UCSF

Physical activity is critical for children's health, but activity levels are low. Physical education (PE) provides an ideal opportunity for all students to be physically active and learn the skills to support activity throughout life. Eighty-six percent of states have policies mandating the minimum PE minutes that students should receive. In California, the state with the largest number of public school students, education policy mandates elementary students receive 200 minutes of PE every 10 days. Yet policy compliance both nationally and in California is low, especially at the elementary level. The purpose of this dissertation was to use participatory action research methods, which include deliberate power sharing and collaboration between the researcher and the researched, to objectively assess and improve PE quality and quantity in elementary schools in the San Francisco Unified School District (SFUSD), with a focus on PE policy compliance. After forming a strategic alliance between the SFUSD, the San Francisco Department of Public Health, and UCSF, we conducted a 2-year quasi-experimental study to (1) assess PE policy compliance in 20 elementary schools in the spring of 2011 (Time 1); (2) share results within the school district and publically disseminate data on non-compliance; and (3) examine changes in PE from 2011 to 2013 (Time 2) that may have resulted from the work of the strategic alliance, including publically disclosing data. PE schedules were collected and PE classes were directly observed (Time 1, n= 91; Time 2, n=101) using a validated systematic observational tool. Results from Time 1 were shared throughout the district and received local media coverage. From Time 1 to Time 2, the proportion of schools meeting the PE mandate increased from 20% to 30% (p<0.03). PE increased by 11 minutes/week based on teachers' schedules (95% CI: 3.0, 19.6) and by 14 minutes/week (95% CI: 1.9, 26.0) based on observations. Key stakeholders reported increases in priority and funding for PE and attributed improvements to the public disclosure of local data on the status of PE. Public disclosure could be a method for increasing PE quantity and ensuring greater policy compliance. Testing this approach in other settings is warranted.