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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 8: Physical Activity

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Strategy. Individual Supports

Approach. Provide individually-catered behavior change strategies through counseling, goal setting, peer support, summer camps or community efforts, or virtual coaching.

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Overview. Individually tailoring strategies to incorporate physical activity into daily routines is the basis for this intervention. This can include teaching behavioral skills, such as goal setting and problem solving, as well as counseling or peer-influenced guidance to help achieve an active lifestyle. These interventions can also include community-based elements such as summer camps or youth groups and may also use technology as a part of the intervention strategy (such as delivering coaching/guidance through texts or other virtual mailings). Examples of studies with positive outcomes used promotion of physical activity from coaches in a sports camp, and organized physical-activity opportunities within a summer camp.1, 2

Evidence. Emerging. Initial research showed positive results for strategies to increase physical activity levels and behaviors using individually tailored approaches. Further research is needed to identify critical components and confirm effects. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience.Children/adolescents.

Outcome.  Increased minutes of moderate-to-vigorous physical activity, increase motivation, decreased sedentary behavior. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that aligns with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.

Sample ESMs. Using the approach “Provide individually-catered behavior change strategies through counseling, goal setting, peer support, summer camps or community efforts, or virtual coaching,” here are sample ESMs you can use to model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of children/adolescents receiving counseling and education on change-behavior strategies.
  • Number of children/adolescents attending summer camps or youth groups promoting physical activity.
  • Number of children/adolescents receiving texts/online coaching as a means to promote physical activity.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of students/adolescents who receive educational materials and counseling to help encourage physical activity.
  • Percent of students/adolescents who participate in summer camps and youth groups encouraging physical activity.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of children/adolescents who report increased understanding of goal-setting and behavioral change strategies.
  • Number of children/adolescents who report increased self-motivation to engage in physical activity.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Number of children/adolescents who report meeting the 60 minutes of moderate-to-vigorous physical activity per day guideline.
  • Number of children/adolescents who report positive behavioral changes regarding physical activity.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


1 Guagliano JM, Kolt GS, Rosenkranz RR, Dzewaltowski DA. Does self-determined motivation interact with environmental contexts to influence moderate-to-vigorous physical activity during a girls' youth sport camp? Journal of Sports Sciences. 2019 Dec;37(23):2720-2725.

2 Rauber SB, Castro HO, Marinho A, Vicente JB, Ribeiro HL, Monteiro LZ, Praça IR, Simoes HG, Campbell CSG. Effects of a physical activity and nutritional intervention in overweight and obese children through an educational and recreational camp. Nutrition and Health. 2018 Sep;24(3):145-152.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.