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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Physical Activity.

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Strategy. Active Recess

Approach. Promote an active, semi-structured recess break during the school day, ideally scheduled before lunch

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Overview. Analysis indicates that active recess strategies effectively increase daily Moderate-to-Vigorous Physical Activity (MVPA) while keeping all students engaged. Investigation shows positive outcomes from interventions such as supervised games, multicomponent playground investments (e.g., providing activity equipment and painting colorful markings on pavement), and specialized training for staff to promote physical activity throughout the school day [1,2,3].

Evidence. Scientifically Rigorous Evidence. Strategies based on scientifically rigorous evidence are proven effective across multiple robust studies. While success is highly likely, local impact may vary. Monitor outcomes and use data to tailor these strategies to the community's unique needs.

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source.

Potential Data Sources. Data to support this strategy can be accessed through:

  • Classroom teacher observation and feedback surveys
  • School climate surveys
  • Student self-regulation and emotional check-in data

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.
  • Health and Health Behaviors/Behavior Change. This strategy improves individuals' physical and mental health and their adoption of healthy behaviors (e.g., healthy eating, physical activity).

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Policy Development and Enforcement (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. Access descriptions of ESMs that use this strategy or aligned components.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the RBA framework (see The Role of Title V in Adapting Strategies).

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

  • Number of schools partnered with Title V implementing structured for semi-structured active recess programs. (Assesses adoption of strategy)
  • Number of recess supervisors trained in facilitating active play. (Measures capacity building)

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

  • Percent of recess periods that include structured physical activities organized by Title V. (Measures implementation fidelity)
  • Percent of recess activities that accommodate students of all physical abilities organized by Title V. (Assesses program design)

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

  • Number of peer leaders trained to facilitate active recess games who report an increase in knowledge and/or skill. (Shows student leadership development)
  • Number of students reporting improved social interactions during active recess as a result of implementing active play. (Assesses social-emotional benefits)
  • Number of students showing improved classroom behavior following active recess. (Quantifies academic benefits)
  • Number of schools reporting improved overall school climate due to active recess. (Assesses broader school impact)

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

  • Percent of active recess resources allocated to schools with limited existing physical activity opportunities. (Measures resource distribution)
  • Percent of active recess evaluations that analyze participation across different student subgroups. (Ensures impact assessment)
  • Percent of students showing improved classroom behavior following active recess. (Quantifies academic benefits)
  • Percent of schools reporting improved overall school climate due to active recess. (Assesses broader school impact)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

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

References

1 Frost MC, Kuo ES, Harner LT, Landau KR, Baldassar K. Increase in physical activity sustained 1 year after playground intervention. American Journal of Preventive Medicine. 2018 May;54(5 Suppl 2):S124-S129.

2 Gutiérrez-Martínez L, Martínez RG, González SA, Bolívar MA, Estupiñan OV, Sarmiento OL. Effects of a strategy for the promotion of physical activity in students from Bogotá. Revista de Saúde Pública. 2018 Aug;52:79.

3 Morris JL, Daly-Smith A, Archbold VSJ, Wilkins EL, McKenna J. The Daily Mile™ initiative: Exploring physical activity and the acute effects on executive function and academic performance in primary school children. Psychology of Sport and Exercise. 2019a Nov;45:101583.

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.