M-SPANM-SPANMiddle School Physical Activity and NutritionMiddle School Physical Activity and Nutrition

Study of environmental interventions to increase PA and reduce dietary fat at middle schools

Funded by NIH-NHLBI, 1996-2000 6 semesters of measurement:

1 baseline; 4 intervention; 1 maintenance School was unit of analysis (12 Interv; 12 Control) Females not targeted specifically Individuals not tracked

M-SPAN Key PersonnelM-SPAN Key Personnelcontinuing with TAAGcontinuing with TAAG

Jim Sallis (PI)Jim Sallis (PI) Thom McKenzie (Co-PI)Thom McKenzie (Co-PI) John Elder (Co-PI)John Elder (Co-PI) Terry Conway (Co-PI)Terry Conway (Co-PI) Paul Rosengard (Intervention Director)Paul Rosengard (Intervention Director) Jamie Strelow (Project Coordinator)Jamie Strelow (Project Coordinator) John Alcaraz (Design)John Alcaraz (Design) Marie Luna (Measurement)Marie Luna (Measurement)

Physical Education/Activity Physical Education/Activity InterventionIntervention

Vision: Initiate and facilitate Vision: Initiate and facilitate

environmental changes to environmental changes to

increase the physical activity increase the physical activity

levels of studentslevels of students

PA and PE ConsiderationsPA and PE Considerations Total accumulated minutes of P.A. throughout the Total accumulated minutes of P.A. throughout the

day, in- and out-of-PEday, in- and out-of-PE

Healthy People Goals 2010 Objective: 50%Healthy People Goals 2010 Objective: 50% or or more MVPA in PE classesmore MVPA in PE classes

CA Educational Code: minimum 400 min./10 days CA Educational Code: minimum 400 min./10 days (grades 7 & 8) 200 min./10 days (grade 6)(grades 7 & 8) 200 min./10 days (grade 6)

P.E. Specialists provide more than 90% of classesP.E. Specialists provide more than 90% of classes Collaborate with organizations with similar goalsCollaborate with organizations with similar goals

Opportunities for PA During School DayOpportunities for PA During School Day

Before schoolBefore school After lunchAfter lunch After schoolAfter school PE classesPE classes

No recess at middle schoolsNo recess at middle schools

M-SPAN Study SchoolsM-SPAN Study Schools

24 middle schools (grades 6-8) in 24 middle schools (grades 6-8) in San Diego County (26,000 students) San Diego County (26,000 students)

9 school districts9 school districts 1082 1082 avg. size (range 456-1776)avg. size (range 456-1776) 43% ethnic minority (13-71)43% ethnic minority (13-71) 39% free/low cost meals (5-70)39% free/low cost meals (5-70) 36% arrive by bus (0-85)36% arrive by bus (0-85)

Physical Activity AssessmentPhysical Activity Assessment

1. 1. SOFITSOFIT (System for Observing Fitness (System for Observing Fitness Instruction Time). Instruction Time). Student Activity Levels, Lesson Context, and Student Activity Levels, Lesson Context, and Teacher Behavior during PE lessons.Teacher Behavior during PE lessons.

2. 2. SOPLAYSOPLAY (System for Observing Play and (System for Observing Play and Leisure Activity in Youth). Leisure Activity in Youth). Activity levels in PA areas before Activity levels in PA areas before school, at lunch, and after school.school, at lunch, and after school.

3. 3. SPASSPAS (Sources of Organized Physical Activity in (Sources of Organized Physical Activity in Schools). Schools). Director report of frequency, duration, and numbers in Director report of frequency, duration, and numbers in interscholastic, intramural, and other programs.interscholastic, intramural, and other programs.

4. 4. Student/Parent SurveysStudent/Parent Surveys.. Reports of student participation Reports of student participation in specific sports and activities.in specific sports and activities.

PE LessonsPE Lessons

Offered daily; primarily co-edOffered daily; primarily co-ed Allocated length = 49.8 minAllocated length = 49.8 min Actual length = 34.3 minActual length = 34.3 min Held outdoors = 94%Held outdoors = 94% Taught by PE specialists = 88%Taught by PE specialists = 88% Students per class = 36.9Students per class = 36.9

PE InterventionPE Intervention

Five, 3-hour, staff development workshops conducted at schools by M-SPAN staff focus on active PE curriculum and

instruction efficient management & appropriate

activities

Sample active curricula On-site follow-up visits (~ 1.5 per month)

Parent InvolvementParent Involvement(minimal)(minimal)

Monthly articles in school newslettersMonthly articles in school newsletters ““How Parents Can Help” brochure at How Parents Can Help” brochure at

Open HouseOpen House PTA presentationsPTA presentations PTA rep at school policy meetingsPTA rep at school policy meetings

Focus of PE Staff DevelopmentFocus of PE Staff Development

Assist teachers with developing & implementing curricula & instruction that: provide many opportunities for PA during class are effective for boys & girls at all skill levels are enjoyable teach generalizable movement skills encourage present & future physical activity have minimum “down time”

PE Staff Development PE Staff Development ContentContent

Design:Design: Interactive, collaborative effort, empowering attendeesInteractive, collaborative effort, empowering attendees

Strategies:Strategies:1. Yearly plan analysis1. Yearly plan analysis

2. 2. ActionAction planning/community collaborations/volunteers planning/community collaborations/volunteers

3. Individual/partner/group format3. Individual/partner/group format

4. Organization/management techniques4. Organization/management techniques

5. Variety of Teaching Styles5. Variety of Teaching Styles

PE Staff Development PE Staff Development ContentContent

Strategies: (continued)Strategies: (continued)6. “Super Starts”6. “Super Starts”

7. High activity roll taking7. High activity roll taking

8. High activity skills progressions8. High activity skills progressions

9. Modifying games/dance/sports9. Modifying games/dance/sports

10. “Quality Lesson Assessments”10. “Quality Lesson Assessments”

M-SPAN PE Inservice Evaluation: Quality

(N=155; Lowest = 1; Highest = 5)

0 1 2 3 4 5

Facilitator knowledge

Ease of understanding

Presentation skills

Organization

New information

Environment

AV materials

M-SPAN PE Inservice Evaluation: Usefulness

(N=155; Lowest = 1; Highest = 5)

0 1 2 3 4 5

Overall usefulness

Activity curriculum

Activitydemonstrations

Creatingenvironment

Promoting activityoutside of PE

Recommendations for Staff DevelopmentRecommendations for Staff Development

Complete detailed needs assessments in Complete detailed needs assessments in eacheach target environment first (e.g., yearly programs, target environment first (e.g., yearly programs, schedules, curricula)schedules, curricula)

Lead by experts (i.e., Lead by experts (i.e., experiencedexperienced middle school middle school physical educators and recreation specialists)physical educators and recreation specialists)

As long as possible (15 hours min for PE alone)As long as possible (15 hours min for PE alone)

Focus Focus directlydirectly on the measurable objectives on the measurable objectives

Interactive, recognizing implementers are Interactive, recognizing implementers are collaborating professionalscollaborating professionals

M-SPAN PE: M-SPAN PE: Effects on Student MVPA MinutesEffects on Student MVPA Minutes

14

15

16

17

18

19

20

Baseline Year 1 Year 2

Intervention

Control

MV

PA

Min

P

er L

esso

nM

VP

A M

in

Per

Les

son

N=24 Schools; 214 Teachers; 1847 LessonsN=24 Schools; 214 Teachers; 1847 Lessons

M-SPAN: Effects on MVPA in PEM-SPAN: Effects on MVPA in PE

1012141618202224

Baseline Year 1 Year 2

Int-BoysCo-BoysInt-GirlsCo-Girls

MV

PA

Min

P

er L

esso

nM

VP

A M

in

Per

Les

son

N=12 Intervention & 12 Control Schools; 1847 lessonsN=12 Intervention & 12 Control Schools; 1847 lessons

Effects of M-SPAN: Effects of M-SPAN: MVPA% During Lesson ContextsMVPA% During Lesson Contexts

-12 Intervention Schools--12 Intervention Schools-

0

10

20

30

40

50

60

70

80

Baseline

Year 2

MVPA Percent

Effects of MSPAN: Change (Year 2-Baseline) in MVPA Effects of MSPAN: Change (Year 2-Baseline) in MVPA Percent during Lesson ContextsPercent during Lesson Contexts

-10

-5

0

5

10

15

20

Control

Intervention

MVPA %

MVPA by GenderMVPA by Gender

51.4

32.2

57.464.5

46.548.4

0

10

20

30

40

50

60

70

Before School Lunch Time After School

Boys

Girls

N=24 M-SPAN schools; 151 areasN=24 M-SPAN schools; 151 areas(McKenzie et al., (McKenzie et al., Prev Med,Prev Med, 2000) 2000)

Per

cent

in M

VP

AP

erce

nt in

MV

PA

* = p<.01* = p<.01

* *

Results for PEResults for PE

Program increased PA (Int=18+%) without Program increased PA (Int=18+%) without increasing frequency or length of lessons (p<.02; increasing frequency or length of lessons (p<.02; d=.88)d=.88)

Greater increases evidenced in Year 2 than Year 1, Greater increases evidenced in Year 2 than Year 1, suggesting effects were cumulativesuggesting effects were cumulative

Program more effective on increasing MVPA rather Program more effective on increasing MVPA rather than vigorous PAthan vigorous PA

Program more effective on increasing boys’ PA than Program more effective on increasing boys’ PA than girls’girls’

Barriers to the PE InterventionBarriers to the PE Intervention Large number of schoolsLarge number of schools Limited time for staff development Limited time for staff development Guests in the school -- no direct powerGuests in the school -- no direct power PE class sizePE class size Facilities: limited grass fields, few gyms, few Facilities: limited grass fields, few gyms, few

indoor areasindoor areas PE staff turnoverPE staff turnover Natural resistance to changeNatural resistance to change

M-SPAN PE Teacher DebriefingUsefulness: (Lowest = 1; Highest = 7)

0 1 2 3 4 5 6 7

Clarity of handouts

Group sessions

Plans/materials

Follow-up

Out-of-schoolresources

Volunteers

M-SPAN PE Teacher Debriefing(Lowest = 1; Highest = 7)

0 1 2 3 4 5 6 7

Recommend M-SPAN to others

Overallimpression

Students’impression

Attempted tochange

Ease of makingchanges

M-SPAN PE Teacher Debriefing(Lowest = 1; Highest = 7)

0 1 2 3 4 5 6 7

Improved status ofPE at school

Improved personalinstruction

Helped clarifyschool PE goals

Administrationsupported changes