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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. School-Based Physical Education Enhancements

Approach. Expand or enhance school-based physical education through local school policies or state standards

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Overview. Efforts to expand or enhance school-based physical education (PE) include lengthening existing classes, adding new PE classes, increasing physical activity during class, training teachers, and updating PE curricula. Such efforts can be implemented via local school policies or state government standards. As of 2016, most school PE classes do not meet the US Centers for Disease Control and Prevention (CDC) recommendation that students spend 50% of PE class time engaged in moderate to vigorous physical activity (Hollis 2016*).

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:

  • School/district wellness policy review documentation
  • Physical education teacher professional development records
  • School wellness committee meeting minutes

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

  • 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).
  • Environmental Health. This strategy improves the impact of physical, chemical, and biological factors in the environment on health.

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 enhanced PE curriculum aligned with CDC recommendations. (Assesses adherence to best practices)
  • Number of PE teachers receiving professional development on effective PE instruction. (Measures capacity building)

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

  • Percent of PE curricula oversaw by Title V that incorporates activities for students of all abilities. (Measures program design)
  • Percent of schools partnered with Title V with PE policies that address both quantity and quality of PE. (Evaluates comprehensive policy approach)

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

  • Number of cross-curricular connections led by Title V made between PE and other academic subjects that reports high levels of engagement. (Shows integration into broader education)
  • Number of partnerships led by Title V formed with community organizations to support enhanced PE programs who report high levels of engagement. (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 cross-curricular connections led by Title V made between PE and other academic subjects that reports high levels of engagement. (Shows integration into broader education)
  • Percent of partnerships led by Title V formed with community organizations to support enhanced PE programs who report high levels of engagement. (Assesses community engagement)
  • Percent of students showing improved academic performance correlated with enhanced PE participation. (Quantifies broader educational benefits)
  • Percent of families reporting increased physical activity at home due to student influence from enhanced PE. (Assesses community-wide 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.

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.