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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. Physically Active Classrooms

Approach. Incorporate physical activity in the lesson plan or include classroom energizers during academic lessons

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Overview. Analysis indicates that physically active classrooms, which may take the form of physical activity breaks, can be incorporated into individual lesson plans as well as a larger, school-wide program to promote physical activity and healthy eating. This may include physical education or recess enhancements. Physically active classroom interventions can also include teacher training and professional development opportunities for school staff and faculty.[1, 2] Active learning [3] and flexible seating such as standing desks [4,5] can help incorporate movement into classroom learning too.

Evidence. Moderate Evidence. Strategies based on moderate evidence show a clear trend toward positive results. While these approaches are likely to be effective, further research is needed to confirm their impact. Implement with evaluation to better understand specific local effects.

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:

  • Student on-task behavior/engagement logs
  • Teacher feedback on lesson effectiveness
  • Lesson plan audits

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. Health Teaching (Education and Promotion) (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 classrooms implementing regular physical activity breaks. (Assesses adoption of strategy)
  • Number of teachers trained in integrating movement into lesson plans. (Measures capacity building)

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

  • Percent of classroom physical activities aligned with academic learning objectives. (Measures integration with curriculum)
  • Percent of teachers reporting high comfort levels in facilitating active learning. (Evaluates teacher self-efficacy)

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

  • Number of student-led physical activity breaks implemented in classrooms. (Shows student empowerment)
  • Number of interdisciplinary collaborations formed to develop active learning strategies. (Assesses cross-subject integration)
  • Number of students showing improved cognitive function after implementing active classroom strategies. (Quantifies cognitive benefits)
  • Number of families reporting increased physical activity at home due to student influence from active classrooms. (Assesses community spillover effects)

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

  • Percent of active classroom resources allocated to schools for classrooms in areas facing significant educational challenges. (Measures resource distribution)
  • Percent of active classroom evaluations that analyze participation and outcomes across different student subgroups. (Ensures impact assessment)
  • Percent reduction in achievement gaps correlated with implementation of active learning strategies. (Measures improvements in educational outcomes)
  • Percent increase in physical activity levels among previously inactive for overweight students. (Evaluates impact on groups at higher risk for negative health outcomes)

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 Bartholomew JB, Jowers EM, Roberts G, Fall AM, Errisuriz VL, Vaughn S. Active learning increases children's physical activity across demographic subgroups. Translational Journal of the American College of Sports Medicine. 2018;3(1):1-9.

2 Vazou S, Saint-Maurice PF, Skrade M, Welk G. Effect of Integrated physical activities with mathematics on objectively assessed physical activity. Children (Basel). 2018;5(10):140.

3 Schmidt, S. K., Reinboth, M. S., Resaland, G. K., & Bratland-Sanda, S. (2020). Changes in Physical Activity, Physical Fitness and Well-Being Following a School-Based Health Promotion Program in a Norwegian Region with a Poor Public Health Profile: A Non-Randomized Controlled Study in Early Adolescents. International journal of environmental research and public health, 17(3), 896.

4 Kidokoro, T., Shimizu, Y., Edamoto, K., & Annear, M. (2019). Classroom Standing Desks and Time-Series Variation in Sedentary Behavior and Physical Activity among Primary School Children. International journal of environmental research and public health, 16(11), 1892.

5 Chen, Y. L., Tolfrey, K., Pearson, N., Bingham, D. D., Edwardson, C., Cale, L., ... & Clemes, S. A. (2021). Stand Out in Class: Investigating the Potential Impact of a Sit–Stand Desk Intervention on Children’s Sitting and Physical Activity during Class Time and after School. International Journal of Environmental Research and Public Health, 18(9), 4759.

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.