A qualitative evaluation of remote training to develop a fitness surveillance system

Abstract

Objectives:

In the USA, 18% of school-aged young people are classified as obese, and rural populations appear to be particularly at risk. Achieving high levels of fitness reduces the risk of obesity and underlying health conditions. To better understand youth obesity trends and fitness levels, annual fitness testing ([FT], that is, surveillance) in schools has been recommended. Although many K-12 schools conduct FT, surveillance programmes that compile unified standardised test results are rare.

Design:

Qualitative design.

Setting:

Physical education teachers from 11 schools (n = 13; n = 4 men) participated in remote training about conducting FitnessGram FT.

Methods:

Data included two semi-structured interviews per teacher on experiences with distance fitness training, implementing FitnessGram, and data entry for annual surveillance.

Results:

Inductive analysis using axial and open coding identified four themes: (1) barriers prior to study, (2) study training, (3) implementation challenges and suggestions and (4) teacher feedback. Teachers had an interest in FT but lacked the recommended training and equipment needed to implement it annually.

Conclusion:

Teachers believed the training they received (as part of this study) prepared them to collect reliable and valid data, and that FT had benefits for their students and programmes. Every teacher expressed interest in reporting annual surveillance data. Efforts to train teachers for FT through virtual professional development may be a viable means of establishing a unified surveillance system.

In the USA, 14.4 million (19%) school-aged young people are obese (Centers for Disease Control and Prevention [CDC], 2022), and worldwide just over 18% of young people are overweight (World Health Organization [WHO], 2021). Being overweight or obese is linked to more deaths worldwide than being underweight (WHO, 2021). To combat obesity, researchers have thoroughly investigated the positive role of regular exercise on lowering the risk of obesity and increasing the health status of youth (CDC, 2022; Mandsager et al., 2018). Physical fitness is generally defined as the ability to function effectively when performing daily activities and leisure time activities without undue fatigue (CDC, 2022; Corbin and Le Masurier, 2014). Although exercise and physical fitness levels are distinct, they are complementary to each other as they both influence a person’s overall health status (Morrow et al., 2013). Young people who engage in regular exercise have high levels of physical fitness and lower chances of being obese (CDC, 2022; Corbin and Le Masurier, 2014).

Rates of obesity vary across regions in the USA, and young people who live in rural areas have higher rates of being overweight or obese than their urban peers (National Institute of Health [NIH], 2019). To better understand obesity and fitness levels, and subsequently address health disparities, we must first understand the regions and populations where disparities exist (Cooper, 2010). It is of value to understand youth fitness levels so programmes and interventions for rural youth can be created to meet specific health-related needs (Plowman and Meredith, 2013). One way to evaluate the fitness levels of young people is fitness testing (FT) as part of a physical education programme (Silverman et al., 2008).

Although FT in physical education is not a familiar concept (Morrow and Ede, 2009), a review of literature demonstrates researchers who are critical of this approach (e.g. Alfrey and Gard, 2014; Cale et al., 2007; Rowland, 1995) and others who are supportive (Bianco et al., 2015; Cohen et al., 2015; Lang et al., 2018; Lloyd et al., 2010; O’Keeffe et al., 2021a) of FT in schools. FT has been used in the past to influence content, assessment and policy in physical education (Alfrey and Gard, 2014). For example, FT has shown that young people in the USA were less fit than their European peers (Kraus and Hirshland, 1954), which led to policy creation, test battery development (Presidential Youth Council on Fitness) and a shift from medical professionals collecting data to health and physical education teachers doing so (Alfrey and Gard, 2014). This shift provoked fears that FT in physical education can lead to a narrow view of health (Alfrey and Gard, 2014), poor experiences with testing for teachers and students, and a focus on fitness as opposed to other physical education outcomes (e.g. student learning outcomes; Alfrey and Gard, 2014; Cale et al., 2007; Rowland, 1995).

However, while many agree that FT is a valuable and important part of a comprehensive physical education programme, increased in-depth FT training about appropriate FT practices is needed (Alfrey and Gard, 2014; Cohen et al., 2015; Lang et al., 2018; Lloyd et al., 2010; O’Keeffe et al., 2021a). Supporters suggest that FT in schools represents an attempt to understand and monitor youth health status (Morrow and Ede, 2009; Morrow et al., 2013) and can be integrated into overarching physical education goals (Lloyd et al., 2010) and used to inform physical and health education planning (Lang et al., 2018; Silverman et al., 2008; Tremblay and Lloyd, 2010).

FT is considered beneficial for supporting and measuring the attainment of physical education standards (Society of Health and Physical Educators [SHAPE America], 2013; Tremblay and Lloyd, 2010). However, just over a quarter (26.6%) of US states require it to take place (SHAPE America, 2013), and few countries worldwide have committed to cardiorespiratory fitness surveillance (Lang et al., 2018). Health-related FT is recommended for estimating the health status of young people in schools (Institute of Medicine [IOM], 2012) and encompasses three areas: (1) aerobic capacity, (2) musculoskeletal fitness (i.e. muscular strength, muscular endurance and flexibility) and (3) bodily composition (e.g. IOM, 2012). A test battery commonly used in the USA for assessing comprehensive health-related fitness is FitnessGram (FG; Cooper Institute, 2017; Morrow and Ede, 2009).

FG is designed to estimate (1) cardiovascular endurance (Progressive Aerobic Cardiovascular Endurance Run [PACER]), (2) muscular strength (via a push-up test), (3) muscular endurance (using a curl-up test), (4) flexibility (using sit and reach) and (5) body composition (body mass index [BMI]). Data recorded from FG tests are meant to provide an overview of how healthy participants are within each component of fitness through criterion-based rubrics related to age, gender and performance ranges (Cooper Institute, 2017). To conduct accurate and reliable FG testing, training teachers on FT procedures and protocols is needed (Morrow and Ede, 2009).

Youth FT is often conducted by physical education teachers (referred to from here on as ‘teachers’) with limited knowledge of how to conduct the tests (Alfrey and Gard, 2019; Silverman et al., 2008). Teachers typically receive training for FT during teacher certification training (Hill and Thornburg, 2016) or through professional associations providing in-service training (Morrow and Ede, 2009). However, little is known about the type or degree of training teachers are receiving (Baghurst and Mwavita, 2014; Hill and Thornburg, 2016). In addition, the training teachers receive may not align with appropriate practices for conducting youth FT (Zhu et al., 2018). A recommended method for training in-service teachers for FT includes using remote learning (Marrow and Ede, 2009; Silverman et al., 2008).

In Idaho, where this study was conducted, 80% of schools implement some type of FT as part of their physical education programme (Berei et al., 2018), but there is no standardised testing or reporting system. To evaluate youth fitness levels in school physical education programmes, FG is endorsed by national associations (SHAPE America) to measure health-related fitness (Cooper Institute, 2017). Although FT training for teachers is recommended (Martin et al., 2010; Welk, 2008), little is known about the types of training received or the degree to which FT takes place in K–12 schools. Remote training is recommended when (1) a subset of teachers need specific training that is not part of the school district plan, (2) the expertise is not available to the school or district and (3) teachers need access to colleagues with similar interests who are not available at their home schools (Bates et al., 2016).

Remote training was an ideal choice for this study because Idaho is a predominantly rural US state in which many physical education teachers do not have access to content-specific professional development, there are sometimes only one or two physical education teachers in their district/schools, and generally professional development is geared towards classroom teachers or general teaching versus content-specific training. Thus, the purpose of this study was twofold. First, we aimed to train teachers remotely to conduct standardised FT. Second, we interviewed teachers about their experiences with distance training, and FG testing and data entry for annual surveillance.

This is the first manuscript from a larger project funded by the Mountain West Clinical and Translational Research Infrastructure Network, a part of the US National Institutes of Health Institutional Development Award Programme. The grant’s specific aims are to (1) train physical education teachers via remote training to conduct a standardised FT programme and establish a reporting system for a future surveillance programme; (2) gather process data (e.g. interviews, surveys) on teachers’ experiences with training, implementation and data entry that can be used to improve and streamline efforts for larger scale surveillance; and (3) determine an estimate of prevalence of overweight, obesity and low fitness among grade 3 (8–9 years old), grade 5 (10–11 years old), grade 7 (12–13 years old) and grade 9 (14–15 years old) youth. These data can later be used to create targeted interventions. The current study is focused on specific aims 1 and 2.

Methods

In this study, a FG training programme using remote learning was evaluated and teachers’ experiences with FT and implementation were explored. In addition, descriptive information about participating schools and teachers was collected.

Procedures

The research team received approval from the University of Idaho’s Institutional Review Board prior to beginning the study. Based upon previously conducted FT surveillance literature, we modelled the methods of a state-wide effort in Texas (Martin et al., 2010) that (1) trained teachers to implement FG; (2) examined and evaluated teachers’ ability to set up, score and administer the tests; and (3) recorded and reported youth FT results. FG was used to measure 3rd, 5th, 7th and 9–12th student’s five areas of fitness: (a) body composition (BMI), (b) cardiovascular endurance (PACER), (c) muscular strength (push-up), (d) muscular endurance (curl-up) and (e) flexibility (sit and reach).

Before conducting FG in schools, participating teachers completed a demographic survey (e.g. about school wellness policy, physical education requirements, etc.; phase 1), watched FG training videos on how to properly conduct each of the five FG tests (phase 2) and read FT protocols (phase 3). Teachers were also asked to complete a 44-question written exam related to conducting FG tests (phase 4) with a pass score of 80% or higher (both videos and exam created by researchers). Once teachers had passed their written exam, they took a practical exam (phase 5), the researchers conducted a pre-FG training interview (phase 6), the teachers implemented FG testing (phase 7) and the researchers scheduled a pre-FT implementation interview (phase 8). A password-protected shared drive was used to provide teachers with data entry sheets and resources for carrying out FG testing. After teachers completed FG testing, researchers conducted a post-implementation interview. See Table 1 for more detailed information about the training, phases of data collection and data collected.

Table 1.

Timeline, description of training and data collected.

Phase	Description	Data collected
Demographic survey	Information about teaching background and previous experiences with fitness testing, FitnessGram, Wellness policy, 18 questions. Sample questions included: How many years have you been teaching physical education? Identify the grades in which physical education is required in your school. Were physical education teachers involved in developing your school wellness policy?	Survey data collected via Qualtrics Software
Training videosa	Five videos, one for each test, developed by the research team (i.e. authors). Each video (range = 2–4 minutes) covered the purpose, objective, setup, measurement and common mistakes of each FitnessGram test. The videos were shared in a password-protected Google Drive Folder.
Fitness protocolsa	Teachers were provided written fitness testing protocols that covered the purpose, objective, setup, measurement and common mistakes of each FitnessGram test. In addition, the protocols included information on how to enter data and use data entry forms. The protocols were shared in a password-protected Google Drive Folder.
Written exam	After watching videos and reading protocols, teachers took an online 5-section, 44-question, multiple-choice and true–false test via Qualtrics. Teachers were required to score at least 80% on the exam and were given two attempts to pass prior to collecting data. If a teacher did not pass with 80% on the second attempt, researchers set up a Zoom training session for that teacher.	Test scores collected via Google Forms
Practical examination	A trained researcher scheduled a practical exam with each teacher on two different FitnessGram tests prior to the start of fitness testing. Practical exams were conducted via video-call. Specifically, teachers were randomly assigned two FitnessGram tests and demonstrated setup, scoring and identifying form breaks. The scores and form breaks were compared and discussed between the teacher and researcher.	Researchers made notes of inconsistencies on an Excel spreadsheet
Pre-implementation interview	Prior to collecting data and after completing training (phase 2–5), researchers scheduled a phone-interview with teachers. Teachers were asked about their prior experiences with fitness testing and training, and about their experiences with the current study’s FitnessGram Training (phase 2–5).	Audio recorded (n = 13, M = 12 minutes), sample questions included: Please describe any challenges or issues you experienced with the training; Do you have any recommendations for the training?
Implementation	Teachers conducted fitness testing in their schools, entered data on hard copy data sheets and were asked to input hard copy data onto electronic data entry sheets located in password-protected Google Drive Folder.
Post-implementation interview	After implementation and data entry, researchers scheduled a phone-interview with teachers. Teachers were asked about their experiences with data collection, entering data, suggestions and willingness to report data in the future.	Audio recorded (n = 13, M = 16 minutes), sample questions included: Describe any issues you experienced with implementation? How willing would you be moving forward to report your students’ fitness data annually to establish a state-wide surveillance of school-aged youth fitness?

^aTeachers were given the option to complete these two steps in any order, all other steps were completed in the order listed.

Each teacher was given FT equipment for their school and an iPad to ensure all schools had the equipment necessary to carryout FG testing. Each school received the same scale, stadiometer, curl-up measuring strips, and sit and reach box. Beyond the equipment each school received, researchers provided a list of options to each teacher for additional equipment to aid implementation (e.g. multi-colour cones). Additional resources were also provided to each teacher via a Google Drive folder that included electronic data entry spreadsheet, printable data entry forms, FG training information, FG audio files and additional resources.

Sample

A convenience sample of teachers, n = 13; n = 4 men, Mean (M) age = 47.7 years, from 11 schools were recruited. All participating teachers were non-Hispanic White and certified to teach physical education (n = 7 bachelor’s degree, n = 2 master’s degree, n = 4 master’s degree plus). The teachers had an average of 22.4 years of teaching experience (r = 5–34 years) and taught at multiple school levels (n = 1 elementary and middle, n = 4 elementary, n = 3 middle, n = 5 high). Northern Idaho is considered rural, but three of the participating schools were in areas with populations greater than 25,000, and eight of the schools were in areas with populations less than 1,500.

Analysis

Qualitative analysis.

Each interview transcript was transcribed verbatim (phases 6 and 8), and all teachers were assigned a pseudonym. Inductive analysis using axial and open coding (Corbin and Strauss, 2008) was used. The coding process was completed by two trained qualitative researchers who read and coded the data independently. Subsequently, both researchers met to compare codes, commonalities and consistencies, which eventually led to identifying major themes (Glesne, 2016). Trustworthiness of the data was maximised by means of researcher triangulation, data triangulation, member checking and the use of researcher journals (Yin, 2013).

Quantitative analysis.

Data from the Demographics Survey were analysed to characterise the teachers and schools that participated in the study. Descriptive statistics, including M minimum, maximum, range (r) and frequency, for each survey question were calculated using Qualtrics and SPSS (Version 24, IBM).

Results

Qualitative findings

Teachers (n = 14) discussed their experiences of FT and FG pre- and post-implementation. Based upon their responses, four major themes were developed from the data: (1) barriers prior to study, (2) study training, (3) implementation challenges and suggestions and (4) teacher feedback.

Barriers prior to study.

Teachers discussed (n = 14) their experiences being trained for and conducting FT, which revealed many barriers. Apart from one teacher, every participating teacher (n = 13) had experience of FT. However, the majority of teachers (n = 9) acknowledged they utilised a variety (e.g. FG, Presidential Fitness Challenge, performance tests) of FT batteries. Teri explained, ‘Well the reason we did both [Presidential Fitness Challenge and FG] is because with [the] middle-school we weren’t sure what standards to follow’ (Interview 1). In addition, many teachers (n = 9) reported that the type of FT testing they conducted were based on the equipment available. Many teachers reported they had little-to-no equipment, which influenced their FT implementation. Brynn elaborated, ‘I have limited resources [equipment], so I have students run the mile or do pushups and curl ups for time verses a cadence from the FG’ (Interview 1).

In addition to choosing tests based of equipment available, teachers (n = 9) went on to discuss how equipment influences testing or lack thereof. Rita stated,

Resources, we certainly didn’t have any of the equipment that we do now because of the grant. We had an old [jenky] scale that worked. We didn’t have any height measurement stadiometer or anything. We just had like a measuring tape essentially. And that was just here at the high school, nothing at the elementary school … we did have a sit and reach box, but it was like a homemade one that’s just wooden so there’s no slider on it or anything.

(Interview 1)

In addition, the teachers’ (n = 13) school districts do not recommend a specific FT battery or require data collection. Thus, teachers were provided with very little direction on FT. In contrast, one of the participating high schools completed the FG multiple times per semester and has a physical education department that made a commitment to track student progress. Their department attempted to advocate for the middle and elementary schools in their district do the same. Unfortunately, the high school teachers in the department were unsuccessful in gaining traction with the other schools (Doug and Helen, Interview 2).

Lack of adequate training was one reason for low implementation. Many teachers (n = 10) reported they only received FT training ‘in the dark days of college’ (Rhodes, Interview 1) or were ‘self-taught going through the Internet, reading manuals’ (Becca, Interview 1). One teacher reported their pre-service training in a teacher education programme was recent, and based upon the training they had received, they felt comfortable implementing FG (Phil, Interview 1). For many other teachers (n = 7), it had been 10 plus years since they received any formal fitness training. Many who had received previous FT training (n = 7) noted that testing protocols had changed or teachers had inadvertently started doing things incorrectly (Rita, Rhodes, Becca, Interview 1; Brynn, Helen, Alan, Interview 2).

In addition, teachers (n = 8) noted class size and lack of instructional time as a contributing barrier to implementing FT. Helen emphasised, ‘So when you have 40 kids … it’s that classroom management piece’ and Alan explained that ‘some grades I only get 30 minutes, so we really can only do one test’ (Interview 1). The FG allows student-peer encounters to allow for increased student involvement to help teachers gather data. However, some teachers reported that ‘… partners must watch closely. I see in younger grades there are times when I step in and make sure they are counting correctly’ (Alan, Interview 1). Although, for some tests (push-up, curl-up and PACER) students can measure a partner’s progress, which gives students FT responsibilities and therefore potentially reduces classroom management issues, classroom management during FT provides to be a reported barrier (Becca, Interview 2).

Study training.

Teachers (n = 13) overwhelmingly reported that the FG training provided to them was beneficial. Teachers reported that out of all the resources, the FG videos helped them the most (Rita, Rhodes, Brynn, Alan Helen, Interview 2). Furthermore, the videos refreshed teachers’ knowledge of specific protocol nuances for each fitness test. Brynn explained,

I have been doing this a long time and this [FG videos] brought up a couple of miscues [using incorrect protocols, test set-up, fitness level goals] that I have been doing that until I saw those videos, I wasn’t aware I made those mistakes.

(Interview 1)

Teachers also believed the FG exam ‘held them accountable for the information’ (Whitney, Interview 1) they learned in the training videos. In addition, many teachers (n = 7) reported that the videos could be a useful tool to share with students (Brynn, Becca, Rhodes, Rita, Interview 2).

Implementation challenges and suggestions.

This study was able to address one of the major challenges teachers reported prior to implementation: namely, lack of equipment. However, some previously reported barriers continued during implementation, specifically classroom management. Becca stated, ‘I struggled getting through testing for every student … they have spring fever right now and it’s hard to get them to listen’ (Interview 2). Furthermore, teachers (n = 6) reported that students struggled because they were used to doing FT one way, and the FG tests (from this study) changed their typical FT protocols. For example, several teachers (n = 5) conducted FT prior to the start of this study (e.g. autumn/winter) and used outdated testing protocols or a variety of FT (see Barrier’s theme). Thus, students had to be re-oriented to the FT and/or change how they were tested (Rita, Rhodes, Nancy, Whitney, Becca, Interview 2). While the testing procedures changed for students, teachers in this study were now conducting FG tests based on recommended ‘best practices’ established in the literature (Cooper Institute, 2017).

Another major implementation challenge concerned dealing with absent students and rescheduling missed fitness tests (Becca, Lillian, Helen, Interview 2). For example, many students missed FT days due to illness, injury and other factors. One of the challenges for teachers was rescheduling students who missed FT in these ways. For some tests (e.g. sit and reach), students could easily make up the test with the teacher while the rest of the students participated in other activities (Whitney Interview, 2). However, other tests used the audio system and a large amount of space (e.g. PACER), which made it a challenge to reschedule missed fitness tests and engage the rest of the students in other learning opportunities (Rita, Interview 2).

For most teachers, FG data were collected on hard copy data entry forms (i.e. paper/pencil; Whitey, Helen, Rhodes, Phil, Becca, Rita, Lillian, Interview 2). As part of the study, teachers were asked to enter their hard copy data into electronic spreadsheets, which proved to be very time-consuming (Rhodes, Phil, Becca, Rita, Lillian, Helen, Interview 2). Rhodes explained, ‘my planning period is when I drive to my other school and set up for their classes and after school I coach or have meetings’ (Interview, 2). Other teachers echoed these thoughts and stated that they did not have time to enter ‘a bunch of data’ (Rita, Interview 2) into spreadsheets. However, teachers were more than willing to submit their hard copy data sheets for the researcher to input into the electronic database.

Despite the barriers identified, teachers reported satisfaction and feelings of accomplishment. Helen stated, ‘overall it was a successful and positive experience. I liked getting retrained’ (Interview 2). Teachers (n = 6) also reported that they enjoyed seeing student growth from previous testing. Phil noted, ‘I think this round compared to my trial run in the fall, especially PACER and pushups, that we [students] actually improved across the board … which was encouraging’ (Interview 2). Furthermore, teachers (n = 7) reported that the students took the FT more seriously because of the research study. Whitney stated, ‘they actually wanted to get everything right which is really cool … it was fun to watch them actually want to do this right’ (Interview 2). It appeared that despite the barriers, teachers enjoyed completing FG with their students and overwhelmingly noted FG was beneficial.

One of the major goals moving forward is to set up state-wide FT surveillance system. When teachers were asked if they would be willing to report FG scores annually, they were very positive. Whitney stated, ‘I think collecting data is a good thing, especially in Idaho where we do not have any’ (Interview 2). Only one teacher was hesitant because they struggled with classroom management and collecting data from the younger grades, especially grade 3. As Becca suggested, ‘every couple of years I would be willing to collect data for specific tests, like BMI or PACER’ (Interview 2).

Teacher feedback.

The teachers were more than willing to make suggestions on how to improve the fitness surveillance system moving forward. One of the major suggestions was to include resources on classroom management as part of the training. Helen explained, ‘activity ideas or management ideas … or a progression for teachers, how to layer this throughout your semester’ (Interview 2). Teachers (n = 9) also suggested information be shared on how to manage FT related to achieving a grade (e.g. grade for testing completion, grade for improvement). One teacher discovered, ‘if kids are not worried about their grades, they do not try’ and explained their method for grading FT is on effort and growth (Doug, Interview 2). Helen further emphasised this point by suggesting information be provided on how to teach students the importance of FT. Specifically, the research team could provide informational notes on a fact sheet for the teachers to read prior to each FG test, ‘… just ideas or prompts or summary statements so that teachers can see the whole big picture the “why” of it all’ (Helen, Interview 2).

Quantitative findings

Every teacher reported that physical education was offered and required at each grade level of their respective schools. However, teachers reported allowing exemptions from physical education for one period or longer, with long-term physical or mental disability the most common reason (78%, n = 7), followed by cognitive disability (56%, n = 5), enrolment in other courses (i.e. mathematics or science; 33%, n = 3) and for religious reasons (33%, n = 3). In addition, teachers reported the number of students per class, and days per week and minutes per week physical education was offered (Table 2).

Table 2.

Physical education class data across all schools.

Grade level	Physical education class size (number of students per class)			Physical education instruction (days per week)			Physical education instruction (minutes per week)
	Mean (SD)	Min	Max	Mean (SD)	Min	Max	Mean (SD)	Min	Max
K–5th	19.0 (7.59)	8	27	2.06 (1.16)	1	4	61.14 (36.59)	30	120
6–8th	16.0 (7.47)	4	34	3.91 (1.16)	2	5	150.83 (89.1)	50	250
9–12th	16.0 (16.90)	6	42	4.25 (0.96)	3	5	248.80 (59.306)	200	350

SD: standard deviation; Min: minimum; max: maximum.

Teachers also reported their involvement with school wellness policies and perceived support of their physical education programme. Teachers expressed varying levels of involvement in developing school wellness policies, with only 22% being actively involved. In regard to school wellness policy, 38% percent of teachers reported their school was taking an active role in meeting the goals of the policy, and 33% indicated the school wellness policy was adequately assessed (33.3% neutral, 33.3% disagree). All teachers reported feeling supported by their principal, parents, peer teachers and students. Practical tests were conducted, and it appears that the FG training prepared the teachers to collect data while following protocols, without being too long or cumbersome, as only two minor issues with the practical tests were reported (setup and procedures).

Discussion

The purpose of this study was to train teachers using virtual professional development to conduct standardised FT and explore teachers’ experiences with FG training, implementation and data entry for annual surveillance.

As observed in previous FT literature (Cooper, 2010; Martin et al., 2010; Morrow et al., 2008; Welk, 2008), the majority of teachers who participated in our study indicated previous FT training they had received was either outdated, or they had received no training or could not remember the training received, and/or they were self-trained on how to conduct FT. FT in physical education has a storied history. This history includes a variety of FT recommendations across multiple decades (Morrow et al., 2009), political implications because of FT scores (e.g. physical education shifting its main focus to fitness and improving fitness scores; Alfrey and Gard, 2014), negative experiences for students (Alfrey and Gard, 2014) and the replacement of FT with more overarching physical education goals (Alfrey and Gard, 2014; Cale et al., 2007; Rowland, 1995).

Regarding specific training for administering FT, the type and/or degree of FT training received in a certification programme is largely determined by the time in which a teacher is enrolled (Morrow et al., 2009). For example, a teacher who completed a certificate in physical education during the 1970s will most likely conduct presidential FT or tests that are not relevant to health-related outcomes (Morrow et al., 2009). Without ongoing professional development, the type of instruction or content delivered may not be appropriate or negated due to socialisation factors (Richards and Gaudreault, 2016).

Teachers who lack adequate training demonstrate inappropriate testing practices (Alfrey and Gard, 2014; Cale et al., 2007; Zhu et al., 2018), which can impact the student experience of testing and data validity (Martin et al., 2010; Morrow et al., 2008). Without adequate and ongoing in-service training, teachers test as they were tested, which may be developmentally inappropriate or include inappropriate practices (Zhu et al., 2018). Furthermore, without proper training on how to teach and progress through FT and integrate FT into other physical education curricular goals, FT in physical education can result in negative experiences for students and teachers (Alfrey and Gard, 2014).

A novel finding of our research is that remote professional development conducted virtually for teachers is advantageous and a viable option for future FT training and surveillance endeavours. Previous research recommends remote training (Cooper, 2010; Martin et al., 2010), but to our knowledge, results from remote FT training have not been published. Based on the distance training our participants received, teachers were confident leading FT and believed they collected reliable and valid student fitness data. Remote professional development is well established in the literature as a viable option especially when in-person training is not offered and is cost-prohibitive (Bates et al., 2016) and remote training can be as effective (e.g. in meeting learning goals) as in-person training (Fishman et al., 2013). In this study, teachers reported wanting more specific training on classroom management, and the literature recommends integrating appropriate FT practices (Alfrey and Gard, 2014; Zhu et al., 2018). Effective and outcome-based professional development should align with school/district initiatives, be for an extended duration and employ active learning techniques (Garet et al., 2008). Thus, future research should examine the viability of remote FT training in tandem with professional development about FT practices and the integration of fitness content.

The teachers in this study noted time and classroom management as barriers to FT and suggested future professional development should address strategies to overcome these barriers. Elsewhere, Keating (2003) found that teachers were challenged with large class sizes and time-consuming tests. Unlike standardised tests conducted in schools for core academic content (i.e. mathematics, science), other school faculty typically do not help teachers with their standardised FT (Keating, 2003; Silverman et al., 2008). To overcome these barriers, timesaving and teacher assistance recommendations (e.g. parental support, teacher aid help) have been suggested (Keating, 2003; O’Keeffe et al., 2021a; Silverman et al., 2008). Furthermore, a multidisciplinary team (e.g. health professionals, school wellness team, university partners) is recommended for ensuring FT results are shared meaningfully with parents and students (Cohen et al., 2015). Finally, training should incorporate best practices including how to integrate FT into physical education, while still meeting other non-fitness-related student learning outcomes (Lloyd et al., 2010).

As it relates to the goals of our study, to establish consistency in the implementation and assessment of youth fitness in schools, some researchers suggest teachers frame fitness as a public health issue, and suggest community stakeholders (e.g. public health, health educators and parents) and multiagency teams have a responsibility to support FT and report accurate data (Cohen et al., 2015; Keating, 2003). Future research should consider exploring these issues. In addition, fitness and FT should be part of classroom goals in physical education, ‘… without a solid curriculum it is merely testing [fitness testing] and nothing more’ (Silverman et al., 2008: 149). FT and fitness-related knowledge should be visited regularly throughout the semester (Keating, 2003) and be reinforced with assessment to motivate student learning (Stewart et al., 2005). Conducting FT is time-consuming (Keating, 2003). However, when students are well-versed in the FT protocols, tests are completed with time efficiency, and data are more reliable (Cooper, 2010; Keating, 2003; O’Keeffe et al., 2021a; Silverman et al., 2008).

Training teachers to discuss the purpose behind testing with students and educate them on how to complete tests is aligned with best practices (Keating, 2003; Silverman et al., 2008; Zhu et al., 2018) and should be included as part of future training. Teachers in this study believed FT data could support school wellness policies and were willing to participate in future surveillance at the state-wide level as an important advocacy tool for their programme. However, teachers noted how recording data electronically could be problematic (e.g. time-consuming). FG includes web-based tracking (Plowman and Meredith, 2013) but requires purchasing the software system and renewing the licence annually, which can be cost-prohibitive for schools. O’Keeffe et al. (2021b) developed a software system for monitoring health in school settings. Teachers in their study reported that while they understood how to use the software, doing do was still time-consuming. Despite this challenge, teachers reported that they would continue to use the software if it became available. In the present study, teachers with previous experience using data collection software did not report electronic recording issues. Perhaps teachers unfamiliar with electronic data entry need more time and training to input data. Other suggestions for electronic data entry include having the ability to enter multiple students’ data at the same time and including student and teacher outputs against criterion referenced values (O’Keeffe et al., 2021b; Plowman and Meredith, 2013). Finally, as solutions to data entry systems are sought, attention should be paid to the cost as many schools in the current study have limited funding for their physical education programmes.

Recommendations

Our research has direct implications for the state of Idaho, but also appeal and relevance for paediatric and adolescent health researchers, public health officials, legislators and teachers across the USA. Our study showed that teachers were able to be effectively trained remotely to implement FG and report student fitness data for annual surveillance. To effectively train teachers for FT and report annual fitness data at a state-wide level, researchers recommend a myriad of factors be considered before initiating state-wide efforts. Specifically, training teachers remotely is a viable option, but instructional and management strategies should be included due to varying teacher experiences with conducting FT as well as the aforementioned best practices for FT (e.g. educating students about fitness process, integrating fitness into other physical education learning outcomes). In addition, we recommend that reporting software (i.e. FG software or WellNet) be available to all participating teachers. Finally, teachers need equipment, support and assistance from administrators, faculty, school wellness teams and community stakeholders to be successful and to maximise the efficiency and accuracy of FT.