Brief: Active Physical Education (PE) in Iowa

The information in this brief is intended only to provide educational information.

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This brief summarizes the findings from a CHOICES Learning Collaborative Partnership model examining a strategy supporting the implementation of a guideline that 50% of physical education (PE) class time be spent in moderate-to-vigorous physical activity, consistent with best practice guidelines in quality physical education programs.

The Issue

In Iowa, only three out of every 10 children meet the national recommendation for participating in 60 minutes or more of moderate-to-vigorous physical activity each day.1 Evidence shows that physical activity helps kids grow up at a healthy weight, preventing diseases like diabetes and heart disease. Physical activity also has important brain health benefits for students, such as promoting cognition and reducing symptoms of depression.2 High-quality physical education programs in schools can help students get the recommended amount of daily physical activity.2 However, research shows that some children may spend less than half of the PE class being physically active.3

About Active PE

Active PE would support educators’ equipment, curricular, and training needs to ensure that their students can participate in high-quality physical education. Curriculum training specialists would train physical education teachers in Iowa schools in an evidence-based, standards-aligned curriculum and training program that can increase the quality of the existing physical education program and the proportion of time students are active while in PE class.4 This strategy would support the implementation of Iowa’s Physical Education standards and aligns with Iowa Department of Public Health’s goal to ensure students have the opportunity to engage in one hour of physical activity each day.5 Implementation of Active PE would include a two-day training workshop for PE teachers, providing the necessary curriculum and equipment materials for schools, and include state-level coordination.6,7

Comparing Costs and Outcomes

A CHOICES cost-effectiveness analysis compared the costs and outcomes over 10 years (2020-2030) of implementing Active PE with the costs and outcomes associated with not implementing the strategy.

Implementing Active PE in Iowa is an investment in the future. By the end of 2030:
If Active PE was implemented in Iowa, then by the end of 2030, 495,000 children would be reach over 10 years. It would cost $8 per child to implement Active PE. Each child would get 7 more active minutes per week.

Conclusions and Implications

Implementation of Active PE strategies is projected to increase physical activity and improve the health of 495,000 elementary and middle school students in Iowa over 10 years. On average, each student would participate in seven more minutes of moderate-to-vigorous physical activity during each school week. We also estimate there will be 137 fewer cases of obesity in Iowa in 2030 alone just by implementing these strategies to increase the active time during existing physical education classes.

This strategy also provides professional development opportunities for 912 teachers annually at 1,033 schools, enabling them to learn new instructional strategies to foster a fun and enjoyable environment where children can gain standards-based skills that support lifelong physical activity.4 Implementing the Active PE best practice guideline would ensure that most students in Iowa could benefit from high-quality PE time without requiring changes to staffing or school schedules. This could be incorporated into a comprehensive plan to help support healthy growth and development at an average cost of under $8 per student per year.

Strategies to ensure that students have access to high-quality physical education classes where more time is spent in active movement can help children get more physical activity.2 In addition to promoting a healthy weight, physical activity benefits students in other ways. Regular physical activity builds strong bones and muscles, reduces symptoms of anxiety and depression, and improves cognition.2 Additionally, evidence shows that when children are physically active, they tend to perform better in the classroom, have higher school attendance, and have fewer disciplinary problems.8 These other benefits are not quantified in this analysis but are key for children’s education and well-being.


  1. Child and Adolescent Health Measurement Initiative. 2018-2019 National Survey of Children’s Health (NSCH) data query. Accessed October 29, 2020.

  2. 2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Washington, DC: U.S. Department of Health and Human Services, 2018.

  3. Institute of Medicine. Educating the Student Body: Taking Physical Activity and Physical Education to School. Washington, DC: National Academies Press, 2013.

  4. Lonsdale C, Rosenkranz RR, Peralta LR, Bennie A, Fahey P, Lubans DR. A systematic review and meta-analysis of interventions designed to increase moderate-to-vigorous physical activity in school physical education lessons. Preventive Medicine. 2013;56(2):152-161.

  5. Iowa Department of Public Health. Play Your Way. Accessed November 30, 2020.

  6. Barrett JL, Gortmaker SL, Long MW, et al. Cost Effectiveness of an Elementary School Active Physical Education Policy. American Journal of Preventive Medicine. 2015;49(1);148-159.

  7. Cradock AL, Barrett JL, Kenney EL, et al. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Preventive Medicine. 2017; 95;S17-S27.

  8. Centers for Disease Control and Prevention, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion. Physical Education. April 21, 2020. Accessed December 15, 2020.

Suggested Citation:

Hopkins H, Lange J, Olson E, Taylor-Watts S, Jenkins L, McCulloch S, Barrett J, Reiner J, and Cradock AL. Iowa: Active Physical Education (PE) {Issue Brief}. Iowa Department of Public Health, Iowa Department of Education, Des Moines, IA, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; April 2021. For more information, please visit

The design for this brief and its graphics were developed by Molly Garrone, MA and partners at Burness.

This issue brief was developed at the Harvard T.H. Chan School of Public Health in collaboration with the Iowa Department of Public Health through participation in the Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This brief is intended for educational use only. This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376). The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.