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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. Physical Education Enhancement

Approach. Expand and strengthen physical education (PE) efforts

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Overview. Analysis indicates physical education (PE) enhancements that increase the time children are participating in PE and reduce the time they are sedentary can increase physical activity levels in elementary and middle school children. Enhancements can include lengthening PE lessons, adding in more PE classes to the schedule, improving PE curricula, or PE teacher training.[1,2]

Evidence. Emerging Evidence. Strategies based on emerging evidence show promise but have not undergone extensive testing. While these approaches demonstrate potential, their effectiveness remains unconfirmed. Prioritize rigorous monitoring to ensure they achieve desired outcomes for all MCH populations.

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 self-reported physical activity levels
  • Qualitative data from students, teachers, and parents
  • PE teacher lesson plan adherence

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 schools implementing enhanced PE curriculum aligned with national standards. (Assesses adherence to best practices)
  • Number of PE teachers receiving specialized training in effective PE instruction. (Measures capacity building)

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

  • Percent of PE curricula that incorporate relevant activities reflecting student demographics. (Measures responsiveness)
  • Percent of PE programs that offer adaptive activities for students with disabilities. (Evaluates program design)

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

  • Number of cross-curricular connections made between PE and other academic subjects. (Shows integration into broader education)
  • Number of partnerships formed with local sports organizations to enhance PE programs. (Assesses community engagement)
  • Number of students showing improved academic performance correlated with enhanced PE participation. (Quantifies broader educational benefits)
  • Number of families reporting increased physical activity at home due to student influence from enhanced PE. (Assesses community-wide impact)

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

  • Percent of PE enhancement resources allocated to schools in areas with additional needs. (Measures resource distribution)
  • Percent of PE program evaluations that analyze outcomes across different student subgroups. (Ensures impact assessment)
  • Percent reduction in gaps in physical fitness levels between different student subgroups. (Measures improvements in health outcomes)
  • Percent increase in physical activity levels among students with previously low activity levels. (Evaluates impact on groups facing higher health risks)

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 Cronholm F, Rosengren BE, Karlsson C, Karlsson MK. A comparative study found that a seven-year school-based exercise programme increased physical activity levels in both sexes. Acta Paediatrica. 2018 Apr;107(4):701-707.

2 Palmer SE, Bycura DK, Warren M. A physical education intervention effects on correlates of physical activity and motivation. Health Promotion and Practice. 2018 May;19(3):455-464.

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.