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Comprehensive School Physical Activity Programs
Putting Research into Evidence-Based Practice
Edited by Russell Carson and Collin A. Webster
408 Pages
That’s where Comprehensive School Physical Activity Programs: Putting Research Into Evidence-Based Practice comes in.
CSPAP Model Brought to Life
The comprehensive school physical activity program (CSPAP) model, originally outlined as a 2008 position statement by the National Association for Sport and Physical Education to promote physical activity throughout K-12, is brought to life through this comprehensive, all-in-one resource. In the decade since that position statement, CSPAP has been spreading through numerous initiatives, which have mobilized a CSPAP field of study and a national framework for physical activity and physical education. CSPAP acts as a hub, supporting physical activity through multiple components that can include physical education; physical activity before, during, and after school; staff involvement; and family and community engagement. Moreover, each CSPAP component can serve to strengthen and reinforce the academic goals of physical education.
Accommodates Needs of Diverse Audiences
Comprehensive School Physical Activity Programs, published in association with SHAPE America, accommodates the growing needs of academic researchers, school practitioners, district coordinators, educators, advocates, organizations, university faculty, and students who want to learn more about CSPAP or undertake ways to increase daily physical activity opportunities in and around schools.
The Text’s Strengths
This text does all of the following and more: Synthesizes all the foundational and emerging research, theory, and practice on CSPAP
- Synthesizes all the foundational and emerging research, theory, and practice on CSPAP
- Provides a higher- and deeper-level look at the CSPAP model, as opposed to short reports and position papers, which contain limited strategies for schools
- Offers much more in-depth coverage of the CSPAP model by delving into assessment, evaluation, advocacy, policy, partnerships, international perspectives, technology, and more
Comprehensive School Physical Activity Programs was written by a diverse team of pioneers and leaders in the CSPAP field. This team brings national and international perspectives on all aspects related to implementing and maintaining CSPAP in K-12 schools. These recognized experts provide incisive guidance in, and understanding of, the most prominent concepts, issues, and developments in the field.
Book Organization
The text is organized into six sections:
- Part I provides the historical and foundational perspectives and policy landscapes of the CSPAP approach.
- Part II outlines internal, external, and psychological factors to consider in program design, implementation, and sustainability.
- In part III, the contributors examine and interpret the research on the effectiveness of established programs and previous interventions.
- Part IV highlights special considerations for effective programming within urban and rural settings, reviews current and ongoing international CSPAP initiatives, and addresses the application of the model to alternative contexts beyond the K-12 school setting.
- In part V, the contributors focus on using assessments to determine the physical activity promotion needs of a school community, on the instruments and procedures for measuring school-wide programming, and on the processes for evaluating and advocating for CSPAPs.
- Part VI examines current reform efforts within preprofessional programs in teacher education, reviews the tools and future potential for using technology to deliver and assess CSPAP efforts, and looks at future directions for the disciplines of study that inform the CSPAP knowledge base.
An Invaluable Resource
The rapid growth of the field and the increasing number of diverse and exceptional scholars (many of whom are contributors to this book) are indications of the need for this resource. Comprehensive School Physical Activity Programs offers unique perspectives about how to generate and sustain successful initiatives to increase youth physical activity and promote long-term engagement in active behavior. It provides access to leading thought, invaluable tools, and challenging questions that will propel the CSPAP field to its next level of depth and clarity.
Human Kinetics is proud to publish this book in association with SHAPE America, the national organization that defines excellence for school-based health and physical education professionals across the United States.
Chapter 1. CSPAPs: History, Foundations, Possibilities, and Barriers
Hans van der Mars and Kent A. Lorenz
Emergence of CSPAPs
History and Emergence of CSPAPs
CSPAP’s Roots Within Public Health and National Physical Activity Recommendations
CSPAP’s Theoretical Roots
Why CSPAPs: A Critical (and Final?) Opportunity to Thrive
Possibilities of CSPAPs
Barriers to Overcome
Learning Aids
Chapter 2. Emerging Policy Landscape Surrounding CSPAPs
Justin B. Moore, Abigail Gamble, David Gardner, Alexandra Peluso, and Danny Perry
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Part II. Conceptual Models for CSPAP Implementation
Chapter 3. Internal Capacity Building: The Role of the CSPAP Champion and Other School Professionals
Russell L. Carson, Catherine P. Abel-Berei, Laura Russ, Jessica Shawley, Tanya Peal, and Cyrus Weinberger
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Chapter 4. Capitalizing on Internal–External Partnerships to Maximize Program Sustainability
Collin A. Webster, Cate A. Egan, and Kevin Brabham
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 5. Social Psychological and Motivational Theoretical Frameworks for CSPAP Intervention
Megan Babkes Stellino, Spyridoula Vazou, Lyndsie M. Koon, and Katie Hodgin
Review of Theoretical Frameworks for CSPAP Research and Intervention
Description of Theoretically Guided Efforts Across CSPAP Components
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Part III. Research on Program Effectiveness
Chapter 6. Quality Physical Education
Kim C. Graber, Chad M. Killian, and Amelia Mays Woods
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 7. Physical Activity During School
Aaron Beighle, Heather Erwin, Collin A. Webster, and Michelle A. Webster
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Chapter 8. Physical Activity Programs Before and After School
Brian Dauenhauer, Megan Babkes Stellino, Collin A. Webster, and Chuck Steinfurth
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Chapter 9. Staff Involvement
Collin A. Webster, R. Glenn Weaver, Martha Carman, Lee Marcheschi, Athanasios (Tom) Loulousis, Spyridoula Vazou, Tan Leng Goh, and Russell L. Carson
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Chapter 10. Family and Community Engagement
Gregory J. Welk and Joey A. Lee
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 11. Multicomponent Optimization Strategy and CSPAP Implementation
Ashley Phelps, Yeonhak Jung, and Darla M. Castelli
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidenced-Based Recommendations and Applications
Learning Aids
Case Examples
Part IV. Contextual Considerations
Chapter 12. CSPAPs in Urban Contexts
Sarah Doolittle, Paul Rukavina, and Kevin Mercier
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 13. CSPAPs in Rural Settings
Pamela Hodges Kulinna, Michalis Stylianou, Kent A. Lorenz, Shannon C. Mulhearn, Tom Taylor, Shawn Orme, and Alan Everett
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 14. International Perspectives and Initiatives
Jaimie M. McMullen, Déirdre Ní Chróinín, Michalis Stylianou, and Tuija Tammelin
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Chapter 15. Implementation of CSPAPs in Nontraditional Settings
Timothy A. Brusseau and James C. Hannon
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Part V. Developing, Measuring, and Promoting CSPAPs
Chapter 16. Conducting a Systematic Needs Assessment for CSPAP Success
Eloise Elliot, Sean Bulger, Emily Jones, and Alfgeir Kristjansson
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 17. Assessing School Physical Education and Physical Activity Programs: Selected Tools
Thomas L. McKenzie
Systematic Observation Tools
Self-Report Tools
A Summary Score and an Advocacy Tool
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Chapter 18. Evaluating CSPAPs: Measuring Implementation and Impact
Erin E. Centeio and Nate McCaughtry
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 19. Advocating for CSPAPs
Heather E. Erwin and Erin E. Centeio
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Examples
Part VI. Looking to the Future
Chapter 20. Preparing Preservice Physical Education Teacher Educators for CSPAP Implementation
Grace Goc Karp, Helen Brown, Ja Youn Kwon, and Pamela Hodges Kulinna
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidenced-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 21. Progress and Possibilities for Technology Integration in CSPAPs
Zan Gao, Zachary Pope, Nan Zeng, Daniel McDonough, and Jung Eun Lee
Review of Research
Knowledge Claims
Knowledge Gaps and Directions for Future Research
Evidence-Based Recommendations and Applications
Learning Aids
Case Example
Chapter 22. A Synergized Strategy Guide for Advancing the Field
Russell L. Carson and Collin A. Webster
How Does the Policy Landscape Reflect the Evolving Values and Traditions of the CSPAP Model?
What Conceptual and Theoretical Approaches Could Guide CSPAP Practice and Collaboration?
How Does Context Factor Into Best Practices for CSPAPs?
What Are Some Promising Strategies for Planning, Evaluating, and Promoting CSPAPs?
What Are the Potential Contributions of Preservice Education and Technology Integration in CSPAP Research and Practice?
Advancement Strategies
Summary
Russ Carson, PhD, has 20 years of academic experience, as a secondary physical education and health teacher, teacher educator, accomplished scholar, professor, and founding director of the University of Northern Colorado Active Schools Institute. He is a long-standing leader of the comprehensive school physical activity program (CSPAP) model and its corresponding training programs. He earned his doctorate in health and kinesiology from Purdue University.
Collin Webster, PhD, earned his doctorate in physical education and sport studies from the University of Georgia in 2006 and has held academic appointments at the University of South Carolina and the University of Wollongong in Australia. He is a nationally and internationally recognized scholar in the area of youth physical activity promotion, particularly comprehensive school physical activity programs.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
Evaluating CSPAPs
The following sections will review literature pertaining to school-based interventions.
Review of Research
The following sections will review literature pertaining to school-based interventions. The first section will examine key school-based interventions that preceded the term “CSPAP,” and the second section will specify evaluation studies performed on CSPAP interventions.
Pre-CSPAP Evaluation Studies
When thinking of seminal work regarding multicomponent school PA interventions, the Sports, Play, and Active Recreation for Kids (SPARK) project (Sallis et al., 1997) is at the top of the list. SPARK was a PA intervention designed to increase PA of elementary aged youth both in physical education class and at home. The intervention was based primarily in physical education. However, a self-management program that focused on increasing PA outside of school included newsletters and homework for youth and families. Results showed a significant increase in PA for those youth who participated in the SPARK intervention, with youth who were taught by a certified physical education teacher experiencing the most gains. Girls also experienced significant gains in abdominal strength and cardiovascular endurance.
The Coordinated Approach to Child Health (CATCH) program has shown numerous benefits to youth over the past decade with early results focusing on significant changes in cardiovascular risk factors (Luepker et al., 1996). A total of 56 intervention schools (40 control schools; N = 5,106) participated in the CATCH program, which included food service modifications, enhanced physical education, and classroom health curricula, and half received additional family education components. The randomized controlled trial that took place across four states showed increases in moderate-to-vigorous PA (MVPA) and a decrease in fat content served at lunch (Luepker et al., 1996). A follow-up to the original CATCH study showed behavioral changes were still present after a three-year period following the intervention (Nader et al., 1999).
In 2003, Caballero and colleagues examined a three-year healthy eating and PA intervention among American Indian youth. The purpose of their study was to examine a multicomponent intervention that included both nutrition and PA components. The PA components included classroom PA breaks; increased energy expenditure during physical education; guided play during recess; and family and community engagement in the form of family fun nights, workshops, and family packs linked to the classroom curriculum. A total of 1,704 youth across 41 schools participated in the study. A decrease in total fat intake but not a reduction in body mass index (BMI) were found.
The Lifestyle Education for Activity Program (LEAP) was designed to increase the PA levels of high school girls through a comprehensive school-based intervention (Pate et al., 2005). The LEAP program was designed after the CATCH program and focused on physical education, health education, school environment, school health services, faculty and staff health promotion, and family and community involvement. This program was unique because it targeted high school girls and increasing behaviors and attitudes toward PA. After one year of intervention, girls in the intervention schools significantly increased vigorous PA compared to those in comparison schools. It is important to note that this program was based on self-reported, three-day PA recall and PA was not objectively measured.
Lubans and colleagues (2011) designed a comprehensive intervention for adolescent boys, which took place in secondary schools in Australia. The primary outcome of the intervention was decreased BMI; secondary outcomes included decreased percent body fat and waist circumference and increased muscular fitness and PA. The duration of the program was six months; the program consisted of school sport sessions, interactive seminars, lunchtime activities, PA and nutrition handbooks, leadership sessions, and pedometers for self-monitoring. Significant reductions were found for BMI and percent body fat, but no change was found for waist circumference, muscular fitness, and PA.
Also, in 2011, Puder and colleagues worked with preschool children to determine if a multicomponent preschool intervention that was culturally relevant for migrant children would decrease BMI and body fat while increasing aerobic fitness. The intervention consisted of structured PA lessons during the week, nutrition lessons, family communication about PA, sleep and screen time, and built environment changes within the preschool classroom. Although BMI did not significantly decrease, there were positive effects on aerobic fitness, waist circumference, percent body fat, PA, media use, and eating habits.
Finally, the Healthy, Energetic, Ready, Outstanding, Enthusiastic, Schools (HEROES) program (Seo et al., 2013) included 1,091 students who participated in a comprehensive intervention with a goal to increase PA of students. Schools made changes in their environment based on individual situations, but all intervention activities were led by a school wellness coordinator. Students significantly increased vigorous PA over the 18-month period but did not significantly improve moderate PA. School-level implementation, however, was a significant predictor of vigorous PA, and small school size predicted moderate PA.
CSPAP Evaluation Studies
Given that the term CSPAP is new, there are fewer studies that identify themselves as evaluating a CSPAP, although some would argue that many studies mentioned previously would qualify as CSPAP interventions. Literature detailing specific CSPAP interventions most often refers to outcomes in metrics, such as increased PA and aerobic capacity, decreased sedentary time, and the prevalence of obesity. Some literature apply more of a whole-of-school approach, which also include nutrition, to study more distal outcomes, such as classroom behavior and academic achievement.
In 2014, the Journal of Teaching in Physical Education released a monograph that included the first set of published research articles that were identified as CSPAPs. In this issue, Centeio and colleagues (2014) described a CSPAP that was implemented with urban students that affected PA levels of both students and parents. Specifically, an intervention that included quality physical education, classroom PA, and after-school PA clubs was implemented across one school year. The primary outcome measure was PA, which was objectively measured with students and subjectively measured with adults. After eight months, Centeio and colleagues (2014) reported that students had increased their MVPA by 4.5 minutes a day, and parents also reported an increase of PA.
Also in 2014, Carson, Castelli, and colleagues trained teachers to become PA leaders. Teachers were then expected to implement CSPAPs in their respective districts in the upcoming school year. Carson, Castelli, and colleagues measured the number of PA opportunities offered by teachers as well as students' PA levels and sedentary behavior using a wearable device. They found that teachers implemented significantly more opportunities for students to be physically active but the effect on students' actual behaviors over eight months was small. All students decreased their time spent in MVPA and increased time spent in sedentary behaviors, with students of trained teachers recording slightly better levels at postintervention (e.g., spent more time in MVPA and less time being sedentary than comparison students).
Step counts were targeted for a CSPAP intervention that was conducted by Burns and colleagues (2015), which focused on quality physical education and having students spend 50 percent or more of physical education classes in MVPA. Additionally, schools promoted active recess and integrated classroom PA breaks. Results showed that intervention students increased their steps from pre- to postintervention by approximately 1,126 steps per day (Burns et al., 2015).
In a related CSPAP study conducted by similar authors with at-risk elementary aged youth (N = 1,460), Brusseau et al. (2016) reported that the three-month CSPAP intervention significantly increased students' steps (an increase of ~603 steps per day) and time spent in MVPA (~5 minutes per day) as well as health-related fitness measures (Progressive Aerobic Cardiovascular Endurance Run [PACER] laps, push-ups, and curl-ups; Brusseau et al., 2016). A significant decrease in BMI (small effect size) was also found at the end of 12 weeks. This intervention consisted of three CSPAP components: quality physical education, PA during the school day (classroom and recess), and PA before and after school. These results are consistent with the results found by Centeio and colleagues (2014), who reported an increase of MVPA of approximately 4.5 minutes a day.
In 2016, Burns and colleagues (2016) examined change in elementary children's (N = 1,460) classroom behavior while a CSPAP was being implemented. Although there was no control group, they saw a significant increase in on-task behavior after CSPAP implementation in 70 classrooms over 6- and 12-week periods.
In 2017, Centeio and colleagues reported the impact of an eight-month CSPAP program on youth rate of improvement in reading and math achievement. They found that levels of PA (measured in steps) had a direct impact on youth rate of improvement in math and the level of school implementation of the CSPAP had a direct impact on rate of improvement in reading (Centeio, Somers, et al., 2018). Although there was no control group, this study is one of a few studies that examined a full CSPAP in relation to academic achievement of youth.
Also in 2017, Burns and colleagues used cardiometabolic health markers as an outcome measure of a nine-month CSPAP performed in five low-income schools. In this study, the schools hired a physical activity leader to assist in implementing PA experiences throughout the school day. The physical activity leader was responsible for helping the physical education teacher implement quality curriculum, provide semistructured recess for students, instruct classroom teachers on how to implement activity breaks, and provide opportunities for drop-in PA events. Improvements were made amongthird- through sixth-graders in high-density lipoprotein cholesterol, triglycerides, and mean arterial pressure, and sixth-graders also showed improvements in low-density lipoprotein cholesterol (Burns et al., 2017). Although this study did not employ a control group, it is the first of its kind to measure the effects of a CSPAP on the cardiometabolic health markers of youth.
Centeio, McCaughtry, and colleagues (2018) found that the Building Healthy Communities (BHC) program led to a decrease in obesity and central adiposity offifth-grade students. The program was a whole-of-school approach (including a CSPAP) that targeted both PA and healthy eating, with a central focus on PA. The program consisted of six components: quality physical education, principal engagement, classroom education and activity, active recess, student leadership teams, and an after-school PA club. The program was evaluated using a quasi-experimental design with four treatment and two comparison schools. Students in the treatment schools significantly decreased their central adiposity (measured by waist-to-height ratio) and BMI compared to students in the comparison schools, who slightly increased their central adiposity (Centeio, McCaughtry, et al., 2018).
The previously discussed examples measure CSPAPs with different outcome measures. However, the most common measure used has been the PA behavior of students. Few articles examine the impact outside of student outcomes. The study conducted by Centeio and colleagues (2014) assessed the impact of CSPAPs on teachers' and parents' PA levels, and Pulling Kuhn and colleagues (2015) found that the work engagement of CSPAP-trained teachers significantly increased when compared to a control group.
Knowledge Claims
Given the information previously provided, following are the knowledge claims that we know about CSPAPs.
- Many multicomponent school intervention programs have been successful at increasing PA behaviors of youth, irrespective of gender. Most programs measure physical activity or MVPA, but some of them have shown success in decreasing BMI.
- Most outcome measures of the evaluations conducted focus on youth PA levels and overweight and obesity. Although not a focus of this chapter, many of the successful interventions also include nutrition programming in addition to the PA programming.
- Few studies saw a decrease in BMI or obesity-related measures.
- Among the few studies that have examined the extended impact of multicomponent school programming in adults (parents and teachers), the effects are promising.
- Common components include classroom PA breaks and quality physical education as the two components mostly present in the current CSPAP interventions.
Knowledge Gaps and Directions for Future Research
Understanding where the field has been and where it should be headed regarding the evaluation of CSPAPs is important. After reviewing the evaluation literature in relation to CSPAPs, the authors have outlined where they believe knowledge gaps exist and some suggestions for future research. To begin, little if any CSPAP research has been conducted with randomized controlled groups or using a randomized controlled trial (Centeio, McCaughtry, et al., 2018). Future research should include randomized controlled groups in order to fully understand the impact of such interventions. Additionally, little research has examined the effect that CSPAPs have on the collective school environment (e.g., policies) and longitudinally how these cultural shifts might affect youth health and behaviors post-CSPAP intervention. Furthermore, few CSPAP studies have focused on outcome measures beyond physical health indicators (e.g., academic achievement and on-task behavior). Understanding the collective effects of CSPAPs on academic achievement could be one way to advocate for CSPAPs among principals and school personnel who value academic classroom time.
In addition to the previous suggestions, among the literature that was reviewed, most programs are designed for elementary aged students, and few of the interventions previously mentioned are specifically designed for preschool or secondary education settings. Although there have been successful interventions at the elementary level, future research should be conducted to better examine preschool- and secondary level interventions to evaluate the effectiveness of these programs. In addition, few if any publications discuss process evaluation of CSPAP programming. Carson, Pulling, and colleagues (2014) presented a mixed-methods evaluation of the delivery of national CSPAP trainings, but published manuscripts have yet to examine the process that it takes to implement the resultant comprehensive programs. Additionally, there is no known literature that discusses the cost effectiveness of implementing CSPAPs into the school setting and the amount of money they are saving long term. Finally, to date, there is no longitudinal data about the impact that participation in CSPAPs during youth has on adult PA and beyond the K-12 environment. Given the amount of time and money that it takes to implement CSPAPs into the school setting, understanding beyond the short-term effects is important because it influences the health benefits tracking into adulthood.
Internal Capacity Building: The Role of the CSPAP Champion
A conceptual framework for CSPAP research and practice based on a social-ecological perspective.
Figure 3.1 A conceptual framework for CSPAP research and practice based on a social-ecological perspective. Dotted lines represent the bidirectional influences of levels. Facilitator-level resources related to personnel, finances, politics, time, space, access, built environment, and transportation support and safety relate to physical, social, and emotional well-being.
Reprinted with permission from R.L. Carson et al., “School-Based Physical Activity Promotion: A Conceptual Framework for Research and Practice,” Childhood Obesity 10, no. 2 (2014): 100-106.
In this chapter, we review the research and offer existing knowledge claims from the growing evidence for each unit of CSPAP leadership—PA champion, supportive administrator, and CSPAP committee; identify knowledge gaps and provide directions for future research around building internal capacity for CSPAPs; propose evidence-based recommendations and practical applications for building and supporting a synergetic CSPAP leadership triad; and conclude with three nationally recognized case examples of the triad operating in unison to create a thriving CSPAP community where reaching the recommended amounts of daily PA is the norm and students and staff are still learning and smiling.
Review of Research
Research for each unit of the CSPAP leadership triad is reviewed in order, organized within each unit by the central tenets produced from the scholarship to date.
PA Champion
A PA champion is the school-level leader, coordinator, or director of CSPAP initiatives (Carson, 2012). The presence of quality leadership has been identified as the foundation for CSPAP success (Doolittle & Rukavina, 2014; Jones et al., 2014; Kulinna et al., 2012). This section gives an overview of what is currently known about a PA champion based on the available literature.
What a Champion Does
The leadership responsibilities of a PA champion typically include setting school-wide PA goals and priorities, identifying and sharing PA resources, ensuring and maintaining clean and safe PA environments, and coordinating community-engaged health and wellness activities (Carson, 2012; CDC, 2013). In addition, the PA champion must be a transformational leader who strives to influence and enhance major changes within a school setting toward a shared vision (Illg, 2014).
Who Are the Champions?
Because teachers are familiar with the unique school environment, policies, procedures, staff, and students, they are ideal candidates to lead during school daily PA opportunities (Kulinna et al., 2012). The most appropriate teacher with the PA expertise, extensive wellness and PA engagement knowledge, professional training (i.e., physical education teacher education [PETE] programs), and understanding of developmentally appropriate PA opportunities is the physical education teacher (Carson, 2012; Castelli & Beighle, 2007). A physical educator helps children achieve the recommended 60 minutes of daily PA so that children live a healthy, active lifestyle (CDC, 2013), yet this daily recommendation cannot be attained in quality physical education classes alone (SHAPE America, 2016). The CSPAP model provides a guide for the school-wide PA opportunities in addition to quality physical education (CDC, 2017). According to current physical educators, they coordinate and implement CSPAPs because (1) they feel more time for PA is needed to achieve recommended amounts of daily PA and to provide opportunities for students to learn and practice skills related to personal and social responsibility; (2) they have personal reasons (i.e., enjoyment and feelings of doing good for children); (3) they believe it is part of their job description; and (4) they want to promote a positive image of physical education and the physical education teacher (Berei, 2015; Carson, Pulling, et al., 2014; Centeio, Erwin, et al., 2014). In addition, stakeholders in school environments, such as principals and classroom teachers, view the physical educator as the essential change agent for CSPAP implementation (Deslatte & Carson, 2014; Doolittle & Rukavina, 2014).
While the physical educator may be well suited to be a PA champion, it may not always be realistic for a physical educator to fill this role. In these situations, leadership can come from school administrators, classroom teachers, school staff, or any capable and willing parent or community member (Berei, 2015; Jones et al., 2014). Ideally, any potential PA champion participates on a school-level CSPAP committee or team to facilitate CSPAP change (Carson, Castelli, Beighle, et al., 2014). Kulinna and colleagues (2012) found that classroom teachers are willing and able to be part of school-based PA programming but they need assistance from a knowledgeable and skilled leader to provide training and encouragement. In many cases, classroom teacher training programs do not address how to establish healthy and active school environments; therefore, it may be necessary to educate faculty and staff on how to teach and practice healthy behaviors (Beighle et al., 2009; Castelli et al., 2017).
What a Champion Needs
First and foremost, the PA champion must have adequate CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014), including a deep understanding of how the five CSPAP components interact within the organizational structures of a community and school setting (Centeio, Erwin, et al., 2014; Illg, 2014). The CSPAP champion must be willing and able to go beyond his or her traditional role as the physical educator and provide PA opportunities outside of physical education classes in innovative and creative ways (Carson, 2012; Doolittle & Rukavina, 2014). An effective CSPAP cannot be implemented by the PA champion alone; therefore, effective leadership and advocacy skills are necessary (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014; McMullen et al., 2014). One strategy to ensure PA champions have the knowledge and skills they need to effectively fulfill their role is through CSPAP professional development.
Knowledge for Successful PA Champions
- Adequate foundational CSPAP content knowledge (Carson, 2012; Illg, 2014; McMullen et al., 2014)
- Theoretical orientations to leadership systems and organizational structures (Illg, 2014):
- Understand the structure of a school and community system
- Understand factors that affect decision making in school settings
- Thinking beyond the role of the traditional physical educator in innovative ways (Carson, 2012; Doolittle & Rukavina, 2014)
Skills for Successful PA Champions
- Implementing an extensive CSPAP needs assessment (Illg, 2014; Jones et al., 2014)
- Organization, management, and leadership skills:
- Develop and plan short- and long-term CSPAP objectives
- Demonstrate strong communication skills
- Find and organize resources
- Prepare, recruit, educate, and train others to lead and provide PA opportunities
- Utilize effective strategies to implement and promote PA beyond the physical education classroom, such as during the school day (work with classroom teachers and increase PA at recess) and before and after school
- Strategic policy development
- Understand when and how to delegate responsibilities (Doolittle & Rukavina, 2014; Illg, 2014; Jones et al., 2014)
- Advocacy skills:
- Find support and collaborate and network with colleagues, administrators, and other community partners and stakeholders
- Build community and share visions
- Effectively market programs
- How to relate to and with and motivate others (Centeio, Erwin, et al., 2014; Doolittle & Rukavina, 2014; Illg, 2014; McMullen et al., 2014)
Case Examples of Strategies to Implement PA
This chapter includes three case examples that highlight strategies to implement PA in schools.
This chapter includes three case examples that highlight strategies to implement PA in schools.
Recess: Tabor Valley School
My name is Faith Jackson, and I serve as the headmaster of Tabor Valley School in England. We implement what I believe to be an effective strategy for managing equipment that not only teaches student responsibility but also decreases equipment cost. At the beginning of the year, we require students to pay a small fee to receive their equipment token for recess periods. Our parent organization and school budget supplement for students who cannot pay the fee. Money from the token fees is used to purchase playground equipment. We store the playground equipment in a small shed located on the playground. Each week, a specific class is assigned to manage the equipment shed. This means students from that class are assigned shifts to work in the shed. During recess, all equipment must be checked out of the shed using the token system. For instance, if Louis wants a jump rope, he gives his token, with his name on it, to the shed worker, who in turn gives him the jump rope. When Louis is finished, he returns the rope and gets his token back. At the end of recess, any missing equipment can be accounted for with the tokens.
Recess: Maize Field Elementary School
My name is Hope Martinez, and I serve as the physical education teacher at Maize Field Elementary School, which is located in eastern Nebraska. The school was involved in a study, after which we decided to take the recess intervention to the next level. We have added the RAW component that was discussed in this chapter. I incorporate an activity within my physical education lesson each week, and then, I am sure to include any and all equipment required with the recess equipment pack so students can engage in that activity during recess. I also more frequently add activities via short lunchtime videos so students will be reminded of the activities available to them. To enhance PA despite difficult climates, in the winter months, students voluntarily bring in shovels to clear snow from the blacktop areas during recess. We allow students to bring small sleds to slide down a hill at recess as well. If proper attire is not available for students who want to participate, our school works with local community organizations to find resources to get the appropriate clothing. We usually have no issues with finding organizations or businesses to donate.
Classroom MI
Michelle A. Webster
Rosewood Elementary School
I am in my 18th year as an elementary classroom teacher and, in 2015, was Teacher of the Year at my previous school. For most of my teaching years, I have taught second grade. This year is my first time teaching third grade. When I first started teaching, I was reluctant to have my students leave their desks because I felt I would lose control of my classroom if I allowed children to move too much. But over the years, my attitude toward classroom movement opportunities has changed. Now, I understand how critical PA is to classroom management and students' academic performance. In fact, I often assign special leadership roles that involve more movement to students who tend to stray off task the most. I have these students pass out materials to the rest of the class.
While MI helps with classroom management, classroom management also helps with MI. I establish a strong management system at the beginning of each year. My students know my expectations, which include how to behave during movement opportunities. Even though some years I have had students with physical disabilities in my classroom, I have never found it impossible to provide movement opportunities for all of my children. One year, I had a student with brittle bone disease who was in a wheelchair. He was still able to participate in PA while in my classroom because I made sure the other students understood that they needed to give him his own space and avoid touching him. My students love it when they get to be active during class, and I am able to incentivize good classroom behavior using PA as a reward.
One of my goals as a teacher is to make sure my students never sit too long; I estimate that my students spend about half of their time in my classroom out of their desks. I use a wide range of strategies to incorporate PA into my classroom routines. A lot of movement time is transition time from one lesson or activity to the next. I try to transition my students every 10 minutes or so. I'll tell them to free dance to the carpet or back to their seats, and they love coming up with their own movements. My classroom setup promotes more movement during transitions because I arrange the desks in pods (groups of four or five desks), which affords more space than putting the desks in rows. I also store materials in different places around the classroom. Students must travel around the room to get the things they need during the day.
Another way I get my students moving is by integrating PA into academic lessons. I like to use songs with accompanying movements in science and social studies. For example, we sing songs about the water cycle (condensation, precipitation, and evaporation) and move our bodies to illustrate these concepts. In English language arts, my students perform reader's theater, in which they act out a story while practicing fluency. During math class, I like using task cards with math problems (e.g., multiplication and division) to review units. I tape the cards on the walls around the room, and each student and a partner walk to the different cards to solve the problems. I place the cards at different levels on the walls so students have to bend or stretch to read the problems.
My students usually show signs of losing focus in the afternoon after lunch and recess. They either fidget or slump more and need movement to keep them going during the last two hours of the school day. So we do lots of different kinds of movement breaks. We use video-based breaks from GoNoodle, and I find lots of helpful resources on websites, such as Teachers Pay Teachers. Much of the time, however, I find that my students prefer to create their own movements as opposed to following along with someone else's. My experience has taught me that students want autonomy as learners and enjoy learning more when they can choose how to move. They also like being able to decide when to stand and work instead of sitting at their desks. Many teachers desire autonomy too. I have a better time at school when I am free to teach the way I want to. In spite of all the free resources and prepackaged ideas out there for MI, my most successful strategies to help children stay active during school have been those I came up with myself.
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