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Cost-Effectiveness of an Elementary School Active Physical Education Policy

A CHOICES study found that implementing an active physical education policy at the elementary school level increases physical activity and could lead to future reductions in BMI and obesity-related healthcare expenditures.

Barrett JL, Gortmaker SL, Long MW, Ward ZJ, Resch SC, Moodie ML, Carter R, Sacks G, Swinburn BA, Wang YC, Cradock AL. Cost Effectiveness of an Elementary School Active Physical Education Policy. Am J Prev Med. 2015 Jul;49(1):148-59. doi: 10.1016/j.amepre.2015.02.005.

Children playing basketballUpon visiting an elementary school physical education (PE) class, you would expect to find children engaged in exercise. In reality, the typical PE class in the US may not be so active. While most elementary schools do require some PE, students on average spend less than half of class time engaged in moderate-to-vigorous physical activity (MVPA). Additionally, PE activity levels are lower when more class time is spent organizing students or reviewing rules and techniques, and when PE classes are led by classroom teachers instead of trained PE specialists.

In recent years, school districts and states have pursued “active PE” policies, or policies aimed at increasing MVPA levels during PE class. In this study, researchers modeled an active PE policy intervention based on those passed by state legislatures in Texas and Oklahoma. The intervention policy specified the requirement that “50 percent of PE time be devoted to MVPA,” and implementation was assumed to take place during existing PE classes.

Using a simulation model, researchers scaled the state-based active PE policy to a national level and found that it would increase MVPA per 30-minute PE class by nearly two minutes, and cost $70 million in the first year to implement. BMI could be reduced after two years, and the policy would reduce healthcare costs by $60 million over a 10-year period.

“Physical education is the building block for getting kids active during the school day,” says lead author Jessica Barrett, MPH, a data manager and analyst and the Harvard Prevention Research Center. “We found that a policy ensuring that kids are active during PE class can increase physical activity levels and reduce healthcare costs. Even small increases in physical activity can lead to better health and also better learning for students in the classroom.”

The intervention was estimated to reach more than 17 million children aged 6–11 years attending over 47,000 public elementary schools in the 47 states eligible to adopt the active PE policy, representing 71% of the total 2015 US population in that age group. The study demonstrates the positive impact of an active PE policy, at a cost that appears reasonable compared to alternative approaches for increasing physical activity among children.

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