long-term (defined as ongoing, not a temporary disability like a broken bone) physical, medical, or cognitive disabilities. Specifically, states required schools to include physical education in 504 plans (defined as documents that describe a program of instructional services to assist students with special needs who are in a regular educational setting) or individualized education programs (IEPs) (defined as documents written by school administrators, teachers, and parents that identify annual goals, strategies, or services provided for students with special educational needs) (91.5%), to mainstream students with disabilities into regular physical education (89.6%), to provide adapted physical education as appropriate (87.5%), to use modified equipment or facilities in regular physical education (87.0%), to use modified assessment (81.6%), and to use teaching assistants in regular physical education (74.5%). Nearly all districts required schools to implement measures to meet the needs of students with longterm disabilities. In 98.5% of all districts, schools were required to mainstream students with disabilities into regular physical education, 96.3% required the inclusion of physical education in 504 plans or IEPs, 93.8% required the use of modified assessment, 93.2% required the use of modified equipment or facilities in regular physical education, 92.7% required schools to provide adapted physical education as appropriate, and 86.5% required the use of teaching assistants in regular physical education.

Professional Preparation. Nationwide, 64.7% of states and 76.8% of districts had adopted a policy stating that newly hired staff who teach physical education at the elementary school level will have undergraduate or graduate training in physical education; 86.3% of states and 81.2% of districts had adopted this policy for newly hired staff who teach physical education at the middle school level and 88.2% of states and 88.5% of districts had adopted this policy for newly hired staff who teach physical education at the high school level.

All states offered at least 1 type of certification, licensure, or endorsement to teach physical education. Specifically, 52.9% of states offered certification, licensure, or endorsement to teach physical education for grades K-12, 52.9% offered it for elementary school, 56.9% offered it for middle school, and 60.8% offered it for high school. In addition, 47.1% of states offered a combined physical education and health education certification, licensure, or endorsement for grades K-12, 27.5% offered it for elementary school, 33.3% offered it for middle school, and 33.3% offered it for high school.

Many states and districts required newly hired staff to be certified, licensed, or endorsed by the state to teach physical education. Specifically, 68.6% of states and 84.2% of districts had adopted a policy stating that newly hired elementary school physical education teachers will be certified, licensed, or endorsed by the state to teach physical education, 88.2% of states and 86.5% of districts had adopted such a policy for newly hired staff at the middle school level, and 90.0% of states and 92.6% of districts had adopted such a policy for newly hired staff at the high school level.

Staffing and Staff Development. Nationwide, 14.0% of states had adopted a policy stating that all districts will have someone to oversee or coordinate physical education, and 8.0% had adopted a policy stating that each school will have someone to over see or coordinate physical education at the school (eg, a lead physical education teacher). Among all districts, 54.0% had adopted a policy stating that each school will have someone to oversee or coordinate physical education at the school.

Nationwide, 66.0% of states had adopted a policy stating that teachers will earn continuing education credits on physical education topics to maintain state certification, licensure, or endorsement to teach physical education. Among all districts, 47.4% had adopted a policy stating that those who teach physical education will earn continuing education credits on physical education topics.

Staff development was defined as workshops, conferences, continuing education, graduate courses, or any other kind of in- service on physical education topics. During the 2 years preceding the study, 77.6% of all states and 90.9% of all districts provided funding for staff development or offered staff development for physical education teachers on at least 1 of the topics listed in Table 3. Specifically, more than half of all states provided funding for staff development or offered staff development for physical education teachers on administering or using fitness tests; assessing or evaluating student performance in physical education; encouraging family involvement in physical activity; methods to increase the amount of class time students are physically active; teaching movement skills and concepts; teaching physical education to students with long-term physical, medical, or cognitive disabilities; teaching team or group activities or sports; using physical activity monitoring devices; and using technology such as computers or video cameras for physical education (Table 3).

During the 2 years preceding the study, more than half of all districts provided funding for staff development or offered staff development for physical education teachers on administering or using fitness tests; assessing or evaluating student performance in physical education; chronic health conditions; encouraging family involvement in physical activity; injury prevention and first aid; methods to increase the amount of class time students are physically active; teaching individual or paired activities or sports; teaching movement skills and concepts; teaching physical education to students with longterm physical, medical, or cognitive disabilities; teaching team or group activities; and using physical activity monitoring devices (Table 3).

Collaboration. During the 12 months preceding the study, state physical education staff worked on physical education activities with state school nutrition or food service staff in 88.2% of states, with state health education staff in 84.3% of states, with state health services staff in 82.4% of states, and with state mental health or social services staff in 50.0% of states. State physical education staff also worked with colleges or universities in 88.2% of states, with state affiliates of the American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD) in 88.2% of states; with a statelevel school health committee, council, or team in 84.3% of states; with state affiliates of the Action for Healthy Kids in 84.0% of states; with state-level health organizations (eg, the American Heart Association or American Cancer Society) in 78.0% of states; with a state-level school nurses' association in 62.7% of states; with the Governor's Council on Physical Fitness and Sports in 60.0% of states; with a state-level physicians' organization (eg, the American Academy of Pediatrics) in 43.1% of states; with businesses in 43.1% of states; and with a state parks or recreation department in 41.2% of states.

During the 12 months preceding the study, district physical education staff worked on physical education activities with district-level general curriculum coordinators or supervisors in 61.0% of districts, with district-level health education staff in 54.8% of districts, with district-level school health services staff in 48.1% of districts, with district-level nutrition services staff in 46.0% of districts, and with district-level mental health or social services staff in 27.1% of districts. District physical education staff also worked with a health organization in 59.2% of districts, with a local health department in 34.3% of districts, with local parks or recreation departments in 31.2% of districts, with a local college or university in 29.7% of districts, with a local youth organization (eg, YMCA, Boys or Girls Clubs, or the Boy Scouts or Girls Scouts) in 24.4% of districts, with a local hospital in 24.2% of districts, with a local mental health or social services agency in 22.5% of districts, with a local business in 21.5% of districts, with a local health or fitness club in 19.9% of districts, and with a local service club (eg, the Rotary Club) in 16.4% of districts.

Evaluation. During the 2 years preceding the study, 63.9% of all districts evaluated their physical education curricula, 54.1% evaluated their physical education policies, and 52.7% evaluated their staff development or in-service programs.

Physical Education Coordinators. Among the 88.2% of states that had someone to oversee or coordinate physical education at the state level, 86.7% had that person serve as the respondent to the state- level physical education questionnaire. Among those respondents, all had an undergraduate degree. More than three fourths (76.9%) majored in physical education, and 46.1% majored in health education. In addition, 66.7% had an undergraduate minor, and 7.7% minored in physical education, 30.8% minored in health education, 7.7% minored in other areas of education, and 65.4% minored in other disciplines. Most (87.2%) of the state-level coordinators who served as the respondents had a graduate degree. The most common graduate degrees were in physical education (32.4%); health education (29.4%); other areas of education (20.6%); and kinesiology, exercise physiology, or exercise science (8.8%). Among the state-level coordinators who served as the SHPPS respondents, 86.1% had an undergraduate major, an undergraduate minor, or a graduate degree in physical education; 64.1% were certified, licensed, or endorsed by their state to teach elementary school physical education; 69.2% were certified, licensed, or endorsed to teach middle school physical education; 69.2% were certified, licensed, or endorsed to teach high school physical education. However, 30.8% were not certified, licensed, or endorsed to teach physical education at any of the 3 school levels.

Nationwide, 68.9% of districts had someone to oversee or coordinate physical education. Unfortunately, the number of these coordinators who served as the respondents to the district-level physical education SHPPS questionnaire was too small for meaningful analysis of the data about their qualifications. Physical Activity and Interscholastic Sports at the State and District Levels

Elementary School Recess. Few (11.8%) states required and 25.5% recommended that elementary schools provide students with regularly scheduled recess, whereas 57.1% of all districts required and 33.1% recommended that elementary schools provide students with regularly scheduled recess. Among all districts, 38.5% required or recommended 30 minutes or more of recess per day, 23.0% required or recommended 20-29 minutes per day, and 15.9% required or recommended 10-19 minutes per day. Nationwide, 8.0% of states and 19.7% of districts prohibited elementary schools from excluding students from all or part of recess as punishment for bad behavior, and 49.0% of states and 23.9% of districts actively discouraged this practice.

Physical Activity Breaks and Walk and Bike to School Programs. Districts were more likely to require or recommend that elementary and middle schools, compared with high schools, provide regular physical activity breaks (outside physical education class and recess) during the school day. Specifically, 15.5% of all districts required and 25.0% recommended that elementary schools provide regular physical activity breaks, 10.0% of all districts required and 23.7% recommended that middle schools provide regular physical activity breaks, and 3.8% of all districts required and 8.6% recommended that high schools provide regular physical activity breaks.

States and districts were also asked about their policies related to supporting or promoting walking and biking to and from school, such as promotional activities, designated "safe routes" or "preferred routes," and storage facilities for bicycles and helmets. Among all states, 13.7% had adopted a policy encouraging districts or schools to support or promote walking or biking to and from school, and 17.5% of all districts had adopted a policy that supported or promoted walking or biking to and from school.

Interscholastic Sports Coaches. Some states and districts had adopted policies stating that head coaches of interscholastic sports will complete a coaches' training course (50.0% of states and 61.5% of districts), be certified in first aid (47.7% of states and 61.3% of districts), be certified in cardiopulmonary resuscitation (CPR) (47.7% of states and 57.7% of districts), be employed by the school or by the school district (39.1% of states and 56.8% of districts), have a teaching certificate (32.7% of states and 46.0% of districts), have previous coaching experience in the sport they will coach (15.2% of states and 28.7% of districts), and have previous coaching experience in any sport (12.8% of states and 33.5% of districts). Nationwide, 31.1% of states and 55.0% of districts required assistant coaches or volunteer athletic aides (defined as a person who assists the coach but is not paid for doing so and who may or may not be a school employee) to complete a training course. During the 2 years preceding the study, the state education agency provided funding for staff development or offered staff development to coaches of interscholastic sports in 20.8% of states. Another state-level organization or agency provided funding for staff development or offered staff development to coaches of interscholastic sports in 60.0% of states. Among all districts, 72.3% provided funding for staff development or offered staff development to coaches of interscholastic sports during the same time period.

Use of Protective Gear. Nationwide, 12.0% of states and 43.6% of districts had adopted a policy requiring students to wear appropriate protective gear during physical education; 14.0% of states and 44.8% of districts had adopted this policy for students engaged in intramural activities or physical activity clubs and 49.0% of states and 84.2% of districts had adopted this policy for students engaged in interscholastic sports.

Changes Between 2000 and 2006 at the State and District Levels. Many changes were detected in state- and district-level policies and practices related to both physical education and physical activity and interscholastic sports between 2000 and 2006. For example, changes were detected in the percentage of states and districts that had adopted policies regarding physical education standards and guidelines. Between 2000 and 2006, the percentage of states that required or encouraged districts or schools to follow standards or guidelines based on the National Standards for Physical Education17 increased from 59.2% to 76.0%. In addition, the percentage of districts that had adopted a policy stating that schools will follow national, state, or district physical education standards or guidelines increased from 66.5% to 81.4%.

Between 2000 and 2006, positive changes were detected in the percentage of states and districts with policies and practices supporting elementary school physical education instruction. For example, the percentage of districts that had adopted a policy stating that elementary schools will teach physical education increased from 82.6% to 93.3%. Further, the percentage of states that had adopted goals, objectives, or expected outcomes for elementary school physical education increased from 64.7% to 76.5%, and the percentage of districts that had done so increased from 71.5% to 81.9%. Increases were also detected in the percentage of states and districts in which goals or objectives for elementary school physical education specifically addressed achievement and maintenance of a health-enhancing level of physical fitness (from 62.0% to 74.5% among states), regular participation in physical activity (from 61.2% to 74.5% among states and from 70.3% to 81.0% among districts), and responsible personal and social behavior that respects self and others in physical activity settings (from 62.0% to 74.5% among states and from 68.5% to 80.6% among districts).

Between 2000 and 2006, states adopted policies allowing fewer exemptions from required physical education in elementary schools. Specifically, the percentage of states that had a policy stating that elementary school students can be exempted from physical education requirements for 1 grading period or longer for religious reasons decreased from 30.6% to 15.0%. However, among districts, the percentage allowing exemptions for elementary school students for high physical competency test scores increased from 0.5% to 4.9% as did the percentage of districts allowing exemptions for participation in community sports activities (from 2.1% to 8.9%).

Also, between 2000 and 2006, an increase was detected in the percentage of states providing plans during the 2 years preceding the study for how to assess or evaluate students in elementary school physical education (from 35.3% to 51.0%).

Changes were also detected in the percentage of states and districts with policies and practices supporting middle school physical education instruction. Between 2000 and 2006, the percentage of states with goals and objectives that addressed responsible personal and social behavior that respects self and others in physical activity settings increased from 62.7% to 76.5%. Regarding student exemptions from required physical education, the percentage of states that had adopted a policy stating that middle school students could be exempted from physical education requirements for 1 grading period or longer for religious reasons decreased (from 35.0% to 15.8%), and the percentage of districts that had adopted a similar policy also decreased (from 32.4% to 17.7%). However, the percentage of districts that had adopted policies allowing middle school students to be exempted from physical education for high physical competency test scores increased (from 2.0% to 10.5%) as did the percentage of districts allowing exemptions for participation in community sports activities (from 3.7% to 10.5%) and the percentage of districts allowing exemptions for participation in community service activities (from 1.8% to 7.7%). In addition, the percentage of states that provided plans for how to assess or evaluate students in middle school physical education during the 2 years preceding the study increased from 33.3% to 49.0%, while the percentage of districts that provided lesson plans or learning activities for middle school physical education decreased from 55.7% to 43.3%.

A few changes were also detected in the percentage of states and districts with policies and practices supporting high school physical education instruction. Between 2000 and 2006, the percentage of states that had adopted goals, objectives, or expected outcomes for high school physical education increased from 66.7% to 80.4%. Increases were also detected in the percentage of states with goals or objectives for high school physical education that specifically addressed achievement and maintenance of a health- enhancing level of physical fitness (from 66.7% to 80.4%) and regular participation in physical activity (from 62.7% to 78.4%). In addition, the percentage of states providing lesson plans or learning activities for high school physical education during the 2 years preceding the study increased from 30.6% to 41.2%, and the percentage of states providing plans for how to assess or evaluate students in physical education increased from 32.0% to 49.0%.

Both states and districts increased requirements and recommendations for fitness tests between 2000 and 2006. For elementary schools, the percentage of states that required or recommended that elementary schools use Fitnessgram increased from 16.0% to 29.4%, and the percentage of districts that required or recommended that elementary schools use the Youth Fitness Test from the YMCA increased from 1.5% to 5.0%. For middle schools, increases were detected in the percentage of states and districts that required or recommended that middle schools use Fitnessgram (from 17.6% to 35.3% among states and from 9.5% to 24.1% among districts) and in the percentage of districts that required or recommended that schools use the Youth Fitness Test from the YMCA (from 1.7% to 8.1%). Similarly, the percentage of states and districts that required or recommended that high schools use Fitnessgram increased from 17.6% to 31.4% among states and from 8.3% to 21.2% among districts. Between 2000 and 2006, the percentage of states that actively discouraged schools from excluding students from physical education for bad behavior in another class increased from 20.4% to 54.0%, and the percentage of districts that prohibited schools from this practice increased from 19.2% to 36.5%. The percentage of states that had adopted a policy prohibiting schools from using physical activity to punish students for bad behavior in physical education increased (from 2.1% to 16.0%), and the percentage of states actively discouraging schools from this practice also increased (from 25.5% to 56.0%).

Between 2000 and 2006, both states and districts adopted policies to help meet the needs of students with long-term physical, medical, or cognitive disabilities. For example, the percentage of states that had adopted policies requiring schools to meet the physical education needs of students with long-term disabilities using teaching assistants in regular physical education increased from 55.8% to 74.5%. At the district level, the percentage of districts that had adopted policies requiring schools to meet the physical education needs of students with long-term disabilities using teaching assistants in regular physical education increased (from 57.2% to 86.5%), as did the percentage of districts that had adopted policies requiring schools to provide adapted physical education (from 74.6% to 92.7%) and the percentage of districts that had adopted policies requiring schools to meet the needs of students with long-term disabilities by mainstreaming them into regular physical education as appropriate (from 82.3% to 98.5%).

Between 2000 and 2006, the percentage of districts that evaluated their physical education policies during the 2 years preceding the study increased from 43.0% to 54.1%, and the percentage that evaluated their staff development or in-service programs increased from 40.4% to 52.7%.

Collaboration between state and district physical education staff and staff from within their own and other agencies and organizations increased in many ways between 2000 and 2006. For example, collaboration between physical education staff and nutrition services staff increased from 42.0% to 88.2% among states and from 12.1% to 46.0% among districts, and collaboration between physical education staff and health services staff increased from 48.0% to 82.4% among states and 29.8% to 48.1% among districts. In addition, collaboration between physical education staff and mental health and social services staff increased from 34.0% to 50.0% among states and from 12.4% to 27.1% among districts, and collaboration between physical education staff and health education staff increased from 72.0% to 84.3% among states and from 40.9% to 54.8% among districts.

Increases were also seen in the percentage of states in which physical education staff worked on physical education activities with state-level health organizations (from 64.6% to 78.0%), the state-level AAHPERD (from 70.0% to 88.2%), the Governor's Council on Physical Fitness and Sports (from 42.9% to 60.0%), the state parks or recreation department (from 26.7% to 41.2%), colleges or universities (from 70.6% to 88.2%), and businesses (from 31.3% to 43.1%). Finally, increases were detected in the percentage of districts in which physical education staff worked on physical education activities with the local health department (from 24.1% to 34.3%) and the local health organizations (from 46.4% to 59.2%).

Positive changes were detected in professional preparation expectations. Between 2000 and 2006, the percentage of states that had adopted a policy stating that newly hired staff who teach physical education at the elementary school level will have undergraduate or graduate training in physical education increased from 51.1% to 64.7%. In addition, the percentage of districts that had adopted a policy stating that newly hired staff who teach physical education at the high school level will have undergraduate or graduate training in physical education increased from 78.4% to 88.5%, and the percentage of districts that had adopted a policy stating that these teachers will be certified by the state to teach physical education increased from 78.6% to 92.6%. Similarly, the percentage of states that had adopted a policy stating that teachers will earn continuing education credits on physical education topics to maintain state certification, licensure, or endorsement to teach physical education increased from 51.0% to 66.0%.

Positive changes were also detected in staffing. Between 2000 and 2006, the percentage of states that had someone who oversees or coordinates physical education increased from 68.6% to 88.2%, and the percentage of states that had adopted a policy stating that each school will have someone to over see or coordinate physical education increased from 3.9% to 8.0%.

Between 2000 and 2006, increases were detected in the percentage of states and districts that offered funding for staff development or provided staff development during the 2 years preceding the study to those who teach physical education on administering or using fitness tests (from 30.6% to 61.2% among states and from 49.8% to 62.5% among districts), assessing or evaluating student performance in physical education (from 54.0% to 71.4% among states and from 48.0% to 62.2% among districts), encouraging family involvement in physical activity (from 24.5% to 59.2% among states and from 28.0% to 51.0% among districts), methods to increase the amount of class time students are physically active (from 28.0% to 55.1% among states and from 32.6% to 54.3% among districts), teaching individual or paired activities or sports (from 32.7% to 49.0% amo

Source: Journal of School Health, The

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