Abstract
Centers for Disease Control (CDC) guidelines recommend schools use a coordinated health approach to support healthy eating and physical activity. This study examines whether the number of healthy eating and physical activity programs and activities used by schools and their perceived success relate to students’ health-related fitness. This observational study used data from the Healthy Zone Schools Program. Data (collected in 2017–2019) were integrated from three sources: (1) school surveys, (2) FitnessGram®, and (3) the Texas Education Agency. Independent variables were the number of health promotion programs and activities and their perceived success; dependent variables were meeting Healthy Fitness Zone Standards (HFZ) for aerobic capacity and body mass index (BMI). We used mixed-effects logistic regression models. Fifty-six schools were in the analytic sample (n = 15,096 students with aerobic capacity data and n = 19,969 with BMI data). Results indicated the perceived success of physical activity programs/activities was significantly associated with students meeting HFZ standards for aerobic capacity (OR = 1.32, CI = 1.06–1.63). There was a significant direct association between the number of physical activity and healthy eating activities implemented (OR = 1.04, CI = 1.01–1.06) and students meeting HFZ for BMI. Schools using multiple health programs and activities need to balance the number provided with their capacity to maintain success.
Highlights
When examining school-level variables separately, enrollment, Title 1 status, English language learners, and school-level race/ethnicity were all related to students meeting Healthy Fitness Zone Standards (HFZ) standards for aerobic capacity
Model results revealed the total number of physical activity programs and activities provided by schools were not significantly associated with meeting HFZ standards for aerobic capacity (OR = 0.99, CI = 0.83–1.13; OR = 1.06, CI = 0.93–1.22, respectively)
The intraclass correlation coefficient (ICC) for meeting HFZ standards for body mass index (BMI) was 0.04, indicating about 4% of the variance in students meeting HFZ standards was explained by differences in schools
Summary
Improving children’s physical activity and nutrition are two public health priorities in the United States [1]. About 25% of children (6–17 years old) participate in the recommended 60 min per day of moderate-to-vigorous aerobic physical activity [2]. Many children consume an unbalanced diet that does not align with key dietary guidelines; 60% of U.S children consume fewer fruits, and 93% consume fewer vegetables than recommended [3]. Inadequate physical activity and a poor diet can negatively impact children’s weight status, metabolic, and cardiovascular health. Given the short- and longterm impacts of children’s health behaviors, there is a pressing need to help children adopt and maintain healthy lifestyles
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