Promoting Physical Activity in School Settings

The increasing prevalence of childhood obesity in children has brought in adverse problems, and it is considered a serious health hazard in the public health sector. The condition is as a result of excess energy intake in relation to the amount expended by the body through functions of the body such as growth and development, and metabolism. Obesity has been noted among the young people (2-19) years in the U.S between the year 2003 and 2006. This increases their chances of being obese in adulthood. As a result, public health has emphasized physical activity to expend the excess energy.  Public approaches could be used alongside others to advocate for physical activity. There are four factors that fall under this approach. They include socio-cultural, physical environmental, intra-personal, and policy factors. Focusing on the fourth factor, the stakeholders in policy-making departments face many challenges because they are unacquainted about the subject. Epidemiologists are, therefore, needed to help them understand and efficiently make the right policies. Epidemiologic evidence are also required at various stages in policy-making. However, the process of making the policies is dynamic and faces a lot of constraints from its environment, such difficulties change the policy-making agenda. For instance, if PE is recognized as a program in physical activity, it is important for policymakers to comprehend the relationship between the same and the general physical activities so that they not only focus on the state’s requirements but also focus on devoting more time and teachings about additional skills for whole-life physical exercises.  To address physical activity, the following stages are followed to understand the process of policy-making. The agenda policy involves identification of issues that demand national attention. The formulation policy involves consideration of other judicial policy options for solving a problem. The third stage is policy adoption, where the policy makers accept a particular option among the alternative solutions available. The fourth is policy implementation. The chosen alternative is practiced. It is followed up through evaluation to find out if it meets its objectives. Finally, decisions to proceed, change or quit the program adopted.  Some pieces of evidence that promote physical activity among youths are categorized into three, based on the relationship with their risks. The first is strength and size of risks (preventable). For instance, diabetes result from obesity, and lack of physical activity causes obesity. Secondly are ineffective interventions in public health. For example, accessibility of places of physical exercise increases the chances of participating in physical activities. The intervention should be effective. The third category is about practicing effective interventions and calls for an emphasis on how interventions can be implemented. All the categories imply that actions should be taken to outweigh the risks of inactivity.  Many tools could be implemented to estimate the risks, and evaluate the effectiveness of an intervention. They include economic evaluations, health impact evaluations, and systematic reviews among others. Systematic reviewing tool is the most efficient. The community guide is an example of such and provides guidance on proven interventions that address lack of physical activity among the youth. According to the reviews, a school-based PE session should entail the following components; increasing the time for physical education, PE classes should include vigorous or moderate activities, incorporation of enhancements from the environment, as well as adopting interventions targeting certain populations. The guide faces such challenges as inadequate intervention research for other risk factors, difficulty in addressing various communities about scientific results, and limited training of public health officers.  Epidemiologic intervention should not only focus on internal but also the external validity of the subject, that is, whether a study’s findings are applicable to other settings, populations, as well as times. For instance, Klesges studied childhood obesity and found out that some variables are not present in the literature reviewed which talks about prevention of obesity. This necessitates another type of evidence that deals with adoption, implementation, and sustainability of an intervention. First is to develop, experimentally, more evidence that is relevant to the policy. It involves circumstances that exist naturally among populations that have experienced or not experienced specific factors. For instance, new schools could implement a policy that mandates PE on a daily basis. The policy should be followed up and evaluated to ascertain its effectiveness.   Legislation should be comprehended as a political process. It is subject to public interests, results of elections, and distribution of ideas in the Congress. So, epidemiologists should be aware of the political issues involved, and be willing to engage other advocates who champion the interest. For instance, they could inform the Congress about the contribution of physical activity to academic achievements.   Also, the factors affecting policy dissemination should be articulated. Here, the primary focus is on the best ways of accomplishing widespread dissemination of various policies and programs that enhance physical activity. Some factors that influence adoption of intervention include complexity, relative advantage, variability, and compatibility. Therefore, maximum attention should be employed on compatibility and besides apply the best ways of addressing policymakers about epidemiologic data.  Challenges experienced when disseminating policies in schools should be comprehended well, because the schools are controlled by local, federal, and state systems. The most outstanding problem is pressure on the need for excellent performance in standardized testing. Studies indicate that much time is spent on math, writing, and reading, while arts, PE, and social studies are allocated limited time. Also, there is limited understanding of the relationship between academic achievements and physical education. For that reason, legislatures should be informed that physical inactivity results in behaviors such as violence, and substance abuse among students. It also results in poor academic performance and reduced class attention and school attendance.  To enhance progress in the discussed policy, trans-disciplinary teams should be involved. Varied reviews of the discipline yield numerous ideas about promoting physical activity so that it is not only spearheaded by the public health group, but it is also done in urban planning, education, recreation, and environmentalism among any other fields. Efforts in tobacco control programs could be promoted by other disciplines such as medicine, epidemiology, behavioral science, advertising, and business. These collaborations have been proved to be significant in preventing obesity and increases policy implementation. Different stakeholders, such as travel engineers, administrators, PE teachers, students, parents, community members, as well as city planners should take part in implementation and advocacy. Epidemiologists should actively participate in the same and support the trans-disciplinary team.

Reference

Brownson, R. C., Chriqui, J. F., Burgeson, C. R., Fisher, M. C., & Ness, R. B. (2010). Translating epidemiology into policy to prevent childhood obesity: the case for promoting physical activity in school settings. Annals of epidemiology, 20(6), 436-444.