Evaluation of Let’s Move! Active Schools Activation Grants

Abstract

Let’s Move! Active Schools (LMAS), now Active Schools, is a national initiative in the United States (US) that aims to engage schools to increase students’ opportunities to be physically active. This evaluation describes changes in school-level practices related to physical education (PE) and physical activity (PA) among schools that received an LMAS-partner grant from ChildObesity180 or Fuel Up to Play 60 (FUTP60). ChildObesity180 and FUTP60 asked grantee schools to complete nine common questions, between October 2013 and August 2014, before and after receiving the grants to assess progress in implementing practices for PE and PA. “Yes” responses indicated presence of PE/PA-supportive practices. For schools with complete pre and post data (n=972), frequencies of “yes” responses were calculated for each practice at pre/post. Schools receiving a FUTP60 partner grant reported statistically significant improvements from pre to post across five practices for PE and PA, and ChildObesity180 grantees reported significant increases on all practices except daily recess, which was already in place at 95% of schools at pre-survey. Schools across both grant programs reported the largest increases for promoting PA via messaging, implementing classroom PA breaks, and providing PA before and after school. Schools in both programs reported smaller, but statistically significant, increases in requiring the recommended minutes of PE. This study illustrates the feasibility of offering small grants, at a national scale, for schools to make changes that support PA throughout the day. Results suggest that schools can shift PA policies and practices over the course of a school year.

Introduction

The Physical Activity Guidelines for Americans recommend that children and adolescents engage in at least 60 minutes of daily moderate-to-vigorous physical activity (MVPA).¹ According to the 2016 National Physical Activity Report Card, less than half of US children and adolescents meet the national recommendation.² The vast majority of children and adolescents in the United States attend school; ³ therefore, schools are particularly important places for equitably providing PA opportunities for students. The Institute of Medicine recommends that children engage in at least 30 minutes of MVPA (half of the daily recommended 60 minutes) within the school day.⁴

Although the Centers for Disease Control and Prevention and other national organizations provide guidance and resources to create active school environments,^4–7 implementation is not widespread. The 2014 School Health Policies and Practices Study showed that, in a nationally representative sample of elementary, middle, and high schools, less than 4% required daily PE for the entire school year; less than half (45%) provided opportunities for students to participate in classroom PA breaks; only 55% offered opportunities for students to participate in PA clubs or intramural sports programs; and the majority of schools had 10% or less of their students walking or biking to and from school.⁸ Such limitations on school-based PA may be one contributing factor underlying children’s and adolescents’ failure to achieve the nationally recommended minutes of daily PA.

Let’s Move! Active Schools (LMAS) was launched to develop and empower champions within schools to help them create PA-supportive environments with the goal of increasing PA among all students.⁹ LMAS has partnered with organizations that provide grants to schools to improve PE and PA practices. These grants are considered “activation” grants and provide schools with funding that supports specified programming. Enrollment in LMAS was not required to receive an LMAS-partner grant. Schools that received LMAS-partner grants were encouraged to enroll in LMAS, if they had not already. This study evaluated the programs of two LMAS partner organizations, ChildObesity180¹⁰ and GENYOUth.¹¹

ChildObesity180 awarded schools grants to implement one of three programs: a before-school PA program, an in-class PA break program, or a school-based walking and running program.¹² These programs were identified for nationwide dissemination through a national competition designed to surface innovative school-based PA program models that were both cost-effective and ready for scale. The before-school program is a structured PA program that aims to get students moving at the start of the school day. The in-class program is designed to get students up and active using activity cards that educators or assigned students use to lead the class in PA. The school-based walking and running program presents students with a straightforward challenge to accumulate miles over the course of the school year by running, jogging, or walking during designated program times before, during, or after school. ChildObesity180 grantees were provided $1,000 to support program implementation.

GENYOUth’s flagship program, Fuel Up to Play 60 (FUTP60), awarded schools grants to implement a PA “Play” from the 2013–2014 Fuel Up to Play 60 Playbook. “Plays” are customizable action strategies designed to increase opportunities for and participation in PA before, during, or after school.¹³ Grantees implemented a PA Play focused on adopting in-class PA breaks, implementing walking clubs at school, creating a dance activity or events at school, or championing for PE in school. FUTP60 provided grantees with funds ranging from $300 to $2000 to support the implementation of the FUTP60 PA plays.

Previous studies have identified effective strategies to increase PA among youth during school hours.¹⁴ This study evaluates changes in PE and PA practices among schools participating in a grant partnership initiative. The primary purpose of this evaluation was to determine the extent to which schools that received LMAS-partner grants reported changes in select PE and PA practices.

Methods

ChildObesity180 and FUTP60 collected pre-implementation and post-implementation survey data from grantee schools. ChildObesity180 collected the first round October 2013 through November 2013 and the second round May 2014 through August 2014. FUTP60 collected the first round from August 2013 through November 2013 and the second round from May 2014 through June 2014. Throughout this report, the term “pre” is used to refer to the time period when grant participants completed the initial surveys and “post” to refer to the surveys completed at the follow-up period. The Institutional Review Board (IRB) at Tufts University approved the collection of ChildObesity180 data. IRB approval was not needed for FUTP60 data collection, as the data have no individual identifiers and were aggregated for release.

ChildObesity180 and FUTP60 each developed their own evaluations but included the same set of nine questions on the pre and post surveys to assess whether schools had adopted specific practices for PE and PA. These nine questions (Table 1) were identified by the LMAS Evaluation Committee and assess support for a comprehensive school PA program. All nine questions had “no” or “yes” response options. ChildObesity180 and FUTP60 also collected grade-level data and school enrollment numbers via surveys or other publically available data sources (e.g., National Center for Education Statistics). Additionally, ChildObesity180 asked on the post-survey whether, at the time the survey was completed, the respondent had used all, some, or none of their grant funds and also included an item regarding how funds were used. Respondents selected all that applied from the following options: equipment, printing, events, training, supplies, student incentives, teacher/staff incentives, other.

Table 1.

Measures Used For Physical Education (PE) and Physical Activity (PA) Practices

Measure #	Practice	Question	Answer options
1	Promotes PA via Messaging	Does your school promote the benefits of getting the recommended amount (60 minutes) of daily physical activity to students with posters, banners or other messaging throughout the school on an ongoing basis (e.g., in hallways, stairwell, cafeteria, gymnasium, classrooms)?	Yes/No
2	Requires Recommended Weekly Minutes of PE	Does your school require the recommended minutes of physical education per week for the grade levels your school serves: 150 minutes per week for ELEMENTARY? 225 minutes per week for MIDDLE and HIGH SCHOOL?	Yes/No
3	Supports Professional Development for PE Teachers	Do most physical education teachers participate, at least annually, in professional development focused on physical education and/or physical activity?	Yes/No
4	Requires Fitness Assessments	Does your school require physical education teachers to assess student fitness levels annually (e.g., FITNESSGRAM® assessment)?	Yes/No
5	Requires Specific Time for Daily PA	Does your school or school district have a policy that states specific time requirements for students to participate in physical activity during the school day?	Yes/No
6	Offers Daily Recess	Do students have the opportunity to participate in recess or other physical activity breaks outside of the classroom on a daily basis?	Yes/No
7	Provides Active Classrooms	Do most classroom teachers provide opportunities for students to be physically active in the classroom at different times during the school day (e.g., physical activity breaks, subject-based movement activities, walk and shares, etc.)?	Yes/No
8	Offers Before-and After-School PA	Does your school offer physical activity opportunities in before- and after-school programs that are available to most/all students?	Yes/No
9	Shares Use of School Grounds	Does your school provide access to school grounds for physical activity before and/or after school for parents, families and/or community members?	Yes/No

PE=physical education; PA=physical activity.

In total 1587 schools received grants from FUTP60 and ChildObesity180. Pre and post surveys were completed by 1041 schools. Fifteen unique schools received grants from both programs and were excluded from the analysis. Schools that provided incomplete data were also excluded (N=39). This study presents findings about the 972 schools that participated in one of the two LMAS-partner grant programs and had complete data for pre survey and post survey.

In May–June 2015, ChildObesity180 sent grantees a short follow-up survey that asked whether the PA program was sustained in the 2014–15 school year. Respondents who indicated they did not sustain programming were asked to identify challenges that prevented re-implementation (options included: space for the program, financial support for the program, personnel support, scheduling, participation, other). Respondents who sustained programming were asked whether they planned to re-implement again in the 2015–16 school year.

Stata version 13 (College Station, TX: Stata Corp LP) was used to conduct all statistical analysis. We present frequencies of “yes” responses for pre survey and post survey for each LMAS-partner organization. We tested for statistically significant differences between pre and post periods using two-sample tests of proportions. A z-score was used to determine statistical significance.

For the ChildObesity180 subsample, we calculated the percentages of schools that responded to questions on the post survey regarding their funding (e.g., how much of their funds were used and for what kinds of purchases). The percentages of schools reporting response options to questions related to program sustainability in the 2015 follow-up survey were also calculated.

Results

Of the 972 schools in the analytic sample, 72% (N=698) received a grant from ChildObesity180 and 28% (N=274) received a grant from FUTP60. ChildObesity180 awarded a higher percentage of its grants to elementary schools (91%) than did FUTP60 (69%). Across participating schools, enrollment ranged from 18 to 3,099 students. The potential reach of these grant programs, that is, the total enrollment of students in participating schools, was 487,476. Schools in 49 states and the District of Columbia (D.C.) are included in this sample, with FUTP60 grantee schools in 40 states and ChildObesity180 grantee schools in 49 states and D.C. Participating schools were primarily from urban (33%) and suburban (33%) areas as well as towns/townships (11%) and rural communities (22%).

In the pre surveys, a large proportion of schools from both programs reported having many of the PE and PA practices in place; however, schools varied in which practices they had already adopted (Table 2). Among schools enrolled in ChildObesity180’s grant programs, daily recess was the most prevalent, with 95% of schools reporting having this practice in place in the pre survey. The most prevalent practice among FUTP60 schools was offering professional development to PE teachers (91%). The least common practice among grantees from both programs was requiring the recommended minutes of PE; this requirement was reported to be in place at only 40% of ChildObesity180 grantee schools and 41% of FUTP60 grantee schools.

Table 2.

Percentage of Schools that Reported Having Physical Education and Physical Activity Practices in Place, by LMAS-partner Grant Program

PE and PA Practice	ChildObesity 180 (N=698)			Fuel Up to Play 60 (N=274)
	PRE	POST	Change in % Yes	PRE	POST	Change in % Yes
Promotes PA via Messaging	57%	76%	19%	74%	89%	15%
Requires Recommended Weekly Minutes of PE	40%	48%	8%	41%	47%	6%
Supports Professional Development for PE Teachers	81%	87%	6%	91%	93%	2%
Requires Fitness Assessments	62%	69%	6%	80%	82%	2%
Requires Specific Time for Daily PA	67%	73%	6%	63%	66%	4%
Offers Daily Recess	95%	95%	0%	78%	83%	5%
Provides Active Classrooms	65%	80%	15%	53%	70%	18%
Offers Before- and After-School PA	61%	72%	11%	62%	71%	9%
Shares Use of School Grounds	76%	81%	4%	79%	81%	1%

Note: Data were collected from October 2013 and August 2014 among schools that received a LMAS-partner grant. The percentage change in “yes” values is calculated from rounded values. PE=physical education; PA=physical activity.

Z-scores were determined using a 5% significance level. Statistically significant results are presented in bold.

In the post survey, FUTP60 grantee schools reported significant increases for promoting PA via messaging, requiring the recommended minutes of PE, providing active classrooms, offering daily recess, and offering before- and after-school physical activity. ChildObesity180 schools reported significant increases for all practices except daily recess, which started out and remained high at 95%. For grantees from both programs, the largest statistically significant increases were seen in the percentage of schools reporting they promoted PA via messaging, provided active classrooms, and offered students opportunities to be physically active before and after school.

FUTP60 grantee expenditures included the purchase of small (e.g., jump ropes, playground stencils) or large (e.g., weights) fitness equipment, video game consoles or software for active gaming, promotional materials, student incentives, and stipends for staff or outside PA professionals. Information on grantee expenditures was derived from the school’s grant applications. For ChildObesity180 grantees no specific restrictions were placed on how funds were to be spent.

In the ChildObesity180 post survey, 54% of grantees reported having used all of their grant funds, 43% had used some of the funds, and 3% had not yet used any of the funds (n = 693). Among those that used all or some of the funds, the most commonly reported use was for student incentives (62% of respondents), followed by equipment (51%), supplies (37%), printing (21%), events (19%), teacher incentives (13%), and training (3%); 11% of respondents indicated grant funds were used for other purposes not listed. Complete responses to ChildObesity180’s 2015 follow-up survey were provided by 411 schools. About two-thirds of respondents (67%) indicated that they had re-implemented their program. Among respondents who did re-implement programs (n = 275), 90% indicated they would re-implement again in 2015–16. Among respondents that did not re-implement (n = 136), 41% indicated that personnel support was a barrier to implementation, 33% indicated schedule, 30% indicated financial support, 16% indicated participation, 16% indicated space, and 24% indicated other factors.

Discussion

Schools receiving grants from ChildObesity180 and FUTP60 reported overall improvements in select PE and PA practices. While the programmatic approaches of ChildObesity180 and FUTP60 differed, they shared similar goals of increasing students’ opportunities to be physically active across the school day. Previous evaluations of schools receiving grants for PE programs also have shown improvement in school policies, practices, and student outcomes.¹⁵ However, this was the first study to demonstrate the potential of coordinating national partners to offer grants to impact school PE and PA practices. These results provide new insight on how other large-scale grant making programs might benefit schools through similar coordinated effort at the national level. This study also demonstrates the feasibility of having schools nationwide apply for grants and complete standardized pre- and post- surveys.

Both ChildObesity180 and FUTP60 grantees reported the greatest statistically significant percentage increases for promoting PA via messaging, providing active classrooms, and offering before and after- school opportunities for physical activity. A 2009–2010 evaluation of FUTP60 programs also showed a focus on before- and after-school activities.¹⁶ Compared with other practices that require more training or administrative buy-in, these three practices might have been easier to implement within the course of one school year. Most of these practices also were aligned with the primary focus of the grant programs. Additionally, schools might have found more creativity and autonomy in these three practices, which may have made them more appealing to adopt compared with other practices. For example, schools may have more flexibility with providing different types of before- and after- school PA programs than with requiring a specific quantity of weekly PE.

For ChildObesity180, the only practice that did not have a significant increase was offering daily recess, which was already in place at 95% of schools at pre-survey. For FUTP60, there was a percentage point increase for all nine practices; however, smaller changes, such as those reported for using fitness assessments, providing professional development for PE teachers, or having a shared use agreement, were not statistically significant. Some of these practices (e.g., fitness assessments) were widely in place at participating schools prior to their implementing the LMAS-partner grant program, so the expectations for improvement would be smaller. Practices that involve policy change, additional resources, and scheduling represent larger shifts within the school environment. Other studies have shown that some of these school practices could have legal liability implications, generate high costs, or prove time-intensive to plan and implement.^6,17 For example, it might be challenging for principals and school administrators to rearrange the school schedule during the school year to make more time for daily recess or other opportunities for PA, or to engage in a process to develop, pass, and implement a shared use agreement in the course of a single school year.¹⁶ It is encouraging, therefore, that programs reported some positive movement across these longer-term practices.

This evaluation had some limitations. First, without random assignment and a comparison group, we were unable to determine whether the LMAS-partner grant programs were causing the observed improvements. Schools with personnel/staff that were motivated to seek out LMAS-partner grants might have already been on track to make changes to PE and PA practices. Second, the surveys were self-reported, and respondents were not required to be a specified person or to hold a particular position; accordingly, individuals completing the surveys might have differed in their levels of knowledge of school practices. Grant recipients might have felt compelled to report improvements. Lastly, schools might have had different respondents complete the survey at each time point. Each situation could lead to potential response biases.

This research was not able to test potential effects of other components of LMAS participation beyond the activation grants. During the implementation of these LMAS-partner grants (August 2013–2014), the LMAS initiative was in its infancy stage and many of the supports for LMAS, such as trainings for physical activity leaders, process for providing technical assistance, and online community for physical activity leaders, were still being developed. Therefore, this study did not include an analysis comparing LMAS enrolled and non-enrolled schools as there were not meaningful differences in the supports and resources given to enrolled and non-enrolled schools at the time of this research. Future efforts should examine the differences between LMAS enrolled and non-enrolled schools after the full range of LMAS supports were available.

In future studies, it would be worth exploring whether schools that participated in multiple grant programs were able to make larger improvements compared with schools participating in a single grant program. This study was unable to test for such differences because few schools received both ChildObesity180 and FUTP60 grants, and those schools were excluded from the analysis. Encouragingly, ChildObesity180 found that, one year after the grant period was completed, approximately two-thirds of schools had re-implemented their PA programs. Of those schools that re-implemented, 90% planned to sustain the program for a third year. In choosing the three PA programs it would support through its grants, ChildObesity180 deliberately prioritized those that were sustainable and cost-effective; this may have enhanced potential for program maintenance even after the initial year when grants were provided. These data suggest that relatively small grants may support sustained changes in school physical activity environments. Program sustainability should be further evaluated in future studies. Interventions that have been in place for at least a year may be more likely to be sustained.¹⁸

Data on the socioeconomic profiles of grantee schools (e.g., eligibility for free or reduced priced lunch) were not available for the full sample, so we were unable to fully characterize the economic characteristics of participating schools or to test whether the observed results differed based on such characteristics. The LMAS survey did not include questions on the availability of facilities, support organizations (e.g., local universities or sporting organizations), or other resources that might have influenced changes in schools’ policies and practices. Finally, we did not collect data on students’ physical activity levels and are therefore unable determine whether changes in school policies translate to changes in child-level PA. Such data are needed to understand the impact of changes to school policies and practices on youth physical activity patterns and present an important future research direction.

The 2016 Shape of the Nation report shows that state policies for PE and PA have not changed much over time, and many recommended policies are not being adopted at the school level.^8,19 While most states require students to participate in PE, only five states and the District of Columbia require the recommended minutes of physical education at the elementary school level. This number declines across grade levels: two states require the recommended weekly minutes for middle school students and none do at the high school level.¹⁹ This state policy landscape leaves much leeway for school districts and schools to establish policies and practices that increase student PA.¹⁹ Moreover, systematic reviews indicate that even when PE and after-school programs are available, there is room for improvement when it comes to the minutes that of MVPA that children accrue.^20,21

Partnering with programs similar to ChildObesity180 and FUTP60 to offer school-level grants may be a feasible approach for helping schools increase opportunities for students to engage in PE and PA throughout the school day. Future research could test the influence of state policies on school practices and also whether the influence of grant programs and other supports differs depending on such policies. The improvements observed in the present study may be related to multiple factors, such as existing school policies and programs, champions in the school promoting PE and PA, and other funding sources; nevertheless, the findings suggest that these grant programs may have had a positive impact on PE and PA practices in participating schools.

HIGHLIGHTS.

• Schools can shift physical activity practices over the course of a school year.

• Offering small grants to support school adoption of PA practices appears feasible.

• Grant programs supported by organizations like LMAS (now Active Schools) may play a role in supporting PE and PA in schools.

• Programmatic changes may be faster to implement than policy or scheduling shifts.