Impact of a school-level intervention on leisure-time physical activity levels on school grounds in under-resourced school districts.

Even the best school physical education programs fall short of providing enough physical activity (PA) to meet students' PA guidelines thus increasing PA at other times throughout the school day could help students meet recommended PA levels. Unstructured leisure-time periods during the school day represent an opportunity to promote PA, particularly among students in underserved school districts. Between 2014 and 2018, we partnered with 14 elementary and 5 secondary schools in low-income Latino communities to increase students' leisure time moderate to vigorous physical activity (MVPA). Schools received consultation and technical assistance on their wellness policy, and some created wellness committees. Schools selected 1-2 PA/nutrition promotion activities for the academic year. Following the System for Observing Play and Leisure Activity in Youth protocol, we conducted a pre- vs. post- analysis of observations of school time student PA (levels of MVPA, energy expenditure, proportion of areas in which games and sports were prominent) in 4936 pre-intervention play areas and 4404 post-intervention areas before school, during lunch recess, and after school. We utilized linear and logistic regression analyses to test pre/post changes in these dependent variables using school area characteristics, period of observation, and temperature as covariates. Following our intervention, MVPA levels before school, during lunch recess, and after school increased significantly from 19.8% at baseline to 25.6% among elementary girls and from 25.4% to 33.2% among elementary boys. Decomposition of these effects suggested that the benefits were partially mediated by increased adult playground supervision. We did not observe any significant changes in PA levels among secondary school girls or boys. Our school-level intervention aimed at promoting PA was associated with modest but meaningful increases in leisure-time PA among elementary, but not secondary, school students. The effects were attributable in part to increased adult supervision on the playground.

Program Evaluation of Environmental and Policy Approaches to Physical Activity Promotion in a Lower Income Latinx School District in Southeast Los Angeles.

There is alarming population wide prevalence of low adolescent physical activity as this represents a risk factor for later chronic disease development. There is evidence to suggest that schools with strong wellness policies have students that are more frequently active. We designed an intervention to enhance students' physical activity levels in five majority Latinx, underserved school districts. Evaluation consisted of assessment of written quality of school-district wellness policies; observation of student's physical activity during leisure times; and after-school program practices and policies. We examined one of these district's results more closely, the only participating district with a community coalition, and extracted lessons learned. On the physical activity section of the wellness policy, this district covered a moderate extent of recommended content areas using weak language. Compared to previous reports, we identified low vigorous activity levels for girls and boys at baseline (respectively, 12% and 18%). Finally, we identified that of four after school program sites assessed at baseline, no program reported the recommended 50% or more of program time dedicated to physical activity. Based on these evaluation findings, additional strategies are urgently needed to encourage all students and particularly more girls to be physically active throughout the school day.

RE-AIM analysis of a community-partnered policy, systems, and environment approach to increasing consumption of healthy foods in schools serving low-income populations.

Prevalences of childhood overweight and obesity represent major public health concerns. School-based policy strategies represent one approach to increasing access to healthy foods; however, overall health impact of such initiatives is often overlooked. We undertook program evaluation of a school wellness policy focused approach in low-income, multiracial communities in southeast Los Angeles. We convened groups of key stakeholders including superintendents, principals, teachers, school staff, and parents to prioritize school-level implementation of wellness policy items to improve access to healthy foods, including healthier classroom celebrations. The purpose is to synthesize these findings within the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance) to describe cumulative impact of this health system-led community-partnered effort to promote healthy eating throughout the school day. We evaluated reach by comparing students reached by the intervention relative to the eligible population. We assessed effectiveness by examining changes in nutrition in wellness policy quality and after school program practices pre- and post-intervention interviews). We evaluated adoption by comparing sites that approved participation in the intervention and its evaluation versus completing evaluation assessments. We evaluated implementation as the number of schools convening a wellness council. Finally, we examined maintenance by evaluating changes in wellness policy and afterschool practices for those sites with pre- and post-test assessment. We reached 43.5% of the priority student population. We noted improvement in wellness policy quality and after school practices pre- to post-intervention (effectiveness). We found that 42.9% of after school programs completed the assessment while 40.0% of school districts triggered a post-intervention wellness policy evaluation (adoption). Eleven of 19 schools convened wellness councils (implementation) while in the subset of sites that completed pre- and post-test evaluation some improvements were noted (maintenance). We use this application of the REAIM framework to extract lessons learned from districts and after school programs that participated throughout the grant period. Through our partnership with schools we learned that our program evaluation filled an information gap for districts working to meet USDA's wellness policy requirement. Finally, while the wellness policy is an important lever in striving towards health equity in districts disproportionately impacted by obesity, additional policy, system, and environmental approaches are required to build a culture of health.

Factors Associated With Leisure Time Physical Activity Among Schoolchildren in a Predominantly Latino Community.

BACKGROUND: School initiatives aimed at increasing physical activity (PA) may improve the health of children in low-income communities. METHODS: Assessors completed 5909 observations of students' PA during leisure periods using a validated instrument in 19 schools in low-income Latino communities. We examined relationships between school environment factors (eg, presence of playground equipment) and levels of moderate-to-vigorous physical activity (MVPA). RESULTS: Overall, 16.4% of students were engaged in vigorous activity, lower than reported in prior analyses. Consistent with earlier reports, boys were more engaged in vigorous PA than girls (18.6% vs 13.2%). Playground equipment, such as balls and jump ropes, were present in 27.5% of activity areas. Supervision was present in 83.1% of observations; however, staff members were only observed leading organized activity in 1.7%. Playground equipment was associated with higher rates of MVPA, particularly among elementary boys (p < .0001). Staff supervision was not associated with MVPA, possibly because staff members rarely led organized activity. CONCLUSIONS: We found low rates of leisure time PA among students in this low-income Latino community. The presence of playground equipment was favorably associated with activity levels. Increasing the availability of playground equipment might promote activity among children in similar populations.