Skip Navigation

Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 8: Physical Activity

MCH Best Logo five children on bicycles

Strategy. Comprehensive School Physical Activity Programs

Approach. Implement a comprehensive school physical activity program with a combination of strategies to increase physical activity before, during, and after school.

Return to main MCHbest page >>

Overview. Research indicates that comprehensive school physical activity programs that use a combination of strategies to increase physical activity before, during, and after school can increase physical activity in children and adolescents. Components in these programs include 1) physical education, 2) physical activity during school (recess and classroom physical activity), 3) before- or after-school programs, 4) staff involvement, and 5) family and community engagement. The programs often also include healthy eating or well-being information but the focus is primarily on physical activity.1, 2

Evidence. Emerging. Initial research showed positive results for providing homework or extra credit for physical education class to increase physical activity in school children. Further research is needed to identify critical components and confirm effects. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Schools: children and adolescents, teachers, parents.

Outcome. Increase in overall physical activity in school children and adolescents. 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 “Implement a comprehensive school physical activity program with a combination of strategies to increase physical activity before, during, and after school,” 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 school districts that adopt a comprehensive school physical activity program.
  • Number of school administrators and teachers that are trained to use a comprehensive school physical activity program.

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

  • Percent of school districts that adopt a comprehensive school physical activity program.
  • Percent of school administrators and teachers that are trained to use a comprehensive school physical activity program.

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

  • Number of schools in a school district that implement a comprehensive school physical activity program for a whole school year.
  • Number of trained school administrators and teaching teams that implement a comprehensive school physical activity program.

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

  • Percent of schools in a school district that implement a comprehensive school physical activity program that report increased time in physical activity for students.
  • Percent of trained school administrators and teaching teams that implement a comprehensive school physical activity program.

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.


References:

1 Belton S, McCarren A, McGrane B, Powell D, Issartel J. The Youth-Physical Activity Towards Health (Y-PATH) intervention: Results of a 24 month cluster randomised controlled trial. PLOS One. 2019;14(9):e0221684.

2 Hyde ET, Gazmararian JA, Barrett-Williams SL, Kay CM. Health empowers you: Impact of a school-based physical activity program in elementary school students, Georgia, 2015-2016. Journal of School Health. 2020 Jan;90(1):32-38.

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.