Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children. A DISSERTATION Submitted to the Faculty of the School of Graduate Studies and Research of California University of Pennsylvania in partial fulfillment of the requirements for the degree of Doctor of Health Science (DHSc) in Health Science and Exercise Leadership by Denae Kessel Dostal Research Adviser, Dr. Rebecca Hess California, Pennsylvania 2019 CALIFORNIA UNIVERSITY of PENNSYLVANIA CALIFORNIA, PA DISSERTATION APPROVAL Health Science and Exercise Leadership We hereby approve the Dissertation of Denae Kessel Dostal Candidate for the degree of Doctor of Health Science (DHSc) Date Faculty Rebecca Hess 12-1-2019 ______________ Rebecca Hess, Ph.D. (Chairperson) 12-1-19 Carol Biddington, Ed.D. 12-1-2019 Joseph Zisk, Ed.D. Acknowledgements This process has been a rewarding, challenging, and transformative experience. For that I would like to thank my research advisor, Dr. Rebecca Hess for her guidance, support, and organization throughout every stage of my research; which brought out the best in me! I would also like to thank my committee members, Dr. Carol Biddington and Dr. Joseph Zisk, for their knowledge, thoroughness, and support along with Dr. Melissa Sovak for her help with my statistical analysis. I would like to recognize the many college professors who helped, inspired, and challenged me throughout my time at West Virginia Wesleyan and CALU. I am forever grateful for my family. My parents, Dave & Donna Kessel, for their unconditional love, encouragement, support, and patience as I have navigated the pathways of life. My sister and brother-in-law, Devan and Justin Folts, for always loving me and being in my corner…rock music! Especially my husband, Dan (and our doodles Timber & Mountie), for believing in me, helping me through the ups and downs, motivating me to keep going, and making sure I took breaks for fun and adventures…thank you for helping me achieve my dream! To the administration at Gateway Regional Schools thank you for your unwavering support of me and my research! To my teaching family and my students at Littleville Elementary, you have been the ultimate cheering section. I can’t thank you enough for your understanding, encouragement, support, and solidarity! Lastly, I would like to thank two titans of physical education, who spent their careers fiercely advocating for the health and well-being of children and who have been such a positive influence on my career. Richard O’Neil whose energy and kindness first instilled a love for physical education within me at Burlington Elementary, and Tim Gamble, whose dedication, partnership, and motivation inspired me to be a better PE teacher, coach, and person. TABLE OF CONTENTS Page List of Figures ………………………………………………………………. i Abstract………………………………………………………………………ii Introduction…………………………………………………………………..1 Methods………………………………………………………………………9 Research Design………………………………………………………….9 Participants………………………………………………………………10 Instruments………………………………………………………………11 Procedures……………………………………………………………….13 Data Analysis……………………………………………………………14 Results……………………………………………………………………….17 Quantitative Phase One………………………………………………….17 Demographics……………………………………………………….17 Research aims……………………………………………………….21 Research aims summary…………………………………………….28 Additional Findings……………………………………………………..29 Summary of Phase One Results…………………………………………31 Qualitative Phase Two…………………………………………………..32 Full-time…………………………………………………………….32 Part-time………………………………………………………………38 Itinerant……………………………………………………………….41 Further Insights and Summary……………………………………………48 Discussion…………………………………………………………………….50 Conclusion……………………………………………………………………57 Future Directions for Research……………………………………………….58 References…………………………………………………………………….59 Appendix A Review of the Literature………………………………………….64 Appendix B Problem Statement………………………………………………..96 Appendix C Additional Methodology…………………………………………..98 C1- School Superintendent/Committee Letter and Approval……………….99 C2- Recruitment Email and Survey Link………………………………….103 C3- Recruitment Email Phase Two………………………………………..105 C4- Informed Consent……………………………………………………..107 C5- Email Panel of Experts………………………………………………..109 C6- Survey Questions Phase One………………………………………….111 C7- Interview Questions Phase Two………………………………………118 C8- IRB Materials…………………………………………………………120 References……………………………………………………………………..123 LIST OF FIGURES Figure 1 Page Wave analysis of response rate by week……………………………17 Figure 2 Participant’s teaching experience by years………………………….18 Figure 3 Participants’ field/s of study in conjunction with degree……………19 Figure 4 Participant’s additional credentials and certifications……………….20 Figure 5 Participant’s teaching assignment……………………………………21 Figure 6 PETE programs covering MVPA……………………………………22 Figure 7 PE specific professional development offered by participant’s school ……………………………………………………………………….22 Figure 8 PE specific professional development, teacher initiated…………….23 Figure 9 Attendance at a state, regional, or national PE conference………….23 Figure 10 Professional development cost………………………………………24 Figure 11 Strategies aligned with Theory of Expanded, Extended, and Enhanced MVPA (TEO)………………………………………………………..24 Figure 12 Specific curriculum interventions in use…………………………….25 Figure 13 Days per week students receive PE which may affect MVPA frequency ……………………………………………………………………….25 Figure 14 PE minutes per class which may affect MVPA frequency………….26 Figure 15 PE class size which may affect MVPA frequency…………………..26 Figure 16 Factors promoting and preventing MVPA utilization……………….27 Figure 17 Reduction in PE minutes which may contribute to lack of sufficient time for MVPA……………………………………………………………27 Figure 18 Location of PE classes which may affect MVPA frequency…………28 Figure 19 Contingency table of teaching assignment effect on educational degree ………………………………………………………………………..31 Figure 20 NVivo word cloud of frequent words used by phase two participants ……………………………………………………………………….46 Abstract The purpose of this study mixed-method study was to explore physical education (PE) based MVPA strategies/interventions used by elementary physical education (EPE) teachers within public schools in Western Massachusetts. Research aims included: (1) are EPE teachers in Hampshire/Hampden County aware of MVPA concepts/strategies/interventions, (2) how are EPE teachers utilizing MVPA interventions, (3) what specific interventions are being implemented, and (4) how frequently? This study also sought to discern if MVPA strategies in use aligned with the theory of expanded, extended, and enhanced opportunities (TEO) for physical activity using a sequential explanatory mixed-method design. Phase one consisted of collecting quantitative data using an electronic survey link sent to all EPE teachers in Hampshire/Hampden County, Massachusetts. Phase two collected qualitative data in the form of collective case study using open-ended interviews. EPE teachers were designated to a collective case by teaching assignment: full-time, part-time, or itinerant. Participants included 25 EPE teachers (phase one) and five EPE teachers (two full-time, one part-time, and two itinerants) for phase two. Phase one survey data was analyzed using SurveyMonkey analysis tools and SAS frequency tables. Phase two follow-up interviews were coded into NVivo software for text analysis. Results showed that EPE teachers in Hampshire/Hampden counties are aware of MVPA concepts, and that specific strategies in use align with expanded and enhanced opportunities outlined in the TEO, however, EPE teachers’ assignment did not have direct impact on their ability to implement MVPA. All EPE teachers interviewed, regardless of teaching assignment, reported feasibility of strategies, access to PE specific professional development, and insufficient PE class time as challenges to their implementation of MVPA. Keywords: elementary physical education, MVPA, activity promotion STRATEGIES FOR INCREASING MVPA IN CHILDREN 1 Moderate to vigorous physical activity (MVPA) in children and adolescents creates a powerful impact on their quality of life (Kohl, 2013). Adolescents that regularly participate in physical activity have increased bone and muscular development, heightened emotional wellness, increased attentiveness and achievement in the academic classroom, and are at a decreased risk for developing chronic illnesses such as heart disease, obesity and type two diabetes in adulthood (Center for Disease Control and Prevention, (CDC), 2017). Physical Activity Guidelines for Americans (CDC, 2017) recommend that children and adolescents achieve 60 minutes of MVPA daily. This activity should also include elements that support cardiovascular endurance and muscle/bone strengthening exercises (CDC, 2017). Current reports find that only 28% of children in the United States achieve the daily activity recommendations, and that one in five school-aged children are considered obese (CDC, 2017). Since children and adolescents spend most of their day in school, educators have the opportunity and responsibility to ensure the attainment of these physical activity recommendations through quality school-based strategies (Calvert, Mahar, Flay, & Turner, 2018). Physical education-based interventions are a major component to overall school-based MVPA strategies. Physical education (PE) MVPA intervention strategies highlighted in the literature include providing increased PE class minutes (Reed, Maslow, Long, & Hughey, 2013), fitness focused curriculum (Lonsdale et al., 2013), and use of MVPA specific protocols (Beets, Okely, Weaver, Webster & Lubans, 2016). Increasing PE class minutes is a logical strategy for increasing students MVPA as it allows PE teachers more time to devote to the implementation of MVPA interventions. Yet, as of 2014, 70% of school districts in the United States did not meet the recommended PE time mandate for elementary students to receive a minimum of 150 minutes and secondary students, STRATEGIES FOR INCREASING MVPA IN CHILDREN 2 225 minutes of PE weekly (CDC, 2014). Daily physical education has shown to significantly benefit student fitness performance, body composition, and cognitive function (Reed et al., 2013). Physical and cognitive outcomes in elementary and middle school students who participated in daily 45-minute physical education classes were compared to control groups who participated in only one 45-minute physical education class weekly. Results indicated that students who participated in daily PE performed significantly higher on FitnessGram fitness testing (measuring muscular strength, flexibility, and cardiovascular endurance) and cognitive tests analyzing fluid intelligence and perceptual speed (Reed et al., 2013). Movement and sport concepts have been the focus of PE curriculum for decades and are supported in the National Association for Sport and Physical Education (NASPE) standards (Kohl, 2013). As childhood obesity rates have increased, new curriculum trends seek to emphasize the development and maintenance of student fitness (Kohl, 2013). Fitness focused curriculum strategies include incorporating fitness concepts into all PE lessons, using fitness testing to guide lesson focus, and emphasizing multi-dimensional fitness including strength, flexibility, and cardiovascular endurance (Lonsdale et al., 2013). Specific MVPA curriculum protocols have been developed for implementation in PE classes. Lonsdale et al. (2012) systematically reviewed 14 of these interventions which showed an increase of 24% of class time spent in MVPA. Of the interventions reviewed, the Sports, Play & Active Recreation for Kids (SPARK) intervention, which used classroom organization, management, and instruction to target MVPA time in every PE class resulted in a 15% increase of MVPA minutes, compared to randomly assigned control group not receiving SPARK interventions (Verstraete, Cardon, De Clercq & De Bourdeaudhuij, 2007). Additionally, other research used the Trial Activity for Adolescent Girls (TAAG) intervention that incorporated skill STRATEGIES FOR INCREASING MVPA IN CHILDREN 3 building (student led activity bursts), dynamic equipment choices (medicine balls, balance boards) and class management strategies (less wait time in class), all emphasizing MVPA during PE classes (Webber et al., 2008). Using a cluster randomized control trial, Webber et al. (2008) reported an increase of sustained MVPA over 104 weeks while using TAAG concepts during PE. Additionally, Young, Phillips, Yu, and Haythornthwaite (2006) promoted MVPA during physical education classes by focusing on lessons that incorporated the highest amounts of movement (e.g., soccer vs. softball) and skill competency instead of proficiency. This randomly controlled design produced a 16% increase of MVPA among the experimental groups when compared to the control group participating in traditional PE lessons. (Young et al., 2006). It is unclear how widely these MVPA specific interventions are used by PE teachers. Interventions often require fees and extensive training before they can be implemented. Researchers analyzed the cost effectiveness of providing elementary aged students with Active Physical Education Policy that directly addressed MVPA levels (Barrett et al., 2015). Using a cohort model, they hypothesized that to adequately provide programming for 6-11-year-old students that would achieve at least 150 weekly minutes of PE and equip elementary physical educators with enhanced certifications and knowledge of MVPA, a cost of $70.7 million dollars nationally in the first year and within 10 years, $235 million could be expected (Barrett et al., 2015). Barrett et. al (2015) contend that this programming would however reduce healthcare cost by $60.5 million in obesity related expenditures. Active Physical Education Policy advocates do admit that implementing such programs often neglect school districts that serve lower socio-economic populations due to lack of funding and resources (Barrett et al., 2015). Beets et al. (2016) introduced the theory of expanded, extended, and enhanced opportunities (TEO) for physical activity of children and adolescents to create a unifying STRATEGIES FOR INCREASING MVPA IN CHILDREN 4 language and logical approach to the phenomena of PA/MVPA interventions. The TEO proposes that the reason for lackluster improvements in PA and MVPA statistics for youth is due to a crisis between interpretation and application of strategies and interventions. To successfully promote behavior-change, interventions must follow three approaches according to TEO: expansion of opportunities to include new occasions to be active, extension of existing opportunities, and/or enhancement of existing opportunities (Beets et al., 2016). The TEO suggests practical strategies for expanding PA/MVPA opportunities that include replacing sedentary activities with more active tasks, extending opportunities by adding additional PE lessons per week, and enhancing PE classes by providing more dynamic high intensity activities/sports. A cluster randomized controlled trial (Kriemler et al., 2010) where expansion, extension, and enhancements of PA opportunities were all implemented in conjunction with specialized professional development for EPE teachers, resulted in an increase of seven minutes of MVPA per school day compared to a five-minute decrease of MVPA minutes per school day in control group schools. Over the entire 180 days of school, this study provided an additional 21 hours of MVPA for each student which could produce a ripple effect of health benefits. In a follow-up to the TEO study, the structured days hypothesis (SDH) was introduced which contends that the consistent presence of structure, routine, and regulation within a day positively forms behaviors of children (Brazendale et al., 2017). Creating solid PA/MVPA opportunities within the school day is vital to shaping lasting healthy behaviors. In addition to consistent structure, PA/MVPA interventions are more successful when containing elements of fun and are presented in an engaging format (Jago et al., 2015) Beets et al. (2016) contended that TEO aligned strategies will create engaging, consistent, and meaningful MVPA opportunities in ways that are more realistically implemented in school settings and act as a guide for future STRATEGIES FOR INCREASING MVPA IN CHILDREN 5 research. Practicality, implementation, and cost are the ultimate considerations when choosing whether to expand, extend, or enhance PA and MVPA opportunities. The TEO creates a variety of options for success across different environments and circumstances. However, to realistically implement MVPA strategies current practices and the climate surrounding the MVPA intervention phenomena need to be better understood. Additionally, EPE teachers must have meaningful professional development opportunities to learn the strategies required to increase MVPA, especially if MVPA concepts were not addressed in their physical education teacher education (PETE) program. The National Association for Sport and Physical Education (NASPE) updated its National Standards for Initial Physical Education Teacher Education in 2008 with specific language mandating that new PE teachers have knowledge of fitness related concepts and strategies, including MVPA (Heindorn, 2014). However, many PETE programs have been slow to update their curriculum to reflect this change (Taliferro, Ayers & Housner, 2017). A 2017 study surveyed 609 PETE programs across the U.S.; results revealed that 53.2% of program respondents had adjusted PETE curriculum to reflect the NASPE update, yet these results only account for 156 PETE programs (only 25.6% of programs responded) (Taliferro, Ayers & Housner, 2017). This study revealed that even nine years after the NASPE update, only a little over half of PETE programs surveyed had updated curriculum which may directly affect future PE teacher’s grasp of fitness and MVPA concepts. Castelli and Williams (2007) examined the health-related fitness (HRF) knowledge of PE teachers. Results indicated that though PE teachers in the study were highly confident that they possessed a high level of HRF knowledge, only 38% of those teachers passed (a score of 83% or above) a fundamental HRF knowledge test (Castelli & Williams, 2007). Common errors were recorded in fitness terminology, healthy heart STRATEGIES FOR INCREASING MVPA IN CHILDREN 6 rate zones, workout intensity benchmarks, and fitness program progression which all have direct impacts on successful MVPA (Castelli & Williams, 2007). These statistics highlight the need for meaningful professional development opportunities that address updated NASPE standards and allow all PE teachers to receive education on fitness and MVPA concepts, yet many PE teachers report receiving little content specific professional development provided by their school districts (Cardina & DeNysschen, 2018). PE teachers also detail fewer opportunities to attend conferences, workshops, and in-service trainings and are less likely to receive financial compensation for professional development they receive outside of school hours (Cardina & DeNysschen, 2018). The NASPE update also calls for the implementation of Comprehensive School Physical Activity Programs (CSPAP) where PE teachers serve as PA leaders within their school community and encourages PE teachers to use a school-wide approach where PE teachers often provide PA and MVPA opportunities before and after school (Webster & Nesbitt, 2017). This expands the importance of PE teachers receiving increased training and knowledge to successfully implement appropriate programs (Carson, Castelli, Hodges & Kulinna, 2017). Researchers agree that MVPA is essential for optimal health in childhood. While research has focused on creating intervention strategies to increase levels of MVPA in children and adolescents, many randomized controlled trials utilizing these strategies have produced only small improvements (Beets et al., 2016). Interventions that have high levels of feasibility and effectiveness require specialized training for EPE teachers and/or sufficient funding (Dallolio, Ceciliani, Sanna, Garulli, & Leoni, 2016). MVPA research often neglects specific evidencebased research on how to ensure that intervention strategies can be realistically applied and effectively implemented in a variety of socio-economic school environments (Stathi & Sebire, STRATEGIES FOR INCREASING MVPA IN CHILDREN 7 2011) as well as identifying barriers EPE teachers may encounter that prevent successful implementation. The purpose of this mixed-method study was to explore physical education based MVPA interventions used by EPE teachers within public schools in Western Massachusetts. Research aims included: • Are EPE teachers in Hampshire/Hampden County aware of MVPA concepts/strategies/interventions? • How are EPE teachers in Hampshire/Hampden County schools utilizing MVPA interventions? • What specific interventions are being implemented? • How frequently are these strategies used? • What factors promote/prevent teacher’s from MVPA knowledge and/or these strategies from being used? • How do MVPA strategies differ between full-time, part-time, and itinerant EPE teachers? • How are strategies in use aligned with the current theory of expanded, extended, and enhanced opportunities (TEO) for physical activity? This mixed-method study hoped to reveal such barriers as well as MVPA best practices used among EPE teachers and possibly identify new or innovative MVPA activities not shown in empirical research that are being used in day-to-day EPE lessons. The employment and scheduling of EPE teachers was considered to affect implementation of effective MVPA strategies and can vary widely from school to school. Full-time EPE teachers often must accommodate large class sizes, part-time EPE teachers may not have access to quality equipment STRATEGIES FOR INCREASING MVPA IN CHILDREN 8 and facilities, decreased planning time and professional development, and itinerant EPE teachers often share classroom space and divide resources among multiple schools. This research also examined the differing cases of full-time, part-time, and itinerant physical education teachers and how their scheduling and individual resources might explain and ultimately influence their use of MVPA intervention strategies. Data collected during this mixed-method research also looked to identify trends of the TEO within current MVPA strategies used by EPE teachers within Western Massachusetts in hopes that a deeper understanding of these teachers’ experiences may lead to more comprehensive implementation of successful MVPA strategies. 9 STRATEGIES FOR INCREASING MVPA IN CHILDREN Methods Research Design A sequential explanatory mixed-method design was used for this study which allowed for the collection of quantitative and qualitative data in two phases. Phase one consisted of collecting quantitative data using an electronic survey link sent to all EPE teachers in Hampshire County, Massachusetts. The survey, designed by the researcher, included questions aligned with specific research aims (e.g., What specific interventions are being implemented? How frequently are these used?) and hoped to reveal insights regarding specific MVPA interventions, protocols, and tools used by EPE teachers. This data was analyzed and used to guide phase two, the qualitative follow-up. Participants in phase two were solicited from those EPE teachers who participated in phase one to randomly form collective case studies. Phase two collected qualitative data in the form of collective case study using open-ended interviews. Collective case study allowed an in depth and personal look into the daily teaching schedules and strategies of current EPE teachers and examined, in more depth, what if any MVPA interventions are being utilized, as well as needs and barriers associated with the implementation of MVPA interventions. EPE teachers often work in vastly different environments depending on whether they are full-time, part-time, or an itinerant teacher. Examining these groups as individual cases making up the greater collective case of EPE teachers enhanced the understanding of each groups’ unique experience. This provided a strong basis for application of realistic strategies and served as a guide to provide EPE teachers with meaningful MVPA resources. Limitations to this mixed method study design were that it only provides a snapshot of teachers within Western Massachusetts and may not necessarily reflect the experiences of all EPE teachers nationwide. EPE teachers using MVPA may also have been STRATEGIES FOR INCREASING MVPA IN CHILDREN 10 more inclined to participate in this study which may have limited sampling and put emphasis on curriculum-based strategies that are currently in use. Results could however, indicate trends in the MVPA phenomenon that may lead to further research and application. Obtaining collective case participants from all three EPE teacher groups, which was dependent on adequate survey return from these groups, also limited results. Being a current full-time EPE teacher (and former itinerant PE teacher), the researcher, had to approach this study with objectivity to ensure open perspective when interpreting data. Participants Participants were 25 public EPE teachers in Hampshire and Hampden County (Massachusetts Department of Elementary and Secondary Education, 2018), Western Massachusetts. Hampshire and Hampden County EPE teachers are employed as full-time, parttime, or itinerant teachers. The solicitation of school emails to secure EPE teachers as research participants was approved by the researcher’s school district superintendent and school committee chair (Appendix C1). Once IRB approval was achieved, the researcher also sent an email informing all school district superintendents in Hampshire/Hampden counties that their district EPE teachers would be given the opportunity to participate in this research and highlighted that participation was strictly voluntary and would not interfere with participants teaching duties (Appendix C1) Purposeful sampling occurred for phase one through a recruitment email with survey link (Appendix C2) sent to all EPE teachers in Hampshire County requesting participation in the study. Email addresses were obtained through public school district websites. Consent was implied upon anonymous response to the survey. As a part of the survey, EPE teachers were further asked to identify if they are willing to participate in phase two STRATEGIES FOR INCREASING MVPA IN CHILDREN 11 of the research. Upon volunteering for phase two, willing participants were emailed by researcher (Appendix C3). Data from all respondents were analyzed, then individual case studies were chosen from those willing to participate in phase two separated by the criteria of full-time, part-time, and itinerant teacher distinction. Informed consent (Appendix C4) was then emailed to those participants selected for phase two interviews describing that process. This study hoped to gain a comprehensive sampling to solicit cases for each teacher group. Phase one yielded 25 participants of which five volunteered to be interviewed for phase two. These five participants (two full-time, one part-time, two itinerant) were grouped into phase two collective cases, which included teachers from school districts with varying socioeconomic backgrounds and organizational designs (i.e. regional school districts) (Creswell, 2015). Instruments Instruments for the research included quantitative phase one surveys followed by qualitative phase two interviews. Quantitative phase one data was collected using a survey created by the researcher via online (SurveyMonkey) survey tools and emailed to all EPE teachers within public elementary schools in Hampshire and Hampden County, Western Massachusetts (Appendix C2). Email contact information was obtained through school district websites and Massachusetts Association for Health, Physical Education, Recreation and Dance (MAPHERD) member database. Phase one survey. The Survey Monkey online survey instrument consisted of questions with numerically coded closed-ended answers corresponding to how often EPE teachers used a variety of MVPA strategies and interventions, as well as, options for further elaboration in semiopen-ended answers. Questions were evaluated by a panel of physical education experts STRATEGIES FOR INCREASING MVPA IN CHILDREN 12 (Appendix C5) to increase content validity (Creswell, 2015). The online survey instrument contained 22 questions (Appendix C6) including demographics (type of school, teacher designation, years teaching, etc.) and questions addressing the overall research aims (e.g., Are you aware of MVPA concepts? What specific MVPA interventions are you implementing in your classes? How frequently do you use these interventions?). Of the approximately 60 EPE teachers in Hampshire and Hampden County, an acceptable return rate of 25 (40%) respondents was achieved (Creswell, 2015). Data was analyzed by numerical coding and scored to show trends which were used to form interview questions for phase two convenience collective case study groups. Phase two interviews. Teachers who volunteered to participate in phase two, by indicating their willingness in the phase one Survey Monkey online survey instrument, were classified into three specific cases based on their answer to the demographic question on initial survey which identified, full-time, part-time, and itinerant teachers. Open-ended interviews were conducted by the researcher with each individual teacher via phone. Interviews included follow up questions to the phase one survey (How does your teaching schedule affect your ability to implement MVPA interventions? What specific resources would allow you to implement more MVPA interventions?). Phase one data analysis of the survey responses guided specific questions formed for phase two. Phase two questions which extended the research were based on the specific aims of the research are outlined in Appendix C7. Interviews were recorded using Tape A Call Pro and used for data analysis only. Data was transcribed, coded, and analyzed through sentiment analysis for categorizing opinions, and determining positive, negative, or neutral attitudes. Thematic content and narrative analysis were conducted using NVivo software. STRATEGIES FOR INCREASING MVPA IN CHILDREN 13 Validity and reliability were achieved using triangulation and member checking (Creswell, 2015). Triangulation was achieved by corroborating evidence of the experiences between full-time, part-time, and itinerant EPE teachers, types of data (quantitative phase one and qualitative phase two), and methods of data collection (survey and open-ended interviews). Member checking was conducted by contacting one participant from each case (full-time, parttime, and itinerant) after data analysis and ask questions regarding whether study themes were realistic and complete and if findings represented fair interpretation of MVPA strategies used within EPE teachers in Hampshire and Hampden County. Procedures Quantitative phase one. Approval from the researcher’s superintendent and school committee chair were achieved and a research intention email was sent to Hampshire/Hampden county superintendents before the start of the study and after institutional review board (IRB) approval (Appendix C1). After the study was approved by the California University of Pennsylvania IRB (Appendix C8), but prior to the start of the study, survey questions were reviewed by a panel of three experts in the areas of curriculum design, elementary physical education, and elementary education (Appendix C5). Public records of school emails were used to identify and contact the teachers. The email with survey link was then sent. Participant consent was implied upon receipt of survey response. Upon response, participants received a thank you email written by researcher. Two weeks after initial survey emailing, follow-up surveys were sent to non-respondents. To check for response bias, a wave analysis was conducted which involved grouping returns by intervals (e.g., each week) to check if the answers to a few specific questions changed from the first week to the final week in the study (Creswell, STRATEGIES FOR INCREASING MVPA IN CHILDREN 14 2015). After three additional survey mailings, a meaningful sample (40%) was not achieved through EPE teachers in Hampshire County alone, therefore the researcher amended additional sampling from neighboring Hampden County, Western Massachusetts. Recruitment of Hampden County EPE teachers followed the same procedures as recruitment of Hampshire County EPE teachers. Qualitative phase two. Participants from phase one, willing to participate in qualitative phase two indicated so by following instructions at the end of the Survey Monkey online survey instrument and provided email address (Appendix C3). EPE teachers willing to participate in the phase two interviews were then categorized into three case study groups according to teaching assignment with convenience sampling for each group. The researcher emailed participants with an informed consent form (Appendix C4) which was completed and emailed back to researcher along with request of a reliable phone number and potential interview times; interviews were scheduled based on participant convenience. The researcher conducted one on one interviews which contained open-ended questions derived from data analyzed from phase one survey response and included questions relative to individual participants specific teaching status (fulltime, part-time or itinerant). The researcher recorded phone interviews using Tape A Call Pro for further analysis only with data coded and entered into NVivo computer database for analysis. Data was not released in any form and destroyed at the end of the study. Data Analysis A sequential explanatory mixed-method design was used and allowed for the collection of quantitative and qualitative data in two phases. Phase one consisted of collecting quantitative STRATEGIES FOR INCREASING MVPA IN CHILDREN 15 data using a recruitment email with Survey Monkey link (Appendix C2) sent to all EPE teachers in Hampshire and Hampden County, Massachusetts. The Survey Monkey online instrument (Appendix C6), designed by researcher, included questions aligned with specific research aims. This data was analyzed and used to guide phase two, the qualitative follow-up. Participants in phase two were recruited from those EPE teachers who participated in phase one. Phase two collected qualitative data in the form of collective case study using open-ended interview questions based on research aims. Data analysis was descriptive and visual in representing survey as well as interview data. Quantitative phase one. A SurveyMonkey online instrument (Appendix C6) addressed demographics as well as the following general research aims: RA1: Are EPE teachers in Hampshire/Hampden County aware of MVPA concepts/strategies/interventions? RA2: How are EPE teachers in Hampshire/Hampden County schools utilizing MVPA interventions? RA3: What specific interventions are being implemented? RA4: How frequently are these strategies used? RA5: What factors promote/prevent these strategies from being used? Survey data was analyzed using online software via Survey Monkey consisting of numerical coding of questions to reveal mean, median, and standard deviation for specific questions. Contingency tables were created to examine significant responses. SAS software was also used to complete Fisher’s Exact test, analyzing responses from full-time, part-time, and itinerant EPE teacher groups. Trends from phase one data analysis were used to guide question formulation for qualitative phase two. STRATEGIES FOR INCREASING MVPA IN CHILDREN 16 Qualitative phase two. Semi-structured interviews were conducted via phone with EPE teachers volunteering from phase one. These interviews were recorded using Tape A Call Pro for analysis purposes only. Interview data reduction used case and cross case analysis to identify MVPA intervention commonality, differences, and themes within the three cases involving fulltime, part-time, and itinerant EPE teachers. A sentiment analysis was conducted for categorizing opinions, and determining positive, negative, or neutral attitudes. Thematic content and narrative analysis were conducted using NVivo software to organize and manage data collected from interviews. Triangulation validation was achieved by gathering information from multiple sources, types of data, and quantitative/qualitative methods of collections. Member checking also served to affirm the credibility of research (Creswell, 2015) by contacting one participant from each case (full-time, part-time, and itinerant) after data analysis to ask questions regarding whether study themes were realistic and complete and if findings represented fair interpretation of MVPA strategies used within EPE teachers in Hampshire and Hampden County. Quantitative phase one data was then merged with qualitative phase two findings using software embedded coding to show relationships between the phases and draw conclusions further establishing credibility of the findings. The researcher anticipated that results would highlight the current state of MVPA phenomena and interventions used by EPE teachers in Hampshire/Hampden County, Western Massachusetts, by examining elements of the TEO within current practices, and explaining how experiences of full-time, part-time, and itinerant EPE teachers can affect their use of MVPA strategies. STRATEGIES FOR INCREASING MVPA IN CHILDREN 17 Results Once the respondence rate from the phase one survey had reached 40%, results were analyzed and used to form follow up questions for the phase two interviews. Phase two interviews were conducted over a two-month period, at the participants’ convenience, and results used to uncover a more in-depth investigation of research aims examined in phase one. Quantitative Phase One Demographics. The Survey Monkey online instrument (Appendix C6) was sent to 62 EPE teachers in Hampshire/Hampden County, of which 25 responded (40%) after bi-weekly repeat emailing’s to achieve the highest response rate. Wave analysis (Creswell, 2015), using Survey Monkey settings, revealed no significant differences in question responses from the first week to the last (Figure 1). Figure 1: Wave analysis of response rate by week. 18 STRATEGIES FOR INCREASING MVPA IN CHILDREN Of the 25 participants the median level of teaching experience was 13-15 years with the greatest percentages (20%) having taught for 25+ years and (24%) having taught 10-12 years Physical2). Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged (Figure Children Q1 How long have you been teaching physical education? Answered: 25 Skipped: 0 100% 80% 60% 40% 24.00% 12.00% 12.00% 12.00% 12.00% 4-6 years 7-9years 20% 24.00% 20.00% 8.00% 8.00% 12.00% 12.00% 12.00% 12.00% 16-18 years 22-24 years 20.00% 0% 10-12 years 13-15 years 25+ years ANSWER CHOICES RESPONSES 4-6 years (2) 12.00% 3 7-9years (3) 12.00% 3 10-12 years (4) 24.00% 6 13-15 years (5) 8.00% 2 16-18 years (6) 12.00% 3 22-24 years (8) 12.00% 3 25+ years (9) 20.00% 5 TOTAL 25 BASIC STATISTICS Minimum 2.00 Maximum 9.00 Median 5.00 Mean 5.44 Standard Deviation 2.45 Figure 2: Participants teaching experience by years. All respondents taught EPE within grades PK-5. Forty eight percent of respondents held a master’s degree with an additional 20% having achieved Master’s+45 credit distinction. Though 72% of respondents reported their highest degree being in the field of PE, 28% also 19 STRATEGIES FOR INCREASING MVPA IN CHILDREN reported holding advanced degrees in areas such as health, exercise science, special education, educational leadership, teaching leadership, secondary education, and educational psychology Physical (Figure 3). Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q4 hat ield/s o study is your highest degree? (choose all that apply) Answered: 25 Skipped: 0 100% 72.00% 80% 72.00% 60% 28.00% 40% 28.00% 16.00% 8.00% 20% 16.00% 8.00% 0% ys a a er ease s e y ea er se e e es y ys y ANSWER CHOICES 4.00% 4.00% r a a e e RESPONSES 72.00% 18 Other (please speci y) (6) 28.00% 7 Health (5) 16.00% 4 8.00% 2 4.00% 1 hysical ducation (1) xercise Science/ inesiology/ hysiology (2) Sport Management (3) Total espondents: 25 BASIC STATISTICS Minimum 1.00 Maximum 6.00 Median 1.00 Mean 2.72 Standard Deviation 2.17 Figure 3: Participants’ field/s of study in conjunction with degree. Eighty four percent of respondents had achieved professional teaching licensure and 18 of the 25 respondents also reported holding additional certifications in personal training, group fitness, coaching, CPR, archery, and Drums Alive (Figure 4). 4 / 23 20 STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q5 Do you hold any o the ollowing credentials/certi ications? Answered: 18 Skipped: 7 100% 80% 61.11% 60% 61.11% 38.89% 40% 38.89% 20% 11.11% 5.56% 5.56% 11.11% 0% 5.56% 5.56% er e ers a ra er r er ess sr r er s ... sr e r ea er a asse er ease s e y ANSWER CHOICES RESPONSES Certi ied ersonal Trainer (C T) (1) 5.56% 1 11.11% 2 Certi ied Spin Instructor (4) 5.56% 1 Health certi ication (passed MT L) (6) 38.89% 7 Other (please speci y) (7) 61.11% 11 roup itness Instructor (Aerobics Strength MBA) (2) Total espondents: 18 BASIC STATISTICS Minimum 1.00 Maximum 7.00 Median 6.50 Mean 5.82 Standard Deviation 1.80 Figure 4: Participants additional credentials and certifications. Sixty eight percent reported teaching in suburban schools, 28% serving in rural areas, and 4% in urban school districts. EPE teachers in city school districts represented 68% of respondents while 32% worked in regional school district configurations with a much higher response rate from full-time teachers overall (Figure 5). 5 / 23 STRATEGIES INCREASING CHILDREN 21 Physical Education (PE)FOR Strategies for Increasing MVPA Moderate IN to Vigorous Physical Activity (MVPA) in School Aged Children Q7 hich o the ollowing would most closely describe your teaching assignment? (choose one) Answered: 25 Skipped: 0 100% 80% 84.00% 60% 84.00% 40% 12.00% 20% 4.00% 12.00% 4.00% 0% - e ar - ANSWER CHOICES e era RESPONSES ull-time (1) 84.00% 21 art-time (2) 12.00% 3 4.00% 1 Itinerant (3) TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 3.00 Median 1.00 Mean 1.20 Standard Deviation 0.49 Figure 5: Participant’s teaching assignment. Research aims. Survey questions were developed by the researcher, in conjunction with a panel of experts (Appendix C5), to determine participants knowledge and use of MVPA strategies as well as assess to what extent MVPA concepts were taught within their Physical Education Teacher Education (PETE) program, access to professional development, and teaching schedule (full-time, part-time, or itinerant) might affect overall MVPA knowledge and use and were addressed by the following research aims. RA1: Are EPE teachers in Hampshire/Hampden County aware of MVPA 7 / 23 concepts/strategies/interventions? The following survey questions addressed this aim; results are provided in each figure and summarized at the end of this section. STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children 22 Q19 In your teacher preparatory undergraduate program were moderate to vigorous physical activity strategies discussed? (choose one) Answered: 25 Skipped: 0 100% 96.00% 80% 96.00% 60% 40% 20% 4.00% 4.00% 0% Yes No ANSWER CHOICES RESPONSES es (1) 96.00% o (2) 4.00% 24 1 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 2.00 Median 1.00 Mean 1.04 Standard Deviation 0.20 Figure 6: PETE programs covering MVPA. Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q15 In the last three years how many speci ic pro essional development opportunities have you received as part o your school provided o erings? (choose one) Answered: 25 Skipped: 0 19 / 23 100% 80% 60% 48.00% 48.00% 40% 28.00% 16.00% 28.00% 20% 16.00% 0% 0 12 4 4.00% 4.00% 4.00% 4.00% 6 ANSWER CHOICES RESPONSES 0 (1) 28.00% 7 1-2 (2) 48.00% 12 3-4 (3) 16.00% 4 5-6 (4) 4.00% 1 7+ (5) 4.00% 1 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 5.00 Median 2.00 Mean 2.08 Standard Deviation 0.98 Figure 7: PE specific professional development offered by participant’s school. 15 / 23 STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children 23 Q16 In the last three years how many speci ic pro essional development opportunities have you initiated on your own? (choose one) Answered: 25 Skipped: 0 100% 80% 60% 48.00% 48.00% 40% 20.00% 20% 12.00% 12.00% 20.00% 12.00% 12.00% 8.00% 8.00% 0% 0 12 4 6 ANSWER CHOICES RESPONSES 0 (1) 12.00% 3 1-2 (2) 48.00% 12 3-4 (3) 20.00% 5 5-6 (4) 12.00% 3 7+ (5) 8.00% 2 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 5.00 Median 2.00 Mean 2.56 Standard Deviation 1.10 Figure 8: Physical PE specific professional development, teacher-initiated. Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children 16 / 23 a state regional and/or national physical Q17 In the past three years have you attended education con erence? (choose one) Answered: 25 Skipped: 0 100% 80% 6.00% 60% 44.00% 6.00% 44.00% 40% 20% 0% Yes No ANSWER CHOICES RESPONSES es (1) 44.00% 11 o (2) 56.00% 14 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 2.00 Median 2.00 Mean 1.56 Figure 9: Attendance at a state, regional, or national PE conference. 17 / 23 Standard Deviation 0.50 24 STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q18 Does your school help cover the cost o pro essional development outside o school hours? (choose one) Answered: 25 Skipped: 0 100% 80.00% 80% 80.00% 60% 40% 20.00% 20% 20.00% 0% Yes No ANSWER CHOICES RESPONSES es (1) 80.00% o (2) 20.00% 20 5 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 2.00 Median 1.00 Mean 1.20 Standard Deviation 0.40 Figure 10: Professional development cost. RA2: How are EPE teachers in Hampshire/Hampden County schools utilizing MVPA interventions? The following survey questions addressed this aim; results are provided in each 18 / 23 figure andPhysical summarized the end of this section. Education (PE) at Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q21 Do you utili e any o the ollowing strategies within your classroom: on-elimination games itness ocused lessons active rest active directions decreased wait time active wait time or small group center rotations? (choose one) Answered: 25 Skipped: 0 100% 96.00% 80% 96.00% 60% 40% 20% 4.00% 4.00% 0% Yes No ANSWER CHOICES RESPONSES es (1) 96.00% o (2) 4.00% 24 1 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 2.00 Median 1.00 Mean 1.04 Standard Deviation 0.20 Figure 11: Strategies aligned with Theory of Expanded, Extended, and Enhanced MVPA (TEO). 21 / 23 25 STRATEGIES FOR INCREASING MVPA IN CHILDREN RA3: What specific interventions are being implemented? The following survey questions addressedPhysical thisEducation aim; (PE) results are provided in each figure and summarized at the end of this section. Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q20 Have you utili ed any o the ollowing curriculum within your teaching o that apply) Answered: 25 ? (choose all Skipped: 0 100% 80% 64.00% 64.00% 60% 40.00% 40% 40.00% 20.00% 20% 20.00% 20.00% 16.00% 4.00% 20.00% 16.00% 4.00% 0% 60 e s o e e oo s N e e e e o es ANSWER CHOICES RESPONSES Spark 40.00% 10 20.00% 5 4.00% 1 (1) lay 60 (2) CATCH (3) Let s Move Active Schools (4) 16.00% 4 SHA 64.00% 16 20.00% 5 America rade Level Outcomes (7) /A (8) Total espondents: 25 BASIC STATISTICS Minimum 1.00 Maximum 8.00 Median 7.00 Mean 4.66 Standard Deviation 2.78 20 / 23 Figure 12: Specific curriculum interventions in use. RA4: How frequently are these strategies used? The following survey questions addressed this aim; results are provided in each figure and summarized at the end of this section. Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q11 How many days per week do your students receive physical education? (choose one) Answered: 25 Skipped: 0 100% 80% 64.00% 64.00% 60% 6.00% 40% 6.00% 20% 0% 1 2 ANSWER CHOICES RESPONSES 1 (1) 36.00% 9 2 (2) 64.00% 16 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 2.00 Median 2.00 Mean 1.64 Standard Deviation 0.48 Figure 13: Days per week students receive PE which may affect MVPA frequency. 11 / 23 26 STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q12 How many minutes are your physical education classes? (choose one) Answered: 25 Skipped: 0 100% 2.00% 80% 2.00% 60% 40% 16.00% 8.00% 20% 4.00% 16.00% 8.00% 4.00% 0% 0 ess es o 14 es 46 60 es 61 es ANSWER CHOICES RESPONSES 30 minutes or less (1) 16.00% 4 31-45 minutes (2) 72.00% 18 46-60 minutes (3) 8.00% 2 61-75 minutes (4) 4.00% 1 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 4.00 Median 2.00 Mean 2.00 Standard Deviation 0.63 Figure 14: PE minutes per class which may affect MVPA frequency. Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q10 or what is your average class si e? (choose one) Answered: 12 25 / 23 Skipped: 0 100% 80% 60% 48.00% 40.00% 48.00% 40% 40.00% 20% 8.00% 4.00% 8.00% 4.00% 0% 16 20 21 2 26 0 1 ANSWER CHOICES RESPONSES 16-20 (3) 40.00% 10 21-25 (4) 48.00% 12 26-30 (5) 8.00% 2 31+ (6) 4.00% 1 TOTAL 25 BASIC STATISTICS Minimum 3.00 Maximum 6.00 Median 4.00 Mean 3.76 Figure 15: PE class size which may affect MVPA frequency. 10 / 23 Standard Deviation 0.76 27 STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q22 hat has allowed or prevented you rom utili ing these strategies within your classroom? (choose all that apply) Answered: 22 Skipped: 3 100% 80% 0.00% 60% 4 .4 % 0.00% 18.18% 20% 0% 1.82% 4 .4 % 40% 4. % 4. % e 1 .64% o e e o s o s o 1.82% 1 .64% 18.18% e o e o s e e ss s e e ss e s ANSWER CHOICES RESPONSES Su icient inancial support (1) 4.55% Lack o inancial support (2) 18.18% 4 Su icient provided materials (3) 45.45% 10 Lack o provided materials (4) 13.64% 3 Su icient class time (5) 50.00% 11 Insu icient class time (6) 31.82% 7 1 Total espondents: 22 BASIC STATISTICS Minimum 1.00 Maximum 6.00 Median 4.50 Mean 4.11 Standard Deviation 1.43 Figure 16:Physical Factors promoting preventing utilization. Education (PE) Strategies and for Increasing Moderate toMVPA Vigorous Physical Activity (MVPA) in School Aged Children 22 / 23 Q14 In your teaching tenure have physical education days/minutes been reduced? Answered: 25 Skipped: 0 100% 6.00% 80% 6.00% 60% 40% 24.00% 24.00% 20% 0% Yes No ANSWER CHOICES RESPONSES es (1) 24.00% 6 o (2) 76.00% 19 TOTAL 25 BASIC STATISTICS Minimum 1.00 Maximum 2.00 Median 2.00 Mean 1.76 Standard Deviation 0.43 Figure 17: Reduction in PE minutes which may contribute to lack of sufficient time for MVPA. 14 / 23 28 STRATEGIES FOR INCREASING MVPA IN CHILDREN Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children Q13 here are your physical education classes located? (choose all that apply) Answered: 25 Skipped: 0 100% 100.00% 80% 68.00% 100.00% 68.00% 60% 40% 8.00% 20% 4.00% 8.00% 4.00% 0% oo s oo es e s e o e se s e ANSWER CHOICES RESPONSES 100.00% ym (1) 25 Lunch room (3) 4.00% 1 Outdoor spaces/playground/ ields (4) 68.00% 17 Other (please speci y) (5) 8.00% 2 Total espondents: 25 BASIC STATISTICS Minimum 1.00 Maximum 5.00 Median 1.00 Mean 2.36 Standard Deviation 1.54 Figure 18: Location of PE classes which may affect MVPA frequency. Research Aims Summary 13 / 23 RA1: Are EPE teachers in Hampshire/Hampden County aware of MVPA concepts/strategies/interventions? The data shows that a high majority of EPE teachers did receive education on MVPA strategies within their PETE program, however phase two further addressed to what extent these strategies were taught within each individual’s PETE program. Another resource for learning current trends in MVPA is quality professional development which the data shows is provided sporadically to Hampshire/Hampden County EPE teachers. Phase One also revealed that EPE teacher access to state, regional, and/or national PE conferences is significantly lacking. RA2: How are EPE teachers in Hampshire/Hampden County schools utilizing MVPA interventions? That data shows that the majority of participating EPE teachers are utilizing enhancement MVPA strategies in alignment with the Theory of Expanded, Extended, and Enhanced Opportunities for Youth Physical Activity Promotion (TEO) instead of STRATEGIES FOR INCREASING MVPA IN CHILDREN 29 utilizing commercial curriculums designed specifically for MVPA purposes. RA3: What specific interventions are being implemented? In conjunction with enhancement strategies most of responding EPE teachers used SHAPE America Grade Level Outcomes, a free resource, rather than purchased interventions such as SPARK PE, Play 60, and CATCH PE. Phase two followed up on why commercial interventions are not more prevalent. RA4: How frequently are these strategies used? MVPA frequency can be dependent on PE days, minutes, and location. The data showed that the majority of students in Hampshire/Hampden county receive PE two days per for 31-45 minutes in both indoor and outdoor spaces. The average class size was 21-25 students which can have direct influence on MVPA implementation frequency. Responding teachers also revealed that factors promoting MVPA frequency included sufficient class time and materials whereas insufficient class time and materials prevented them from implementing MVPA. These results directly formed phase two questions to reveal deeper insights. Additional findings from phase one were also explored. Additional Findings Survey Monkey software cross tabulation was used to compare answers filtered by varying demographics which revealed that of the EPE teachers reporting their students received PE twice per week, 82% worked in urban/suburban schools while only 18% taught in rural school districts. Those classes taught twice per week were also more likely to fall into the 30 minutes or less range which would accumulate less than 60 minutes of EPE a week. Sixty two percent of regional school EPE teachers reported having average class sizes of 21-25 students while 38% of city school EPE teachers reported having 16-20 students per class. When asked what factors promote/prevent these strategies from being used, 50-55% percent of full-time STRATEGIES FOR INCREASING MVPA IN CHILDREN 30 teachers cited sufficient provided materials and class time for promoting their ability to incorporate MVPA strategies while 66% of part-time and 100% of itinerant teachers cited insufficient class time for preventing their incorporation of MVPA strategies. It should also be noted that three teachers skipped the question corresponding to promotion/prevention of MVPA, which could indicate a reluctance to report prevention factors. Results to questions regarding PE specific professional development showed that 48% of EPE teacher respondents were offered only one to two PE professional development opportunities by their school district in the last three years, while 28% reported zero PE specific PD. Of the teachers reporting zero PE specific PD opportunities, 75% of those were part-time EPE teachers. When applying non-parametric statistics to full-time, part-time, and itinerant teacher groups, Fisher’s Exact test using SAS version showed clear significance that more full-time EPE teachers hold master’s degrees when compared to their part-time and itinerant colleagues. What is not clear however is if having a master’s degree impacts a teacher’s knowledge and implementation of MVPA strategies. No other significant frequencies were reported; therefore, teachers’ responses were not typically related to their teaching assignment. 1 0 0 0 4.00 0.00 0.00 0.00 33.33 0.00 0.00 STRATEGIES FOR INCREASING MVPA IN0.00 CHILDREN 50.00 0.00 0.00 0.00 2 8.00 66.67 40.00 0 0.00 0.00 0.00 3 12.00 1 4.00 5 20.00 12 48.00 25 100.00 mast+45 masters Total PT 2 8.00 Total Frequency Percent Row Pct Col Pct The FREQ Procedure 1 4.00 4 16.00 Table of teachassign by educ 31 educ teachassign bach edd mast+15 1 4.00 Statistic4.76 50.00 1 4.00 4.76 100.00 4 16.00 19.05 100.00 1 2 12 4.00 8.00 48.00 DF 4.76 Value 9.52 Prob57.14 100.00 40.00 100.00 21 84.00 I 0 0 0 Likelihood Chi-Square 0.00Ratio0.00 0.00 0.00 0.00 0.00 Mantel-Haenszel Chi-Square 0.00 0.00 0.00 0 1 0 10 0.00 13.1604 4.00 0.2148 0.00 0.00 100.00 0.00 1 0.001.069520.00 0.3011 0.00 1 4.00 PT Phi Coefficient 1 FT mast+30 Statistics for Table of teachassign by educ Chi-Square 10 0.1819 00.7432 2 0.00 8.00 0.000.596566.67 0.00 40.00 0 0 4.00 0.00 0.00 Contingency 33.33 Coefficient 0.00 0.00 50.00 0.00 0.00 0 0.00 0.00 0.00 3 12.00 2 1 4 1 5 12 WARNING: of the cells have expected counts 8.0094% 4.00 16.00 4.00 20.00 less48.00 25 100.00 Cramer's V Total 13.8095 0.5255 than 5. Chi-Square may not be a valid test. Statistics for Table of teachassign by educ Fisher's Exact Test Statistic DF (P) Value Table Probability 0.0012 Prob Chi-Square Pr <= P 10 13.8095 0.05510.1819 10 13.1604 0.2148 Mantel-Haenszel Chi-Square 1 = 1.0695 Sample Size 25 Phi Coefficient 0.7432 0.3011 Likelihood Ratio Chi-Square Contingency Coefficient 0.5965 Figure 19: Contingency table of teaching assignment effect on educational degree. Cramer's V 0.5255 WARNING: 94% of the cells have expected counts less than 5. Chi-Square may not be a valid test. Summary of Phase One Results Fisher's Exact Test Phase One survey data clearly revealed that the majority of EPE teachers in Table Probability (P) 0.0012 Pr <= P Massachusetts 0.0551 Hampshire/Hampden counties in Western, have knowledge of MVPA concepts Size to = 25 and utilize strategies that enhance their Sample PE classes include MVPA. Data showed that full- time, part-time, and itinerant teachers have varying access to MVPA specific intervention curriculums and the PE specific professional development which these curriculums often require (Kohl, 2013). EPE teachers also reported differing factors that can either promote or prevent their usage of MVPA strategies, including financial support, access to materials, and sufficient STRATEGIES FOR INCREASING MVPA IN CHILDREN 32 class time. What is still unclear is how these factors, along with EPE teachers specific scheduling circumstances and educational background can influence their ability to incorporate substantial MVPA. Phase Two sought to explain these factors in more depth and acknowledge underlying influences affecting MVPA. Qualitative Phase Two Nineteen (76%) participants from Phase One volunteered for Phase Two, however only five ultimately responded by return of informed consent forms and scheduled an interview time after three email inquiries over a four-week period. Semi-structured interviews were conducted with these five teachers. The interview participants were separated into the designated collective case groups in which, two full-time, one part-time, and two itinerant EPE teachers were represented. Data from phase one was used to guide follow-up questions (Appendix C7) to further explore the research aims as they related to the three collective case groups. While teaching assignment was not significantly related to most phase one research aims, it was important that all cases were represented for phase two analysis. Collective case participants represented a cross-section of educational background, teaching experience, and school district demographics. Each teacher was asked the following 11 direct questions that were derived from data collected in phase one with responses addressed here by their collective cases. Full-time. Case participants included two full-time EPE teachers both female teaching in suburban city elementary schools. Interviews were conducted referring to each participant as Full-time One and Full-time Two. Full-time One has been teaching for 30 years and is approaching retirement in two years. Full-time Two had just finished her 12th year of teaching. STRATEGIES FOR INCREASING MVPA IN CHILDREN 33 Explain your educational background in PE? Full-time One held a bachelor’s degree in PE and a master’s degree in middle school administration. She expressed that she had no intention in becoming an administrator yet had pursed the advanced degree to receive the pay raises her school district offered for achieving this benchmark. Full-time Two pursued teaching later in life, earning her bachelor’s degree in PE in her late 30’s. After teaching a few years, she then earned a master’s degree in educational psychology. Did your Physical Education Teacher Education (PETE) program address MVPA? Fulltime One indicated that her PETE program had not specifically addressed MVPA but focused on sports skills and games as the foundation for lesson units. Full-time One then stated that as her teaching career progressed, and children seemed to be less active outside of PE, she sought out how to incorporate more fitness concepts into her lessons. Full-time Two stated her PETE program addressed MVPA and noted that the program was heavily exercise science-based. She conveyed that going into PE later in life was a benefit in the area of MVPA as she felt she had more knowledge of fitness concepts than other PE teachers in her age bracket who completed their degrees in the late 1980’s and early 90’s when MVPA was less emphasized. Do you use MVPA strategies in your classroom? If yes, what specific strategies do you use and how often? Full-time One set increasing student cardiovascular endurance as one of her teaching goals. She uses an MVPA strategy she created called the “One Song Run” to promote this goal. Upon entering the gym space, she plays an upbeat song over the sound system that lasts at least four minutes. It is the expectation that students run laps for the duration of the song. Full-time One stated that she tries to limit the time her students have to sit during class so while they are running, she takes attendance and adjusts resources needed for the class lesson. She stated that the music is a huge motivator to get her students moving and students often request to STRATEGIES FOR INCREASING MVPA IN CHILDREN 34 do the One Song Run. Full-time One noted that she used more MVPA strategies in the past when she was team teaching with a colleague. They would divide the class, one teacher focusing on continuing cardiovascular endurance work while the other taught a more traditional sports skills lesson and then they would switch groups. Full-time Two indicated the use of gym stations/centers to increase MVPA. Gym centers include several high energy small group activities mixed with lower impact traditional sport skill activities spread throughout the gym. Full-time Two then rotates groups through all the activity centers throughout the class time. She noted that this approach caters to MVPA as well as her student’s attention span, as they often cannot focus on the same task for an entire class session. Full-time Two indicated using this technique during several lessons over the course of a six-week unit. Elaborate on what has promoted/prevented you from implementing MVPA strategies within your PE classroom? Full-time One stressed that a recent schedule change prevented her from devoting time to MVPA. For almost 15 years she team taught with another EPE teacher, but he was transferred to another school in their district to replace a retiring teacher. She indicated that team teaching allowed for more MVPA integration and now that she is teaching alone, her One Song Run is the only specific MVPA strategy she uses consistently. Full-time Two credits her educational background in exercise science in promoting MVPA strategies in her teaching while she cited an activity gap within her school population for preventing MVPA usage, “You can tell the students who have access to MVPA outside of school and those who do not. Some of my student’s do not even meet baseline fitness standards so incorporating too much MVPA can be frustrating for them. That is hard to combat when I see them twice a week for 40 minutes.” Full-time Two also noted that her administration and superintendent value PE which aids in her implementation of MVPA strategies. 35 STRATEGIES FOR INCREASING MVPA IN CHILDREN How does your schedule affect your ability to implement MVPA strategies? Full-time One became passionate when addressing her schedule, “I teach each class of kids one day a week. Say it differently, four times a month. Throw in an assembly or snow day and it can be even less. I get that the state is always coming down hard about academic testing, but this is these kids’ overall health we are talking about.” Full-time Two highlighted that she is the only EPE teacher in her school which serves 450 students which can be a challenge when implementing MVPA strategies, “I feel lucky that I see my students every other day for 40 minutes which I know is more than a lot of other students get. So, the extra class time helps so I can get fitness and skills in every class.” What has been your experience in receiving PE specific professional development (PD) within your teaching career? Full-time One stated that PE specific professional development has been randomly offered over her 30-year teaching career but not consistently. She pointed to in service PD days at her school where the majority of the time she must attend sessions on math or ELA (English Language Arts). Full-time one indicated that if math/ELA PD presenters know that special subjects’ teachers are in attendance they will try to offer ways to incorporate these concepts into their subject however Full-time One added, “including math or ELA in PE is fine and great, but I would really rather learn new ways to help my kids be healthier and more fit.” Conversely, Full-time Two explained that her administration does not see the value in making special subjects attend PD that is not in their content area, so they have provided special subjects with time and budget money to seek out their own subject specific PD through webinars. Fulltime Two added that the majority of the concepts she uses during her PE centers originated from a webinar she viewed during a PD in service. STRATEGIES FOR INCREASING MVPA IN CHILDREN 36 Explain how/why your school’s PE minutes have changed within your teaching career? Full-time one articulated that in her 30 years of being an EPE teacher at the most her students received 110 minutes a week and currently students receive 65, which is a career low. She attributes these decreases to increased focus on standardized testing in academic subjects and not replacing retiring staff members within the PE department district-wide. Full-time two stated that PE minutes have been the same in her teaching career, seeing her students every other day for 40 minutes (80-120 minutes per week). How does your school budget for PE resources? Full-time One receives $1000.00 per year to spend on PE equipment and resources while Full-time Two stated that she does not specifically receive budget money yet at the end of every school year she can submit to her administration if she needs any equipment replaced. Full-time Two added that teachers at her school are allowed to fundraise for classroom resources and several years she raised additional money by offering Jump Rope for Heart, which is offered by the American Heart Association. She mentioned that she stopped utilizing this fundraiser however because her school needed to raise $3000.00 in order to receive $150.00 in PE funds, which she said wasn’t enough incentive so now she only replaces existing equipment when needed. Have you been involved with PE curriculum design within your school district and what would you most like to see as part of your curriculum? Full-time One is given permission from her curriculum coordinator to design her own curriculum as long as it is based in national and/or state PE standards. Full-time One also stated that she would like to incorporate more MVPA concepts and life sports into her curriculum but an increase in class time devoted to PE curriculum would be her ultimate addition. Full-time Two also does not follow a specific curriculum but writes her own based on national PE standards, she added “I know there are some STRATEGIES FOR INCREASING MVPA IN CHILDREN 37 great commercial curriculums out there, but we are on our own which has its positives and negatives.” Have you ever been asked to offer PA or MVPA opportunities before or after school? Full-time One has not been asked to offer these opportunities before or after school, yet she stated that she is regularly asked to provide physical activities that are promoted as a reward for school reading challenges or academic achievement. “I’m glad physical activity is viewed as a reward, but I think all students should get this extra activity time,” she added. Full-time Two has not been asked to provide these opportunities but she does it voluntarily. She organizes a before school fitness club which meets for a half hour on Mondays and Wednesdays. Are you regularly active? What physical activities do you regularly participate in? Fulltime One plays pickle ball five days a week, weight trains three days a week, and with help from her FitBit strives for 10,000-15,000 steps a day. Full-time Two used to be a runner but after nagging injuries has taken up group fitness classes four to five times per week. She added, “I like to be a role model for my own children and my students. I work out a lot with my students during class as well. If they are running, I will run with them. I like to model that. I think it’s important.” Full-time One and Full-time Two are in the same age bracket yet went through PETE programs a decade apart. This was reflected in their implementation of MVPA strategies, Fulltime One out of necessity and Full-time Two as a foundation of her PE education. Both EPE teachers write their own curriculum based on national PE standards and voiced concern that they do not see their students often enough to solidify MVPA concepts. Full-time One experienced varying PE professional development while Full-time Two has access to meaningful PE webinars that she can incorporate into her classes immediately. STRATEGIES FOR INCREASING MVPA IN CHILDREN 38 Part-time. There was one part-time case participant who was a female EPE teacher from a suburban city school. Participant is referred to as Part-time One throughout the interview. Part-time One had taught previously in Washington state for four years then relocated to Western Massachusetts where she was hired as a part-time EPE teacher to supplement PE for kindergarten and first grade classes that were unusually large. Part-time One’s teaching assignment was not renewed at the end of this school year as the district was trying to find alternative ways to deal with large class sizes instead of PE supplementation. Explain your educational background in PE? Part-time One received her teacher preparatory in Washington state where she earned her bachelor’s degree in PE with a concentration in exercise science. She taught in Washington for four years then moved to Western, Massachusetts for her spouse’s employment. She obtained her temporary Massachusetts teaching license and was hired part-time in a suburban city school. Did your Physical Education Teacher Education (PETE) program address MVPA? Parttime one indicated that MVPA was a foundational topic in her PETE program as it was concentrated in exercise science concepts. Do you use any MVPA strategies in your classroom? If yes what specific strategies do you use and how often? Part-time One stated, “I feel like I teach PE very differently than the PE I received as a child. I never teach sports skills” She went on to explain that she teaches only grades K-1 and she feels it is her responsibility to get her students comfortable with moving their bodies and building the stamina to stay active. The MVPA strategies she uses in every class include fitness-based lessons and using music as a movement motivator. Elaborate on what has promoted/prevented you from implementing MVPA strategies within your classroom? Part-time one explained, “My knowledge of MVPA has promoted my STRATEGIES FOR INCREASING MVPA IN CHILDREN 39 ability to give my students these strategies, however it is hard to effectively teach these strategies and nail down those good habits when I only see my students once to twice a week for thirty minutes.” She added that space is an issue with her PE lessons as her school’s gymnasium and cafeteria is in the same space forcing her to teach the first 10 minutes of a few classes either in their academic classroom or outside as to not conflict with lunches being served. How does your schedule affect your ability to implement MVPA strategies? Part-time One was responsible for three classes which she taught twice a week for thirty minutes. The school had a full-time PE teacher but that year the kindergarten and first grade classes were unusually large, so she was hired to supplement instruction. Part-time One found it difficult to incorporate a lot of MVPA strategies with time constraints and noted, “especially with teaching K-1, I feel like at times I was constantly reteaching the same concepts because it is hard for them to recall what they have learned when they only saw me for an hour a week.” What has been your experience in receiving PE specific professional development within your teaching career? Since Part-time One was not a full-time teacher in her district, she was not paid to go to any professional development offerings. She explained, “honestly, I might have gone without being paid if it had been PE specific trainings, but I wasn’t going to go to PD outside my content area if I was not being paid. It just didn’t seem relevant.” Explain how/why your school’s PE minutes have changed within your teaching career? Part-time one skipped this question as she was only a part-time time teacher in Western Massachusetts for one year, so she felt like she could not answer accurately. How does your school budget for PE resources? Part-time one was not involved in any budget process in her district but was informed by the full-time PE teacher in her school that they STRATEGIES FOR INCREASING MVPA IN CHILDREN 40 received $150.00 a year for PE resources. Part-time one indicated that her school had a very generous Parent Teacher Organization (PTO) which supplemented the full-time teacher’s budget. Have you been involved with PE curriculum design with your school district and what would you most like to see as part of your curriculum? Part-time One was not given any curriculum resources to follow and was “left on my own to design the lessons I wanted to teach.” Part-time One collaborated with the full-time PE teacher at her school to ensure lesson continuity but she noted that “it’s just really hard to achieve learning targets of any kind with the limited time I had.” Have you ever been asked to offer PA or MVPA opportunities before or after school? Part-time One indicated that she had not been asked to provide these opportunities within her Western, Massachusetts teaching assignment but had been asked during her previous teaching in Washington state. Are you regularly active? What physical activities do you regularly participate in? Parttime one answered, “I exercise about five days a week and I am a big hiker and mountaineer. I run also.” Part-Time One revealed the challenges that come with having a part-time schedule (in a suburban school) while trying to teach quality PE. Part-time One was not given paid access to the PD of her full-time counterpart. Her schedule also presented challenges in resources and space. Part-time One also shared that her position was not renewed in the budget even though the first-grade class for the next year was still large. When asked what would be done to replace the classes she taught, she speculated that the PE class time would be reduced or replaced with additional time in another special subject (art, music, or science). STRATEGIES FOR INCREASING MVPA IN CHILDREN 41 Itinerant. Itinerant teachers travel between several schools within one school district. They can be employed as full-time or part-time. Their traveling can be done throughout the day or by being assigned to a rotation where they teach at a different school on a specific day of the school week. Case participants included two male itinerant EPE teachers serving rural regional elementary schools. Participants are referred to as Itinerant One and Itinerant Two throughout interview. Itinerant Two had initially stated in phase one that he was a full-time teacher, but at beginning of the interview he disclosed that he travels between schools, making him a (full-time) itinerant so he was moved to the itinerant case group. Itinerant One has been teaching for 32 years and will retire at the end of the upcoming school year while Itinerant Two has been teaching for 22 years. Explain your educational background in PE? Itinerant One earned a bachelors in PE in 1981 and taught high school PE at a private school in PA before returning to Massachusetts to pursue a master’s degree in exercise physiology. Upon graduation with his master’s, Itinerant One started teaching EPE in Western, MA where he has taught for 32 years. He added that to advance on his school district salary scale he also obtained his elementary classroom teacher certification for grades K-5. Itinerant Two stated that he earned bachelors and master’s degrees in PE. Did your Physical Education Teacher Education (PETE) program address MVPA? Itinerant One was taught about MVPA but in the realm of physical fitness. He stated that, “back then they were sticklers for skills and drills. Overall fitness was a part of it though.” Itinerant Two explained that his undergraduate program did not mention MVPA as much as his master’s program. “Several professors emphasized changing PE to more fitness and movement-based lessons”, he said. STRATEGIES FOR INCREASING MVPA IN CHILDREN 42 Do you use MVPA strategies in your classroom? If yes what specific strategies do you use and how often? Itinerant One indicated “I would say for my first 20 years of teaching I did not. I always had parts of my classes that were dedicated to physical fitness like a warm-up that included MVPA but not specifically for MVPA’s sake. More recently, though as my classes started to get shorter and less often, I saw a need to utilize my time more wisely. So out of necessity I try to get the kids moving immediately and for as often as possible.” He further explained that he chooses games with decreased wait time while combing stretching with instructions to limit the time students are seated. Itinerant Two includes a fitness component in every PE lesson even when he is teaching sports skills. In sports units he modifies game play, so all students play at once without groups of students waiting to play. Itinerant Two also emphasized non-elimination games, “It’s a bonus when strategies can promote MVPA and reinforce sportsmanship.” Elaborate on what has promoted/prevented you from implementing MVPA strategies within your classroom? Itinerant One stated that he was sent to the New England regional SHAPE America conference where he participated in a session dedicated to MVPA. “That is where I really learned what MVPA strategies were and how to incorporate them into my classes. I had to modify a lot of the strategies though because I didn’t have the equipment. What type of equipment? “They used a lot of technology, like projecting movement patterns onto the wall. I’m not so great with technology so I chose the strategies that just modified what I already do.” Itinerant One also noted that he tries to increase MVPA where he can but stressed that “I feel like I don’t have enough time with them to really make MVPA have continuity in my classes.” Itinerant Two cited his master’s degree program being rooted in movement science as promoting STRATEGIES FOR INCREASING MVPA IN CHILDREN 43 his use of MVPA strategies, but he added “as far as prevented, I would say that traveling between three schools limits my resources.” How does your schedule affect your ability to implement MVPA strategies? Itinerant One stated, “I currently travel to two schools in my district to teach two subjects, health and PE. I end up sharing a lot of equipment and resources between schools which is a challenge in teaching all concepts, not just MVPA…at one point I was traveling to four schools teaching just PE.” Itinerant Two echoed this by stating, “Each school is a little different. I have three different administrators. Some of them are more open to buying new resources for MVPA while others aren’t. Student’s at different schools get varying experiences. I try to make it equitable.” What has been your experience in receiving PE specific professional development within your career? Itinerant One stated that his district rarely provides PE specific professional development. “My district doesn’t tend to want to send non-academic teachers to conferences either, yet five years ago I was about to recertify my teaching license and I did not have enough PE specific PD to recertify. After complaining to my principal, I was sent to the SHAPE conference.” Itinerant Two’s district does not provide much PE specific professional development in house but allows him days off to attend conferences, at his own expense. Explain how/why your school’s PE minutes have changed within your teaching career? Itinerant One stressed, “When I started teaching in Western, MA in 1987, each elementary school in my district had their own PE teacher. Back then I saw the kids every other day for an hour. It was awesome. I could devote an entire lesson a week to fitness and still have a whole class to cover sports skills. Then budget cuts caused specialists to have to travel and that started the downfall of PE class minutes.” Itinerant Two had a similar experience, “The first school I taught at, in another Western, MA district, I stayed in one building and saw the kids every other STRATEGIES FOR INCREASING MVPA IN CHILDREN 44 day for 45 minutes. In my current district I go between three schools and they have PE once a week for an hour. With holidays and snow days sometimes, they go weeks without having PE. It’s frustrating.” How does your school budget or PE resources? Itinerant One receives $150.00 for each school he travels to and recalled that earlier in his teaching career the PTO organization supplemented his budget but has become less likely to do so in the last few years. Itinerant Two receives $500.00 a year to divide between his three schools. Have you been involved with the PE curriculum design within your school and what would you most like to see as part of your curriculum? Itinerant One again became passionate in stating, “Over my 32 years of teaching I have written and rewritten the PE curriculum about five times. Every time the district gets a new curriculum director, they want us to revamp things. The biggest thing I would change or want is more time with my students. One day a week is not enough. An adult can’t be fit with only one day a week of quality exercise, neither can a child.” Itinerant Two has written his own PE curriculum based on the national PE standards and mentioned that recently his department was tasked with making sure their PE learning targets are reflected in “I Can” statement language which is more meaningful to the student. Itinerant Two also desires more class time with his students to be able to achieve higher standards of physical fitness. Have you ever been asked to lead PA or MVPA opportunities before or after school? Itinerant One has offered after-school sports clubs including lacrosse in which he received a small stipend, but he added that recently his principal has asked him to offer structured activities during his recess duties, “Kids aren’t as active at recess as they used to be, so my principal asks me to lead a kickball game, soccer, or a relay race. It definitely doesn’t come from wanting them STRATEGIES FOR INCREASING MVPA IN CHILDREN 45 to get more MVPA, I think it comes from the fact that if they are occupied, they are less likely to engage in unwanted behaviors.” Itinerant Two has never been asked to lead activities before or after school but has volunteered to offer intramural sports after school. Are you regularly active? What physical activities do you regularly participate in? Itinerant One stated, “I try to stay as active as possible. I have been a runner, although pretty much a jogger these days. I play golf, cycle, and canoe.” Itinerant Two plays in an over 30 soccer league and said “I try to move with the students as much as possible every day during my classes. If they see me doing it, they are going to want to be active too.” Itinerant One and Two teach in similar rural regional school districts. Divergent educational experiences affected their implementation of MVPA in their classes. Though Itinerant One had an advanced degree in Exercise Physiology, he did not learn specific MVPA strategies for students until he attended a SHAPE America PD conference in 2014. Itinerant Two, whose graduate degree sought to change PE foundations to movement-based strategies felt confident in his ability to teach MVPA. Both strongly voiced their frustration with the constraints their schedule can put on their class time. The MVPA strategies they incorporated regularly were enhancements of existing classroom protocols and lesson units. Their curricula were both self-written but in alignment with the national PE standards. They both had a unique perspective on how PE has changed over the last 20+ years and the unique environment they navigate as itinerants. The following word cloud was developed from coding phase two interviews using NVivo qualitative analysis software. 46 play year active based often every want three curriculum try need games keep massachusetts reading paid resources went teaching much big see make schools back feel minutes two get state district moving just strategies one kids time school days five teachers now great also changed activity know teacher music run subjects skills itinerant week mvpa song class got equipment students even part years day lesson full like times think lot possible budget well recently administration specific degree education teach physical good lessons four pulled fitness classes hard new speech classroom STRATEGIES FOR INCREASING MVPA IN CHILDREN Figure 20: NVivo word cloud of frequent words used by phase two participants. Though the five EPE teachers interviewed in Phase Two came from varying educational backgrounds, teaching experience, schedule assignments, and work within differing school configurations, they all reported, with conviction, that they feel they do not have enough time, as the word cloud supports, with their student’s to effectively promote MVPA concepts. PE specific professional development, though sporadically provided, was key to arming them with specialized MVPA strategies. Yet several teachers noted that the MVPA geared professional development they received often required additional specialized curriculum, technology, or equipment that they did not have access to. These teachers would then use their own ingenuity STRATEGIES FOR INCREASING MVPA IN CHILDREN 47 to adapt these MVPA strategies to realistically work in their own setting. Those teacher’s whose undergraduate/graduate degrees were exercise/movement science based reported a greater confidence in their ability to impart MVPA knowledge to their students. Collective case groups proved to have differed and direct influences on these teacher’s ability to effectively use MVPA interventions. Full-time EPE teachers, reported healthy budgets which could promote MVPA resources, yet these teachers also reported reduced team teaching which limit their ability to devote learning goals to MVPA. Full-time teachers acknowledged the appreciation they have for the freedom to create their own curriculum yet expressed frustration when increasing PE opportunities is not an administrative priority. The part-time teacher described limited access to professional development resources, planning time with her full-time counterpart, and a schedule that often forced her to share space which all restricted MVPA continuity. Itinerant teachers also reported limited access to meaningful PE specific PD, shared equipment between schools, have to adapt to differing administrative support of PE, have limited budgets, and are spread thin when providing PE to multiple schools. All EPE teachers across all cases, showed a commitment to the fitness of their students and themselves. Upon completion of phase two data analysis, a summary of phase one and two results was sent via email to one participant from each collective case group for member checking. One response was returned from the itinerant group stating that this study represents an accurate depiction of the current state of MPVA in PE in Hampshire/Hampden counties Western, Massachusetts. This itinerant EPE teacher also expressed a sense of validation that he was not the only EPE teacher in Hampshire/Hampden counties that was struggling to provide meaningful PE and sufficient MVPA opportunities within their classroom. STRATEGIES FOR INCREASING MVPA IN CHILDREN 48 Further Insights and Phase Two Summary While asking phase two direct questions, EPE teacher’s answers prompted extended questions regarding students leaving PE classes to receive other services. During questions about scheduling and class minutes, Full-time One, Part-time One, Itinerant One, and Itinerant Two all referenced students being “pulled” from their PE classes. When asked why a student might be pulled from a PE class, teachers representing each case stated that students are consistently pulled from PE to receive speech therapy, reading intervention, occupational therapy, or counseling services. Teachers from each case expressed frustration with this practice as it further limited students access to quality PE as well as hindering their teaching practices and MVPA intervention by changing the dynamics of a lesson when one or more students are suddenly pulled, return half way through a PE class, or miss the class all together. In addition to this cross-case similarity, there was a generational/experience connection between Full-time One and Itinerant One who both have been teaching EPE for 30+ years. They both reported seeing PE minutes decline in correlation with increased academic testing. It was also in their shared experience that their undergraduate PETE programs offered knowledge of MVPA but only within the realm of physical fitness, which favored sports skill education, not as the core of a PE lesson. They both noted a change over the years in childhood fitness levels and a lack of MVPA in how children organically play at recess, which have led them both to adopt MVPA strategies out of necessity in order to provide their students with meaningful PE experiences. Phase two offered deeper insights as to what specific MVPA interventions are being used by full-time, part-time, and itinerant EPE teachers in Hampshire/Hampden counties Western, Massachusetts which collectively, aligned with key concepts in the Theory of Expanded, STRATEGIES FOR INCREASING MVPA IN CHILDREN 49 Extended, and Enhanced Opportunities for youth physical activity (TEO). Examples of “expanded” opportunities found in Western, Massachusetts included before school fitness club, guided recess opportunities, and after-school intramurals. Time constraints and budget implications do not allow for “extended” opportunities so these Western, MA EPE teachers have crafted specific strategies to “enhance” the time and recourses they currently have including incorporating fitness into every lesson, making cardiovascular endurance a top priority, adopting self-made strategies like the One Song warm-up, combining directions with stretching to decrease sedentary time, use of non-elimination games, and modifying sports to include all students to reduce wait time. Though enhancement is the strategy these teachers use most often, they still fiercely advocate for more “extended” time with their students. STRATEGIES FOR INCREASING MVPA IN CHILDREN 50 Discussion Adolescents that regularly participate in MVPA have increased bone and muscular development, heightened emotional wellness, increased attentiveness and achievement in the academic classroom, and are at a decreased risk for developing chronic illnesses such as heart disease, obesity, and type two diabetes in adulthood (CDC, 2017). Current reports find that one in five school-aged children are considered obese (CDC, 2017). Since children and adolescents spend most of their day in school, educators have the opportunity and responsibility to ensure adequate MVPA through quality PE strategies. This study examined and further explored EPE teaching assignments’ (full-time, part-time, and itinerant) impact on the teacher’s ability to incorporate meaningful MVPA strategies and interventions. The research data showed however that teaching assignments do present challenges in providing adequate MVPA opportunities yet all EPE teacher’s, regardless of assignment in Hampshire/Hampden counties, were more directly influenced by the educational content of their Physical Education Teacher Education (PETE) program, access to meaningful PE professional development, feasibility of MVPA strategies, and the amount of PE class time with their students. The Society of Health and Physical Educators (SHAPE) states that the duty of PE teachers is to foster physically literate individuals who have the knowledge, skills, and confidence to participate in a lifetime of healthful physical activity (SHAPE, 2014). In 2008 the National Association for Sport and Physical Education (NASPE) updated the national standards for initial PETE to include emphasis on scientific and theoretical knowledge of skill and fitnessbased competence with specific attention to MVPA concepts (NASPE, 2018). Yet the study of 156 national PETE programs found that only 53.2% had updated their program content to reflect STRATEGIES FOR INCREASING MVPA IN CHILDREN 51 the new NASPE standards (Taliaferro, Ayers & Housner, 2017). The majority of the EPE teachers in this study indicated that MVPA strategies were discussed in their PETE program. However, when asked to elaborate further, several teachers had vastly different experiences obtaining MVPA knowledge within their individual PETE programs. Interviews revealed that the EPE teachers educated in the 1980-90’s received MVPA knowledge but strictly in the realm of physical fitness, not as the foundational component of PE. The educational concentrations and views of professors within a PETE program can also directly influence the MVPA content knowledge of its graduates as this study showed in the experience of phase two participants whose college PE programs were highly movement science based with professors advocating for restructuring PE classes with fitness focused curriculum. These EPE teachers reported a high level of confidence in their ability to impart MVPA knowledge and implement effective strategies. The advanced degrees obtained by EPE teachers in this study varied from educational leadership, special education, secondary education, exercise science, and educational psychology. Interviews revealed that some EPE teachers obtained these advanced degrees for the attached pay raise not necessarily because they were interested in the program content. This highlights the possible need for incentives for EPE teachers to obtain advanced degrees in PE/fitness related fields. If current EPE teachers do not gain MVPA knowledge within their PETE program or through advanced degree study, they should be able to obtain these skills through meaningful professional development. Survey results also revealed that EPE teachers in Hampshire/Hampden counties in Western Massachusetts have varying access to PE specific professional development (PD). Most EPE teachers surveyed reported little to no PE specific PD provided by their school district and only limited access to PE specific workshops and conferences outside of school hours. Several STRATEGIES FOR INCREASING MVPA IN CHILDREN 52 phase two participants explained that they were required to attend in house PD on English or math skills rather than PD specific to their content area and often lacked the required PE development points when renewing their teacher’s license. These findings align with Cardina and DeNysschen’s (2018) study of the annual nationwide Schools and Staffing Survey (SASS) where PE teachers reported little content specific PD and less likelihood to be financially compensated for the courses they did attend. This study revealed that while the majority of schools offer financial assistance to attend PD, administrators often reserve this funding for classroom teachers instead of specialists such as PE teachers. EPE teachers in this study described PE specific PD as being very powerful when they did have access to it. Conferences offered by SHAPE bolstered knowledge of MVPA strategies and how to implement them, while schools that made all in house PD content specific and provided funding to purchase PE webinars armed teachers with strategies they could instantly add into their teaching practices. These findings reinforce Weaver et al. (2017) who examined the effects of skill building PD workshops that used a participatory format for teachers on the use of PA promotion practices and student’s MVPA. Study protocols focused on empowering teachers with knowledge and practical skills on how to increase MVPA rather than focusing on curriculum overhauls or budgeting for increased resources (Weaver et al., 2017). Using System for Observing Fitness Instruction Time (SOFIT), MVPA levels of these teachers’ students were taken before and after the teachers began implementing strategies they learned as part of their participatory PD. Results indicated that both PA and MVPA of these students increased after their teachers took part in competency building PD. It is essential that EPE teachers have access to meaningful PE specific PD that includes opportunities to learn functional MVPA strategies so that they may effectively meet the needs of their students. STRATEGIES FOR INCREASING MVPA IN CHILDREN 53 A predominant finding of this study was that EPE teachers in Hampshire/Hampden counties passionately seek to have more class time with their students. The data showed that these teacher’s students receive PE between 30-120 minutes per week. The CDC (2012), Healthy People 2020 objectives recommend that school age children and adolescents should participate in daily PE classes and that 50% of this class time should be spent doing MVPA. SHAPE further encourages school districts to mandate that elementary students receive a minimum of 150 minutes and secondary students receive 225 minutes of PE weekly. Interviews detailed the frustration EPE teachers have when they feel their students are not getting the PE minutes they need. Scheduling conflicts due to assemblies, students receiving additional services, and snow days can also hinder their students from receiving PE to less than four times per month. These EPE teachers boldly addressed this problem and some went further to say that ever-decreasing time with students is what first motivated them to incorporate MVPA strategies. Shephard and Trudeau (2013) analyzed the historical significance of the landmark TroisRivieres study of 1969 that tested the physical and mental effects of daily PE on elementary school students. This large-scale longitudinal RCT study followed 546 students in TroisRivieres, Quebec from grade one to grade six. The experimental group of students received one hour of PE daily (taught by a specialized PE teacher) and the other control group 40 minutes of PE weekly (taught by their classroom teacher). The experimental group showed higher academic achievement, psychomotor acceleration, increased cardiovascular fitness, and scored higher in strength-based tests when compared to control group. Studies by Reed et al. (2013), and Ericsson and Karlsson (2014) on EPE students participating in daily 45-minute classes both showed significant benefits of daily PE on academic performance, and fitness/health benchmark tests. This high-level evidence supports the case for daily PE, taught by highly qualified PE STRATEGIES FOR INCREASING MVPA IN CHILDREN 54 teachers, yet PE seems to still lose priority in public schools. The teachers in this study described that students have increasingly sedentary lifestyles which exacerbate the problem of inadequate PE time. If students are not exposed to MVPA outside of school, it should be high priority that they receive this essential time at school. Increased standardized testing was cited in this study as a catalyst for decreased priority of PE. The lack of PE minutes has forced EPE teachers to get creative in the way they present MVPA both inside and outside the classroom. The data in this study affirmed the specific MVPA strategies most utilized by EPE teachers in Hampshire/Hampden counties, Western Massachusetts. Phase one data showed that the majority of EPE teachers were using MVPA strategies such as non-elimination games, fitness focused lessons, active rest, active directions, decreased wait time, active wait time, and small group center rotations. Due to budget concerns and lack of PE specific PD, EPE teachers used commercial based MVPA curriculums such as Spark PE, Play 60, and CATCH PE less often. Several of the specific MVPA strategies used by EPE teachers in Hampshire/Hampden counties aligned with the theory of expanded, extended, and enhanced opportunities (TEO) for adolescent physical activity (Beets et al., 2016). The TEO contends that to successfully promote behaviorchange, MVPA interventions must follow three categories: expansion of opportunities to include new occasions to be active, extension of existing opportunities, and/or enhancement of existing opportunities (Beets et al., 2016). The strategies revealed in this study reinforce the study of Weaver, Beets, Brazendale, and Brusseau (2017) which showed that when MVPA strategies are aligned with the TEO and require low to no cost interventions, meaningful increases in MVPA can be achieved. Extension of existing opportunities for physical activity were not possible for EPE teachers in this study due to already limited PE class minutes. Expanding and enhancing STRATEGIES FOR INCREASING MVPA IN CHILDREN 55 physical activity opportunities to include more MVPA were more realistic. Teachers chose to offer before/after school opportunities for MPVA in the form of fitness club and intramural clubs. Though some received a small stipend for after-school programs others offered them strictly on a volunteer basis because they saw that their students desperately needed more activity time. Calvert et al. (2018) contend that though not a replacement for quality PE opportunities, expanding MVPA interventions throughout the school day can be beneficial for students on nonPE days. Classroom activity breaks like GoNoodle (a web-based activity app), teacher led dance breaks, and fitness flash cards increased students step counts. Students step counts were highest on PE days, but the classroom activity breaks significantly increased non-PE day step counts. Calvert et al (2018) applied these techniques to recess using small, portable choice center games including MVPA in hopes that children would choose these activities at recess rather than sedentary options. Veteran EPE teachers in this study noted that their current students do not organically play as they did at one time which reinforces the need for more structured MVPA opportunities at recess. The enhancement of existing activity opportunities was the overwhelming choice of EPE teachers in this study. EPE teachers, regardless of teaching assignment, reported using MVPA enhancements such as modifying games to have decreased or no wait time, strictly choosing nonelimination games, incorporating fitness into wait time, and using technology to promote movement. Some teachers expressed that the enhancement of MVPA strategies they learned during conferences needed to be modified even further because they did not have access or familiarity with the equipment/technology needed. These findings reinforce research by Powell, Woodfield, and Nevill (2016) that tested primary school MVPA interventions using the SHARP principles (stretching whilst moving, high repetition, accessibility through differentiation, STRATEGIES FOR INCREASING MVPA IN CHILDREN 56 reducing siting and standing and promoting in class physical activity). These principles focused on simple adjustments to PE classes like increasing active learning time, dynamic stretching, high repetition motor skills, and differentiation in instruction to increasing moving time. The quasi-experimental study showed significant increases in MVPA in classes that incorporated the SHARP principles when compared to PE classes using traditional teaching strategies. This shows the benefit of MVPA interventions that focus on the specific environments EPE teachers work in so that they may produce strategies that are the most effective and easily implemented. A central limitation to this study was that two large urban school districts within Hampden County, Holyoke and Springfield public schools, do not offer public databases of teacher email addresses which affected sampling. These school districts were recently taken over by the Massachusetts Department of Education due to underperformance in academics. Including these schools EPE teachers in this study would have served to affirm if underperformance in standardized testing further limited students access to PE minutes which could restrict their exposure to MVPA. STRATEGIES FOR INCREASING MVPA IN CHILDREN 57 Conclusion This study was meant to reveal the current state of MVPA within EPE classes in Hampshire/Hampden counties in Western, Massachusetts. Research aims were affirmed in that the EPE teachers within these counties are aware of and actively using MVPA strategies/interventions. Specific MVPA strategies in use are directly aligned with expanded and enhanced practices outlined in the Theory of Expanded, Extended, and Enhanced opportunities for physical activity (TEO). Although EPE teaching assignment (full-time, part-time, and itinerant) does present unique challenges in implementing MVPA strategies, this study concludes that the main factors affecting EPE teachers use and frequency of MVPA strategies include MVPA content within teachers PETE program, access to PE specific professional development, and sufficient PE class minutes with their students. STRATEGIES FOR INCREASING MVPA IN CHILDREN 58 Future Directions for Research This study uncovered a disconnect between the content of MVPA strategies/interventions and the EPE teachers tasked with implementing these strategies. EPE teachers need MVPA strategies that can be realistically carried out in environments that are low on time and budgetary funds. Future research on how much input from practicing PE teachers goes into the creation/development of MVPA strategies/interventions could help bridge the gap between theory and practice, resulting in MVPA strategies/interventions that are more functional in a typical EPE classroom. This study also highlights that updating PETE programs to reflect MVPA as a foundational concept of PE is essential to producing EPE teachers that are confident in their knowledge of MVPA and their ability to share this knowledge with their students. For EPE teachers educated prior to the NASPE update, it is imperative that school districts provide PE specific professional development that includes MVPA strategies. Additional research that provides data on how highly qualified PE teachers, who provide adequate MVPA, can tangibly impact the health benchmarks of their students could influence schools to once again make PE a priority and serve to combat childhood obesity, while enhancing the overall health and wellbeing of school-aged children nationwide. STRATEGIES FOR INCREASING MVPA IN CHILDREN 59 References Barrett, J., Gortmaker, S., Long, M., Ward, Z., Resch, S., Moodie, M.,…Cradock, A. (2015) Cost effectiveness of an elementary school active physical education policy. American Journal of Preventative Medicine. 1 148-159. http://dx.doi.org/10.1016/j.amepre.2015.02.005 Beets, M. W., Okely, A., Weaver, R. G., Webster, C., Lubans, D., Brusseau, T., . . . Cliff, D. (2016). The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion. 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(2015) Educational research planning, conducting, and evaluating quantitative and qualitative research. Upper Saddle River, NJ: Pearson. Dallolio, L., Ceciliani, A., Sanna, T., Garulli, A., Leoni, E. (2016). Proposal for an enhanced physical education program in the primary school: Evaluation of feasibility and effectiveness in improving physical skills and fitness. Journal of Physical Activity and Health. 13, 1025-1034. http://dx.doi.org/10.1123/jpah.2015-0694 Heidorn, B. (2014). Preparing the next generation of physical education teachers. Journal of Physical Education, Recreation & Dance. 85(9) 6-9. https://DOI:10.1018/07303084.2014.958026 STRATEGIES FOR INCREASING MVPA IN CHILDREN 61 Jago, R., Sebire, S., Davies, B., Wood, L., Banfield, K., Edwards, M.,...Fox, K. (2015) Increasing children’s physical activity through a teaching-assistant led extracurricular intervention: Process evaluation of the action 3:30 randomized feasibility trial. 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School & District Profiles (2018) http://profiles.doe.mass.edu/ Reed, J., Maslow, A., Long, S., & Hughey, M. (2013). Examining the impact of 45 minutes of daily physical education on cognitive ability, fitness performance, and body composition of African American youth. Journal of Physical Activity and Health, 10(2), 185-197. https://journals.humankinetics.com/doi/abs/10.1123/jpah.10.2.185. STRATEGIES FOR INCREASING MVPA IN CHILDREN 62 Taliaferro, A., Ayers, S. & Housner, L. (2017). A descriptive analysis of the application of PETE standards. The Physical Educator. 74, 606-626. https://doi.org/10.18666/TPE-2017-V7414-7499 Stathi, A., & Sebire, S. (2011). A process evaluation of an outreach physical activity program in an inner-city primary school. Journal of Physical Activity and Health. 8, 239-244. https://www.ncbi.nlm.nih.gov/pubmed/21918238 Verstraete, S.J.M., Cardon, G.M., De Clercq, D.L.R., & De Bourdeaudhuij, I.M.M. (2007). Effectiveness of a two-year health-related physical education intervention in elementary schools. Journal of Teaching Physical Education, (26) 20-34. https://doi.org/10.1123/jtpe.26.1.20 Webber, L.S., Catellier, D.J., Lytle, L.A., Murray, D.M., Pratt, C.A., Young, D.R., …Pate, R.R. (2008). Promoting physical activity in middle school girls: Trial of activity for adolescent girls. American Journal of Preventative Medicine, (34) 173-184. https://dx.doi.org/10.1016%2Fj.amepre.2007.11.018 Webster, C. & Nesbitt, D. (2017). Expanded roles of physical education teachers within CSPAP and implications for PETE. Journal of Physical Education, Recreation & Dance. 88 (3), 22-28. https://eric.ed.gov/?redir=http%3a%2f%2fdx.doi.org%2f10.1080%2f07303084.2016.1270 787 STRATEGIES FOR INCREASING MVPA IN CHILDREN 63 Young, D.R., Phillips, J.A., Yu, T., & Haythornthwaite, J.A. (2006). Effects of a life skills intervention for increasing physical activity in adolescent girls. Archive of Pediatric and Adolescent Medicine (160) 1255-1261. https://doi.org/10.1001/archpedi.160.12.1255 STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix A Review of the Literature 64 STRATEGIES FOR INCREASING MVPA IN CHILDREN 65 Moderate to vigorous physical activity (MVPA) in children and adolescents creates a powerful impact on their quality of life (Center for Disease Control, 2017). Adolescents that regularly participate in physical activity have increased bone and muscular development, heightened emotional wellness, increased attentiveness and achievement in the academic classroom, and are at a decreased risk for developing chronic illnesses such as heart disease, obesity, and type two diabetes in adulthood (CDC, 2017). Physical Activity Guidelines for Americans (CDC, 2017) recommends that children and adolescents achieve 60 minutes of MVPA daily. This activity should also include elements that support cardiovascular endurance and muscle/bone strengthening exercises (CDC, 2017). Current reports find that only 28% of children in the United States achieve the daily activity recommendations, and that one in five school-aged children are considered obese (CDC, 2017). Since children and adolescents spend the majority of their day in school, educators have the opportunity and responsibility to ensure the attainment of these physical activity (PA) recommendations through quality physical education (PE) and school-based strategies. This review will present empirical literature on relevant trends in PE that effect MVPA attainment including: the need for comprehensive PE (adequate physical education minutes with curriculum focused on fitness) and updated education of PE teachers (physical education teacher education (PETE) programs, health related fitness knowledge, and application of meaningful professional development). Alternative school-based MVPA strategies will also be reviewed (adding PA and MVPA to the academic classroom, enhanced recess and before/after-school activity opportunities) along with an explanation of the Theory of Expanded, Extended and Enhanced opportunities (TEO) for PA and its potential impact on the MVPA phenomena. STRATEGIES FOR INCREASING MVPA IN CHILDREN 66 Comprehensive Physical Education In 2013 the CDC, in coordination with the Society of Health and Physical Educators (SHAPE formerly known as AAHPERD), published Comprehensive School Physical Activity Programs (CSPAP): A Guide for Schools, which served to advocate the benefits of increased school PA/MVPA opportunities and outline implementation strategies. These strategies consist of a multi-component approach including increased PA/MVPA during school (comprehensive PE minutes, recess, and PA breaks throughout the school day), and activity opportunities before and after school (walk or bike to school programs and intramurals). The CDC and SHAPE emphasize that the cornerstone of effective CSPAP in schools needs to be comprehensive PE that includes adequate class minutes taught by highly qualified PE teachers (CDC, 2013). Adequate Physical Education Minutes The CDC (2012), Healthy People 2020 objectives recommend that school age children and adolescents should participate in daily PE classes and that 50% of this class time should be spent doing moderate-to vigorous exercise. SHAPE further encourages school districts to mandate that elementary students receive a minimum of 150 minutes and secondary students receive 225 minutes of PE weekly (CDC, 2014). Despite these suggestions, as of 2014, 70% of school districts in the United States did not meet the recommended PE time mandate (Strategies for Supporting Physical Education, 2014). Average weekly physical education minutes ranged from 30-125 across elementary and secondary levels according to a recent report, much less than the CDC and SHAPE recommendations (CDC, 2017). Shephard and Trudeau (2013) analyzed the historical significance of the landmark TroisRivieres study of 1969 that tested the physical and mental effects of daily PE on elementary STRATEGIES FOR INCREASING MVPA IN CHILDREN 67 school students. This large-scale longitudinal study followed 546 students in Trois-Rivieres, Quebec from grade one to grade six and tested experimental groups that received one hour of PE daily (taught by a specialized PE teacher) compared to a control group that received 40 minutes of PE weekly (taught by their classroom teacher). Many activities incorporated into the experimental classes were moderate-to-vigorous opportunities including: running relays, soccer, Nordic skiing, and hockey. The experimental group showed higher academic achievement (grades 2-6), psychomotor accelerations in spacial awareness/hand eye coordination, increased cardiovascular fitness including oxygen uptake and work capacity of the heart, and scored higher in strength-based test scores for sit-ups and flexed arm hang as well as shuttle run tests when compared to the control group who received only 40 minutes of PE weekly. The authors concluded that this study should act as the evidence-based foundation for increasing PE minutes in schools and bolster further research on current elementary school populations. The high level of longitudinal evidence presented in the Trois-Rivieres study not only supports the benefits of daily PE but highlights the importance of PE classes being taught by specialized PE teachers (Shephard & Trudeau, 2013). Daily PE has shown to significantly benefit student fitness performance, body composition, and cognitive function (Reed, Maslow, Long & Hughey, 2013). Reed et al. (2013) examined physical and cognitive outcomes in elementary and middle school students who participated in daily 45-minute PE classes compared to control groups who participated in only one 45-minute PE class weekly. The experimental group assigned by academic classroom consisted of 165 students (78 males, 87 females with a mean age of 10.2 years) with control groups of 305 students (158 male, 147 females with a mean age of 11.2) also assigned by academic classroom. Due to differing demographics in control schools, oversampling was used STRATEGIES FOR INCREASING MVPA IN CHILDREN 68 to achieve a representative comparison. Results indicated that students who participated in daily PE performed significantly higher on FitnesGram fitness testing (measuring muscular strength, flexibility, and cardiovascular endurance) and cognitive tests analyzing fluid intelligence and perceptual speed (Reed et al., 2013). Ericsson and Karlsson (2014) conducted longitudinal research studying the effects of increased PE on motor skills and school performance in 251 students over a 9-year period who attended the same small school in Sweden, with the same teachers and access to same activity resources. Students between the ages of 7-9 were split by academic classroom into an experimental group, which participated in daily PE classes for 45 minutes while control group students completed two 45-minute classes weekly. All classes consisted of traditional Swedish PE activities including both indoor/outdoor sports, fitness, and dance. Results indicated that daily PE improved motor skills and achievement in academics in the experimental group when compared to the control group. Further, this population-based controlled research also found that students within the control group who had early motor skill development discrepancies (including lack of precision in movement/balance and decreased reaction time) maintained these deficits throughout the study. At the end of school year 9, 96% of students in the experimental group academically qualified for secondary schools compared to 89% in the control group. Since this study was population based, students had access to same school curriculum, teachers, and came from families of similar socioeconomic background with the only statistical difference being class time length of the PE intervention, further highlighting the impact of increased physical PE minutes (Ericsson & Karlsson, 2014). Providing students with recommended weekly minutes is the foundation of comprehensive PE and creates more learning time to incorporate MVPA opportunities (CDC, STRATEGIES FOR INCREASING MVPA IN CHILDREN 69 2013). Achieving equitable PE minutes also affirms to students the importance of routine PA and exercise. Additionally, physical educators can promote a variety of physical activity options when they have sufficient class time. Traditional PE lessons of sports concepts and skills can be supplemented with fitness curriculum during these increased class minutes which can increase opportunities for MVPA (Kohl, 2013). Curriculum Focused on Fitness Movement and sport concepts have been the focus of PE curriculum for decades and are supported in the original National Association for Sport and Physical Education (NASPE) standards (Kohl, 2013). As childhood obesity rates have increased, new curriculum trends seek to emphasize the development and maintenance of student fitness. Fitness focused curriculum targets cardiorespiratory endurance, muscular strength, and flexibility (Kohl, 2013). Fitness based curriculum has been shown to significantly increase students’ time spent MVPA (Lonsdsale et al., 2013). A randomized, controlled trial of 30 elementary schools from a large multi-ethnic school district compared students who engaged in a fitness-based PE curriculum (experimental) to those in a traditional PE classroom (control) (Sun, Chen, Zhu & Ennis, 2012). The fitness-based curriculum used the concept of the five E’s (engage, explore, explain, elaborate, and evaluate) that help children gain understanding of fitness concepts and why these concepts are essential to long-term health. Results showed significant improvements in the experimental group pre/posttests measuring cardiovascular endurance, muscular strength, and flexibility when compared to control students. Students in control group participated in traditional PE lessons focused on fundamental movement skills and quasi-sport skills and games (Sun et al., 2012). Experimental STRATEGIES FOR INCREASING MVPA IN CHILDREN 70 group students’ lessons focused on fitness activities and incorporated additional exercise concepts during sports/games lessons. Physical educators teaching in the experimental group received a three-day in-service training during the summer and two half day in-service meetings during the school semester which provided training and curriculum devoted to incorporating fitness concepts. Students in the fitness-based curriculum group also reported that they perceived their PE lessons as not just “fun” but informative about the reasons why they should be engaging in exercise such as increased energy, better mood, and developing fitness skills like endurance and flexibility. Many students in the experimental group also reported that they enjoyed that the majority of activities were noncompetitive (Sun et al., 2012). Lonsdale et al. (2012) systematically reviewed interventions designed specifically to increase MVPA in school PE classrooms. Inclusion criteria included studies that focused on primary school students, tested an intervention intentionally meant to increase MVPA, and experimental and quasi-experimental designs only. Online databases Scopus, SPORTDiscus, PubMed, and PsycINFO were searched. The 14 interventions reviewed showed an increase of 24% of class time in MVPA. Study designs included 11 cluster randomized controlled design, cross-over design, quasi-experimental, and a single randomized controlled trial (Lonsdale et al., 2012). Interventions included infusing lessons with fitness, using heart rate monitors and pedometers to track activity and guide lesson design, and enhancing MVPA with specific teaching strategies (Lonsdale et al., 2012). One of the studies reviewed, the SPARK intervention strategy, which used classroom organization, management, and instruction to target MVPA time in every PE class resulted in a 15% increase of MVPA minutes, compared to randomly assigned control group not receiving SPARK interventions (Verstraete, Cardon, De Clercq & De Bourdeaudhuji, 2007). Move It Groove It interventions focused on creating a supportive STRATEGIES FOR INCREASING MVPA IN CHILDREN 71 environment during classes to foster increase physical activity through fundamental movement skills (VanBurden et al., 2003). Webber et al. (2008) used the TAAG intervention that incorporated skill building (student led activity bursts), dynamic equipment choices (medicine balls, balance boards) and class management strategies (less wait time in class), all emphasizing an increase in MVPA (Lonsdale et al., 2012). Using a cluster randomized control trial, 3,504 sixth-eighth grade girls from 36 schools participated in simulated PE classes incorporating TAAG strategies (experimental) and traditional PE class formats (control) (Webber et al., 2008). An increase of sustained MVPA over 104 weeks was also reported in the experimental group by using TAAG strategies including increased movement in PE class, enhanced organization of instruction to increase movement time, focusing on MVPA rich sports, and emphasizing the importance of engaging in MVPA and its positive effects on the body when compared to control group who did not receive TAAG strategies during PE class. Though there was not a significant increase in overall PA between experimental and control groups, the increase in MVPA was compelling (Webber et al., 2008). Young, Phillips, Yu, and Haythornthwaite (2006) promoted MVPA during PE classes by focusing on lessons that incorporated the highest amounts of movement (e.g., soccer vs. softball) and skill competency instead of proficiency. The randomized control trial design produced a 16% increase of MVPA among the experimental groups when compared to the control group who received traditional activities regardless of the MVPA level of the activity (Young et al., 2006). Powell, Woodfield, and Nevill (2016) evaluated the effectiveness of a one-year teaching intervention (SHARP) designed to increase MVPA during primary school PE. SHARP principles revolve around increasing active learning time including stretching while moving, STRATEGIES FOR INCREASING MVPA IN CHILDREN 72 high repetition motor skills, accessibility through differentiation, reduce sitting and standing, and promoting high levels of in class PA. A quasi-experimental design using one control school (210 children) and one experimental school (275 children) was used in West Midlands, UK. The average class size was 30 students taught by one PE specialist and other non-specialized PE teachers in both the control (traditional PE lessons) and experimental groups (lessons incorporating SHARP principles). Results concluded that the proportion of time students were engaged in MVPA during PE lessons in experimental group increasing significantly between baseline levels of 42.51% and post-experimental levels of 72.59% as compared to control group students. This study focuses on the benefits of implementing specific classroom strategies to increase MVPA in PE classes (Powell, Woodfield & Nevill, 2016). Hollis et al. (2016) systematically reviewed studies specifically targeting how much MVPA is achieved during PE classes. Inclusion criteria included studies completed 2005-2014, assessed MVPA in PE lessons of elementary school students, and used objective methods of measuring MVPA. The search yielded 13 studies from nine countries, eight measuring MVPA by teacher observational measures and five using pedometers/heart rate monitors. Most studies were cross sectional in design and five studies were randomized control trials (RCT’s). Results concluded that time spent in MVPA ranged from 11.4-88.5% of physical education class time. PE classes consisting of fitness and game-based lessons scored higher MVPA rates then skillbased sport curriculum. Included in the review, Robinson, Wadsworth, Webster, and Bassett (2014) investigated the implementation of a mandated daily PE intervention in rural Alabama during an observational cross-sectional study. Researchers observed 683 students within five elementary schools and concluded that schools who did provide daily PE classes taught by PE specialists achieved 59.38 percent of PE minutes in MVPA, yet many schools were not in total STRATEGIES FOR INCREASING MVPA IN CHILDREN 73 compliance of the daily PE mandate and the highest levels of MVPA were present in classes over 30 minutes in length (Robinson et al., 2016). The Hollis et al. (2016) review also showed highest levels of MVPA were reported in studies where lessons were taught by specialized PE teachers rather than classroom teachers. Studies that used observational data collection produced higher rates of MVPA than studies that measured MVPA using step count/heart rate criteria. This creates possible bias that physical educators are inflating statistics regarding MVPA during class time or highlights uncertainty that these educators perceive MVPA in the correct way (Hollis et al., 2016). MVPA studies presented in Lonsdale et al. (2013) and Hollis et al. (2016) agree and show significant increases in student MVPA with targeted intervention, including an emphasis on fitness-based activities and games. These studies also highlight the need for PE classes to be taught by specialized PE teachers and with adequate class time. With technology saturating the everyday choices of school-aged students, fitness-based PE curriculum must embrace emerging exercise technology. Bailey and McInnis (2011) tested the effects of fitness-based mobile games that could be used as part of a fitness focused PE curriculum compared to traditional forms of exercise on health outcomes. The study tested fitness-based technology games (exergames) on 39 boys and girls (mean age 11.5) recruited from Boston area schools and after-school programs. When compared to treadmill walking Nintendo Wii boxing, LightSpace bug invasion, Dance Dance Revolution, and Cyber Trazer goalie wars raised children’s energy expenditure higher than walking at 3 miles per hour (Bailey & McInnis, 2011). Though not a replacement for comprehensive forms of exercise, exergaming may create more active choices in a predominantly sedentary technology environment. Highlighting the benefits of fitness technology during PE also serves to encourage students to choose fitness- STRATEGIES FOR INCREASING MVPA IN CHILDREN 74 based video/computer games outside of the school day which will increase their overall activity level. Advances in wearable fitness technology can also contribute to increased fitness-based PE curriculum. Bower and Sturman (2015) reviewed the affordability and impact of incorporating wearable technology into PE pedagogy. After surveying 66 international educators, experienced benefits of wearable technology included student engagement and motivation, meaningful fitness data collection which aided class assessments (FitBit recording student step count and average heart rate), and feedback to guide lesson design (using fitness data to monitor student time in MVPA) (Bower & Sturman, 2015). By utilizing technology as fitness motivator, students develop more autonomy in making healthy choices now and in the future. Sufficient PE class minutes along with a fitness focused curriculum gives physical educators the opportunity to incorporate meaningful MVPA interventions and strategies into their lessons. Using fitness-based units during physical education can enhance student’s overall wellness and ability to achieve MVPA recommendations. Highly qualified physical educators that can incorporate fitness concepts, appropriately assess and implement MVPA strategies, and use technology creatively to boost activity are essential to the achievement of comprehensive physical education and attainment of adequate MVPA levels in schools. Education of Physical Education Teachers NASPE defines a highly qualified PE teacher as an individual that possesses the skills and knowledge to foster effective teaching practices, cultivate quality PE instruction, empower students to achieve and maintain an active and healthy lifestyle, and achieve certification from an accredited Physical Education Teacher Education (PETE) program (NASPE, 2007). Authors in STRATEGIES FOR INCREASING MVPA IN CHILDREN 75 the Journal of Physical Education, Recreation & Dance take this position further and contend that the essential elements to producing highly qualified PE teachers are preservice preparation, designing and delivering a meaningful PE program, and professional development (NapperOwen, Martston, Van Volkinburg, Afeman & Brewer, 2008). Exploring PETE program content, analyzing how much health-related fitness knowledge (including MVPA concepts) are included in these programs, and investigating the effectiveness of PE teacher professional development is crucial to understanding the current PE environment and PE teacher’s ability to implement adequate MVPA opportunities. PETE Programs SHAPE states that the duty of physical educators is to foster physically literate individuals who have the knowledge, skills, and confidence to participate in lifetime of healthful physical activity. (SHAPE, 2014). Though the mission of national PE recommendations and state standards are clear, collegiate PETE programs often vary widely in emphasis, content knowledge, skills, and disposition of students (Heidorn, 2014). Many PETE programs have not updated program content to reflect new NASPE and SHAPE standards and focus instead on achieving requirements such as passing entry exams, minimal grade point averages, and administering assessments (Heidorn, 2014). To ensure all PE teachers achieve highly qualified status and provide students with a comprehensive PE experience, all PETE programs must adopt essential components of initial preparation (Heidorn, 2014). During the initial preparation of PE teachers, PETE programs must align pedagogical methods, curriculum and assessments, and skill development with updated national PE standards (Heidorn, 2014). Content that has predominantly focused on sports skills and group athletics STRATEGIES FOR INCREASING MVPA IN CHILDREN 76 must change to reflect current needs for individual health promotion and MVPA attainment (Kirk, 2018). NASPE updated the national standards for initial physical education teacher education in 2008 including emphasis on scientific and theoretical knowledge, skill and fitnessbased competence, planning and implementation, instructional delivery and management, impact on student outcomes, and using technology (NASPE, 2018). Taliaferro, Ayers, and Housner (2017) sent surveys to 609 PETE program directors, in their descriptive analysis, inquiring if current PETE programs reflected the updated NASPE standards. Survey respondents included 156 PETE program directors of which 53.2% reported use of updated NASPE standards as a guide for their undergraduate PETE programs (Taliaferro, Ayers & Housener, 2017). Emphasizing health related fitness and MVPA as part of the NASPE update was reported by 80% of respondents (Taliaferro, Ayers & Housener, 2017). Limitations to Taliaferro et al. research (2017) included the low response rate of 25.6% which may not reflect PETE changes on a national level. The study also does not address the magnitude of current PE teachers who received their initial PETE preparation prior to the NASPE update and how those teachers are attaining updated content knowledge. Standard two of the NASPE update highlights fitness-based competence and the need for schools to implement Comprehensive School Physical Activity Programs (CSPAP) as part of a commitment to aligning PE standards with public health interests (Webster & Nesbitt, 2017). This initiative has a direct influence on PETE programs. Implementation of a CSPAP focuses on PE providing activities that engage students in MVPA during at least 50% of the time in regularly scheduled PE lessons (Webster & Nesbitt, 2017). Webster and Nesbitt (2017) propose that PETE programs can best prepare PE teachers to incorporate MVPA strategies by weaving these techniques within methods courses, student-teaching internships, and other opportunities STRATEGIES FOR INCREASING MVPA IN CHILDREN 77 where upcoming teachers can practice these principles in a hands-on format. CSPAP also call for a PE teachers’ expertise and influence to extend beyond traditional PE class (Webster & Nesbitt, 2017). Updated PETE programs should train PE teachers to be the PA expert and leader for their school (Webster & Nesbitt, 2017). Promoting CSPAP may require PE teachers to offer additional PA and MVPA at recess, during breaks/free periods, before/after school opportunities, as well as increasing MVPA in the traditional PE class (Webster & Nesbitt, 2017). Updated PETE programs must also advocate for PE teachers to recruit their fellow staff members to become PA and MVPA promoters in an effort to immobilize a school-wide approach to attaining fitness standards (Webster & Nesbitt, 2017). Carson, Castelli, Hodges, and Kulinna (2017) spotlighted nine college/university undergraduate PETE programs that have adopted a CSPAP focus within their courses and are pioneering the push for updated PETE programs. These college/universities (Arizona State University, Central & Southern Connecticut State Universities, University of Idaho, University of Kentucky, Wayne State University, University of West Georgia, University of South Carolina, and West Virginia University) use a combination of learning objectives, sample learning experiences, training/certification, research initiatives, and formation of future strategies to focus on CSPAP standards (Carson et al., 2017). Learning objectives include quality PE practices, curriculum design, components of maximizing PA and MVPA, CSPAP content knowledge, and PA/MVPA assessments. Learning experiences involve school visits, school board presentations, internships, online portfolios, and on site CSPAP implementation. These PETE programs encourage undergraduates to also obtain CSPAP aligned certifications such as Certified Physical Activity Leader (CPAL), FITNESSGRAM certification, and national exercise certifications including personal training and group fitness. Research initiatives highlight effectiveness of PA STRATEGIES FOR INCREASING MVPA IN CHILDREN 78 and MVPA programs, administration support of CSPAP, CSPAP development in PETE, CSPAP preservice and in-service teacher knowledge, and technology supported PA and MVPA. These nine collegiate programs have also formed specific strategies PE teachers may implement in the future like teaching behaviors related to maximizing PA and MVPA, developing PA leadership courses, building partnerships with the community, and expanding before/after school PA/MVPA opportunities (Carson et al, 2017). These programs also highlight that it is not enough for PE teachers to merely follow a curriculum but instead PE teachers should focus on the individual needs of their school population and create innovative strategies for increasing PA and MVPA. These programs however only represent nine college/universities out of the hundreds of collegiate PETE programs across the United States. Until PETE programs nationwide adopt a common curriculum of teacher education, it is unclear if updated standards and methods of achieving PA and MVPA standards will be available to all students. Health-Related Fitness Knowledge/Application Research has shown that to become a physically fit individual and engage in healthy behaviors, one must have critical understanding and application knowledge of health-related fitness (HRF) concepts (Castelli &Williams, 2007). Growing trends of inactivity in children, prompted the updating of NASPE standards to include language on HRF knowledge including: how to assess personal fitness, identify fitness goals, and design physical activity programs (Kohl, 2013). Content knowledge of PE teachers has generally focused on movement, sport education, and foundational pedagogy (Kohl, 2013). Castelli and Williams (2007) examined the HRF content knowledge of physical educators. During a professional development program for 39 male and 34 female middle school PE teachers, tests were given to assess their confidence in STRATEGIES FOR INCREASING MVPA IN CHILDREN 79 their perceived HRF knowledge followed by a test, which measured their actual HRF knowledge. Results indicated that the sampled PE teachers were highly confident in their HRF knowledge and anticipated high scores however only 38% passed the HRF knowledge test. Common errors were recorded in fitness terminology and concepts including inaccurate identification of healthy heart rate zones, workout intensity benchmarks, and fitness program progression (Castelli &Williams, 2007). Physical educators must have solid HRF knowledge and be ready to apply that knowledge in order to effectively impart this information to their students. Kim, Lee, Ward, and Li (2015), analyzed 26 PETE programs for depth of content knowledge in movement concepts. Content knowledge was split into two groups, common content knowledge (CK) including sport and dance movements along with specialized content knowledge (SCK) in areas such as HRF and MVPA. Programs were purposefully recruited by PETE program reputation distinction as ‘in good standing’. Good standing criteria was determined by surveying three PETE professors unaffiliated with the study with 30+ years’ experience in PETE programs and who held national level PE positions and asked them to list two PETE programs in each state with good standing reputations. This yielded 100 PETE programs to be contacted for study. Data was collected using websites, interviews with program coordinators, and course syllabi (provided by 26 of 100 schools contacted) which were analyzed using descriptive statistics. Results showed that on average 10.4% of total credit hours were spent in CK of movement concept courses. Of the 26 programs who provided syllabi, 20 of those schools (76.9%) spent class time assessing students SCK of movement concepts. This study further highlights a disconnect between the national PE standards that mandate PE teachers STRATEGIES FOR INCREASING MVPA IN CHILDREN 80 increase the HRF of their students and the PETE programs (even those in good standing) who are supposed to arm them with the knowledge to do so (Kim et al., 2017). The November/December 2018 issue (p. 67-68) of the Journal of Physical Education, Recreation & Dance, took the issue of HRF and PETE programs a step further as asked its readers this question: Should PETE programs require majors to achieve minimal levels of HRF? The associate dean of research and assessment at the University of West Georgia responded by saying “Participating in regular physical activity at a level sufficient to promote HRF is an important behavior for professionals in all fields of physical activity at all levels.” While a current graduate student at Georgia State University contends that “there is little relationship between what teachers need to teach in PE and teachers’ own HRF levels.” A current PE teacher in Atlanta, GA states that “PETE programs should require minimum levels of HRF because students give their best effort in PE activities if they know their teacher is playing the game or doing the fitness task with them.” SHAPE defines components of a physically literate person as an individual that is physically fit and values physical activity and its contributions to a healthful lifestyle (Heidorn, 2014). PETE programs must supply teachers with pedagogical content including psychomotor, cognitive, and affective characteristics but also solid fitness knowledge in order to adequately promote health and a physically active lifestyle (Bulger & Housner, 2007). A Delphi method (series of questionnaires given to a group of experts) study was conducted to discuss what fitness competencies and instructional methods are essential to provide within PETE programs. Experts concluded that PETE programs should include HRF items related to: developmental exercise physiology application, behavior change, and weight management. The Delphi experts further advocated that staff professional development and opportunities should be STRATEGIES FOR INCREASING MVPA IN CHILDREN 81 given to physical educators to achieve competency in HRF concepts if these essential topics were not included in their own PETE program (Bulger & Housner, 2007). Chen, Mason, Hypnar, and Bennett (2016) contend that PE teachers HRF knowledge is only the first step in increasing the fitness of their students but how they apply this knowledge. Chen et al. (2016) studied nine elementary PE teachers and their use of the NASPE recommended four essential dimensions of quality physical education teaching (QPET) and its effect on the physical fitness of 1,201 fourth and fifth grade students. Participants were nine elementary PE teachers (five females and four males) with teaching experience ranging from 6-26 years, age range from 33-55, and class sizes of 18-28 students. QPET involved lesson task design, task presentation, class management, and instructional guidance. Results showed that consistently implemented QPET standards had a direct effect on student’s cardiovascular endurance, muscular strength, and flexibility fitness levels as tested by the FITNESSGRAM assessment. Chen et al. (2016) contend that PE teachers who provide students with sequentially progression, developmentally appropriate, and maximally and actively engaging lessons had students with higher levels of HRF. However, this study does not examine the educational background, PETE program content, and professional development access of these PE teachers which could explain their ability or inability to successfully implement QPET concepts. Professional Development Professional development and support are key elements of effective teaching (Cardina & DeNysschen, 2018). Physical educator’s knowledge of HRF could be bolstered by increased fitness based professional development. Cardina and DeNysschen (2018) analyzed data in 201112 from new (hired after 2008) and veteran (hired prior to 2008) K-12 physical educators STRATEGIES FOR INCREASING MVPA IN CHILDREN 82 nationwide concerning the frequency and type of professional development they received. This data was obtained from the annual Schools and Staffing Survey (SASS). Physical educators reported fewer professional development opportunities such as workshops, conferences, and inservice training sessions as compared to other subject teachers. They also reported little content specific professional development and less likelihood to be financially compensated for the professional development courses they did attend (Cardina & DeNysschen, 2018). Newly hired physical education teachers reported more professional development opportunities than veteran PE teachers. Numerous MVPA intervention models (TEXAS-ICAN, Play60, and SchoolsOnTheMove) are marketed to physical education teachers as a way to create meaningful lessons for their students, however time to learn implementation of these interventions is limited without adequate professional development for physical educators (Kohl, 2013). Increased professional development time could give physical educators the opportunity to successfully implement these PA and MVPA intervention models by enhancing collaboration, opportunities to apply for grants to fund the purchase of tools and programming and allow for appropriate synthesis of fitness test data that may guide curriculum focus. Furthermore, cluster randomized controlled trial protocols have been crafted by many university researchers including: Internetbased Professional Learning to help support Activity in Youth (iPLAY), and Activity and Motivation in Physical Education (AMPED) (Londsdale et al., 2016), which could add to the body of evidence for increasing MVPA in school-age children and why it is beneficial. By creating professional development partnerships with universities, these study protocols could be effectively carried out by physical educators and give researchers a wealth of data on the current STRATEGIES FOR INCREASING MVPA IN CHILDREN 83 state of MVPA in schools. The time and planning needed to form and conduct these partnerships can only be achieved through increased professional development time for physical educators. Weaver et al. (2017) examined the effects of a participator-based, competency-/skillbuilding professional development workshop for PE teachers on the use of PA promotion practices and students’ MVPA. PE teachers (five female and 4 male) from eight elementary schools in rural Southeastern U.S. were included in this study. Study protocols focused on empowering teachers with knowledge and skills on how to increase MVPA of their students rather than focusing on curriculum changes or budgeting for increased resources (Weaver et al., 2017). To foster a participatory approach, teachers worked in collaborative groups to review best practices, identify goals related to meeting MVPA guidelines, and develop strategies for achieving those goals (Weaver et al., 2017). The working collaborative groups met monthly for seven months and consisted of PE teachers in study, district-level administrator, and college personnel. The primary target of these meetings was to develop low to no cost strategies that could be easily incorporated into existing curriculum and lessons (Weaver et al., 2017). Collaboration meetings results in best practice framework which consisted of professional development trainings for PE teachers, implementing LET US Play Principles, increasing activity opportunities during PE, moving lessons outdoors, and conducting booster workshops (Weaver et al., 2017). Providing effective professional development for PE teachers was a main focus of this study. The school district participating in the study provided professional development days for all teachers however there were no current PE specific professional development opportunities for PE teachers (Weaver et al., 2017). Baseline PA and MVPA levels of students from each participating PE teacher’s classrooms were taken using System for Observing Fitness Instruction STRATEGIES FOR INCREASING MVPA IN CHILDREN 84 Time (SOFIT). After teachers began implementing strategies developed by collaboration meetings (which they learned during PE specific professional development days) PA and MVPA levels were retaken. Results indicated that both PA and MVPA of students were increased after PE teachers had access to participatory-based competency-building professional development (Weaver et al., 2017). The consensus of current research shows that with the increasingly important distinction of being a “highly qualified” PE teacher and given the large population of current PE teachers who were educated in PETE programs prior to the 2008 overhaul of NASPE standards, professional development is vital for PE teachers to receive updated education and skills on current PE trends (Napper-Owen et al., 2008). Professional growth and development are careerlong commitments and do not stop once a PE teacher completes their initial PETE training (Napper-Owen et al., 2008). The implementation of CSPAP expanding the roles of PE teachers makes professional development opportunities even more valuable to foster meaningful PA and MVPA opportunities throughout the school day (Webster & Nesbit, 2017). MVPA Interventions During School Day PE offers structured PA during the school day by using meaningful learning objectives and curriculum units to educate students on the benefits and applications of health and fitness (Calvert et al., 2018). Many school districts have recently reduced PE class opportunities due to the ever-increasing demands of preparing students of standardized academic test (CDC, 2014). Including opportunities for PA and MVPA during other aspects of the academic day has been used to remedy decreased PE minutes while maintaining commitment to adequate PA for students STRATEGIES FOR INCREASING MVPA IN CHILDREN 85 (Calvert et al., 2018). CSPAP also encourage PE teachers to act as PA leaders not just during PE classes but advocate for increasing movement whenever possible whether that be before/after school programs or breaks within the traditional school day (Webster & Nesbitt, 2017). These opportunities include: academic classroom movement interventions, school wide PA and MVPA initiatives, and enhanced recess opportunities. Academic Classroom Calvert et al. (2018) tested the effects of classroom interventions on PA rates of students in five elementary schools. The research study tested 1,346 students across 65 classrooms grades 3-5 wore pedometers to measure step counts during PE, recess and classroom based physical activity (CBPA). CBPA consisted of booklet-based energizers, GoNoodle (a web-based app with activity videos), and teacher designed CBPA activities including dance breaks and fitness flash cards (Calvert et al., 2018). Results indicated that targeted PA opportunities had a profound effect on students overall daily step count. Students overall step count was highest on physical education days (one day per week) yet days when CBPA was offered (non-PE days) students’ step counts were significantly higher than days when recess alone was offered. Gender interaction showed boys to be significantly higher step counts than girls during PE and recess, yet similar step counts during CBPA, especially in 5th grade students. Recess step counts varied widely from student to student depending on which recess activity they were engaged in. Schools suffering from budget cuts and increased demands of standardized testing often cut back on PE classes using the rationale that recess creates adequate physical activity opportunities. Calvert et al. (2018) contends that there is no substitute for comprehensive physical education minutes yet CBPA could provide more meaningful PA opportunities on non- PE days. STRATEGIES FOR INCREASING MVPA IN CHILDREN 86 A pilot study by Bershwing and Brusseau (2013) tested the effects of academic classroom activity breaks on 4th grade students step count and MVPA. The study included 21 children in a rural school in upstate New York using New Lifestyle-100 pedometers, which have been shown to be accurate in measuring step count and time in MVPA. Activity breaks were generally 10 minutes long and utilized one to three times per school day. Students participated in one structured activity break (running/jogging outside or in gym space) but could choose to take up to two additional breaks with teacher’s permission (these breaks were performed in classroom utilizing activities that could be completed at students’ desk like jumping jacks, high knees, or stretching). Results compared baseline step counts and experimental group step count data and concluded that activity breaks in the academic classroom significantly increased students step count (+845 steps daily) and MVPA (+4.6 minutes daily). Bershwing and Brusseau (2013) highlighted the effectiveness of academic classroom activity breaks in increasing student step count which has been shown to improve overall cardiovascular fitness yet further study using larger population and randomized design is needed to increase validity of findings. School Wide Activity Programs Physical activity interventions used in an individual academic classroom setting can be beneficial. School districts often focus on the need to educate the whole child and establishing school wide physical activity and fitness programs that can be accessed by all grade levels can reinforce this commitment. The Physical Activity as a Civil Skill intervention was used to measure MVPA’s effect on adolescent physical competence (Grasten et al., 2017). Implemented on North East Finland, one intervention component was the concept of fitness hall. Fitness hall STRATEGIES FOR INCREASING MVPA IN CHILDREN 87 consisted of a classroom within the school that was converted into a fitness facility that students can utilize for short breaks (average 10 minutes) to exercise or engage is supervised movement activities and then return to their classroom (Grasten et al., 2017). Results showed that MVPA in experimental group raised from “weak” to “moderate” during experimental period as compared to control group which remained classified as “weak.” While PA breaks as short as 10 minutes have been shown to increase MVPA opportunities for students (Bershwing & Brusseau, 2013), they can also provide increased attention when students return to their academic classroom (Gapin, Labban & Etnier, 2011). PA has also been shown to increase focus in students who are suffering from various attention deficit disorders (Gapin et al., 2011). Cluss et al. (2016) conducted a longitudinal study on the effectiveness of the school-wide HEALTHY Armstrong (HA) wellness initiative. This was a district wide intervention consisting of school-based health interventions implemented throughout all elementary schools in Armstrong County, Pennsylvania between 2006-2015. School officials adopted this program when school health testing revealed that 37% of elementary school students in the Armstrong School District were considered obese. School wide PA and MVPA interventions consisted of before school walking program, all school exercises as part of morning announcements, Hoops/Jump Rope for Heart event, several school promoted fun runs to coincide with holidays (pumpkin run, turkey trot, joy jog and shamrock shuffle), brain break physical activity, and fitness as a reward program for good behavior where students had access to GeoMotion Mats instead of sedentary computer time as reward. Activity minutes were collected using pedometers and heart rate monitors and referred to as KidMinutes. There was no comparison or control group in this study yet results concluded that KidMinutes increased 293% over the 10-year study period because of implemented school-wide activity interventions (Cluss et al., 2016). These STRATEGIES FOR INCREASING MVPA IN CHILDREN 88 research studies affirm that extending PA and MVPA opportunities throughout the school day in conjunction with CSPAP plans can have a profound effect on the overall health and attainment of PA and MVPA recommendations of school-aged children (Webster & Nesbitt, 2017). Enhanced Recess Though recess gives school aged students designated time during the school day for PA, these opportunities vary greatly in physical intensity (Calvert et al., 2018). While some students might choose MVPA opportunities like soccer or tag during recess, many students choose sedentary options as recess tends to be unstructured in nature (Calvert et al., 2018). By enhancing MVPA opportunities during recess (e.g. providing various choice centers of portable activities including poly spot tag, speed drill ladders, and juggling implements) students may be more likely to choose these activities over sedentary options (Beets et al., 2016). Using reliable accelerometers, students MVPA during recess was recorded in Chilean secondary school children (Mayorga-Vega, Saldias & Viciana, 2017). Recess showed to produce 40% of daily MVPA in students who chose running based activities but statistically minimal MVPA in students who chose non-running based activities (Mayorga-Vega et al., 2017). As a part of CSPAP plans, PE teachers acting as PA leaders can educate playground monitors and other school staff in providing recess equipment and activities that promote an increase in PA and MVPA (Webster & Nesbitt, 2017). Redesigning playgrounds is another strategy when implementing enhanced recess concepts. Hammer et al. (2017) proposed that reconfiguring playground spaces to limit sedentary activity options would increase physical activity rates among elementary school children, especially in urban schools that lack green space. Five experimental and two control STRATEGIES FOR INCREASING MVPA IN CHILDREN 89 groups consisting of 347 students in inner city London were tested using accelerometers to measure activity level while playing in both traditional and redesigned playground spaces. Experimental groups played in redesigned playgrounds deemed “active playgrounds” which implemented AstroTurf (to encourage running despite weather conditions), climbing frames, trampolines, and themed jungle gyms including ancient ruins, volcano, and cloud decorations. Control groups played in traditional playground, which consisted of some natural green space for running, slides, and swings. Results indicated that redesigned playgrounds did not have a significant effect on MVPA; yet increased light to moderate PA, with a significant decrease in sedentary time among children under nine years old was reported (Hamer et al., 2017). Cost would be a limiting factor when redesigning traditional playground spaces in mainstream schools. Recess has often been reduced do to time on learning mandates required by school districts, which fuels the need for recess enhancements and playground redesign that could make the most of waning recess PA opportunities (Beets et al., 2016). PE teachers should not have to act alone to promote PA and MVPA in schools (Webster & Nesbott, 2017). By taking a coordinated school-wide approach and using the foundations of CSPAP, students will benefit from comprehensive movement opportunities. While not a substitute for meaningful PE instruction, PA and MVPA opportunities throughout the school day will serve to increase the health of the school community at large (Webster & Nesbott, 2017). STRATEGIES FOR INCREASING MVPA IN CHILDREN 90 Theory of Expanded, Extended and Enhanced MVPA Opportunities The theory of expanded, extended, and enhanced opportunities (TEO) for adolescent physical activity could become the foundation of PETE programs, PE teacher professional development, and the realization of comprehensive increases in MVPA among children (Beets et al., 2016). The TEO acknowledges the need for increased physical activity (PA) among youth and praises the studies that research this topic yet proposes that the reason for lackluster improvements in PA and MVPA opportunities for youth is due to a crisis between interpretation and application of strategies and interventions. To successfully promote behavior-change, interventions must follow three categories: expansion of opportunities to include new occasions to be active, extension of existing opportunities, and/or enhancement of existing opportunities (Beets et al., 2016). Weaver et al. (2018) established the Partnerships for Active Children in Elementary Schools, which used a multidimensional intervention approach to collect data in a quasiexperimental study on how best to increase MVPA in elementary school children. The study focused on grades 1-3 in three elementary schools using 229 students along with 14 teachers as participants. Students were split into experimental and control groups and the students in experimental groups received the LET US Play enhanced physical education intervention while the control group participated in traditional physical education class. The LET US Play principles include modifying traditional games to enhance MVPA content, design active warmups/instant activities, directions, and transitions, adapting class formats to decrease wait time, and including more student choice in lesson components. The intervention also focused on enhancing PE lessons to include MVPA goals for each class. Students then worked together to 91 STRATEGIES FOR INCREASING MVPA IN CHILDREN achieve these goals. Games were modified to include more MVPA at little or no cost to school. Students in experimental groups increased their MVPA during PE by 11.5% as compared to control group (Weaver et al., 2018). Barney and Prusak (2015) used music as an enhancement to physical education class to produce more PA in elementary school students. In this quasi-experimental study participants included 115 elementary aged students in grades 3-5, 48 males and 67 females. PA rates were measured using pedometers. Students were split into experimental music and non-music control groups. After learning how to use pedometers and practicing data collection, students in both groups used pedometers while participating in three 30-minute physical education classes on non-consecutive days. Music was selected by physical education teacher and was a moderate to fast tempo. The only change to lesson protocol between experimental group and control group was music. Music was played during entire class, except when instructions were given. Results concluded that PA rates were significantly higher when music was played. Gender-specific results, which showed that regardless of music status boys had significantly higher PA rates than girls (Barney & Prusak, 2015). This is a solid example of how enhancement of existing PA opportunities can have a profound effect on activity outcomes. Weaver, Beets, Brazendale, and Brusseau (2017) used elements of the TEO during an intervention study which implemented low to no cost PE strategies meant to increase PA and MVPA in children during summer program interventions. The most successful strategies again followed LET US Play principles including making off-task behavior more active, increasing time in motor content, and teaching more lessons/activities outdoors. These strategies produced meaningful increases in MVPA while being easily implemented by PE teachers or summer program staff. This study used multiple strategies of expanding, extending, and enhancing STRATEGIES FOR INCREASING MVPA IN CHILDREN 92 MVPA opportunities and also highlights the importance to extending opportunities past the regular school day and school year. This further strengthens the evidence that the TEO model is sound in theory and practice (Weaver et al., 2017). Using the TEO as a guide, researchers and physical educators can convert MVPA intervention theory into actual results. To maximize expansions (replacing sedentary activities with movement alternatives), extensions (lengthening current PA opportunities to include before, during, and after-school options), and enhancements (modifying existing PA opportunities to include more MVPA) the stakeholders who implement these techniques must use a practical and realistic approach. PE teachers are on the front lines of the childhood obesity crisis and could serve to bridge the gap between interpretation and application of MVPA interventions. STRATEGIES FOR INCREASING MVPA IN CHILDREN 93 Conclusion Practicing healthy behaviors starts in childhood. When school aged children have positive associations with PA they are more likely to make healthy choices into adulthood. Sixty minutes of MVPA daily has shown to promote increased physical, social, and emotional health among children and adolescents (CDC, 2012). School districts have the obligation to provide meaningful PA opportunities for their students through comprehensive PE, updated PETE programs, and professional development opportunities that contain essential fitness training and HRF knowledge for PE teachers, targeted MVPA interventions implemented throughout the school day which foster components of CSPAP and use of the TEO model to guide practical application of MVPA. Comprehensive PE must include recommended class minutes of 150 minutes for elementary students and secondary students receiving 225 minutes of PE weekly (CDC, 2014). These minutes must be filled with high quality curriculum strands focusing on fitness knowledge, skills and behaviors that will foster a physically active lifestyle. PE teachers must be able to assess activity levels and implement effective fitness-based strategies that promote MVPA and impart balanced HRF knowledge to their students (Kohl, 2013). Comprehensive PE must also align itself with public health recommendations and transition to a program of health promotion not merely sport skills and team athletics (Kirk, 2018). Meaningful and abundant PE specific professional development for physical educators will ensure that functional fitness and MVPA concepts and strategies become familiar to all PE teachers and can be incorporated into lesson design (Bulger & Housner, 2007). Institutions of higher education must also refine and update the focus of PETE programs to ensure that STRATEGIES FOR INCREASING MVPA IN CHILDREN 94 foundational knowledge reflects NASPE standards and the need for increased fitness-based activities in the increasingly sedentary population of school children (Bulger & Housner, 2007). Creating meaningful partnerships between physical educators and university research departments (through professional development) may reinforce the importance of school-based MVPA strategies, contribute to the body of high-level evidence-based testing, and legitimize the role of comprehensive physical education. PETE programs and professional development opportunities must also promote innovation among PE teachers to think outside traditional PE curriculum and create dynamic lessons that benefit their individual school population. Adopting CSPAP plans and expanding the roles of PE teachers as PA leaders will also serve to translate NASPA standards into a common language and guide for all schools. Increasing MVPA opportunities throughout the school day is also needed to reinforce a commitment to educating and providing for the whole child (Kohl, 2013). PE teachers should not fight the battle of childhood and adolescent obesity and inactivity alone (Webster & Nesbitt, 2017). Creating a school-wide commitment and approach to PA and MVPA attainment will increase the health of the overall school community. Classroom activity breaks, access to fitness hall/school wide PA/MVPA initiatives, and enhanced recess opportunities on redesigned playgrounds give students multiple PA and MVPA opportunities throughout the day, which could lead to higher fitness levels, increased academic focus, and decreased classroom behavioral issues (Kohl, 2013). Future research on MVPA in school age children needs to focus on high levels of experimental evidence. Quasi-experimental study protocols are often implemented when school children are the focus (Kohl, 2013). Though the studies in this review provide compelling data and resounding consensus, RCT studies on larger levels give higher validity to these outcomes. Refining experimental methods will strengthen findings on the STRATEGIES FOR INCREASING MVPA IN CHILDREN 95 effects of MVPA interventions within school-aged populations. Schools are in an optimal position to influence the health of children. Consistent opportunities for PA and MVPA encourage students to make positive choices that contribute to their overall wellness (CDC, 2017). By uniting PE teachers, classroom teachers, and school administrators/staff in comprehensive school-based MVPA interventions, students may develop positive associations with PA and understand these activities to be an integral and positive influence on their quality of life. STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix B Problem Statement 96 STRATEGIES FOR INCREASING MVPA IN CHILDREN 97 Researchers agree that MVPA is essential for optimal health in childhood. While research has focused on creating intervention strategies to increase levels of MVPA in children and adolescents, many randomized controlled trials utilizing these strategies have produced only small improvements (Beets et al., 2016). Interventions that have high levels of feasibility and effectiveness require specialized training for EPE teachers as well as sufficient funding (Dallolio, Ceciliani, Sanna, Garulli & Leoni, 2016). Research has not adequately addressed how these strategies are to be implemented in a variety of socio-economic school environments (Stathi & Sebire, 2011) as well as identifying barriers that EPE teachers may encounter that prevent MVPA knowledge and successful intervention implementation, which this research will examine. This mixed-method study hoped to reveal such barriers as well as MVPA best practices used among EPE teachers and possibly identify new or innovative MVPA activities not shown in empirical research that are being used in day-to-day EPE lessons. The employment and scheduling of EPE teachers may also affect implementation of effective MVPA strategies and can vary widely from school to school. Full-time EPE teachers often have to accommodate large class sizes, part-time EPE teachers may not have access to quality equipment and facilities, decreased planning time and professional development, and itinerant EPE teachers often share classroom space and divide resources among multiple schools. This research will also examine the differing cases of full-time, part-time, and itinerant physical education teachers and how their scheduling, access to professional development, and individual resources might explain and ultimately influence their use of MVPA intervention strategies. STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C Additional Methodology 98 STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C1 School Superintendent/Committee Letter and Approval 99 STRATEGIES FOR INCREASING MVPA IN CHILDREN 100 1594 Cape Street Williamsburg, MA 01095 DOS9983@calu.edu December 13, 2018 Dr. David Hopson, Superintendent, Gateway Regional School District Ms. Michele Crane, Chair, Gateway Regional School Committee Gateway Regional School District 12 Littleville Road Huntington, MA 01050 Dear Dr. Hopson & Ms. Crane, As you know, I am currently a doctoral candidate through California University of Pennsylvania’s Global Online Health Science and Exercise Leadership Program. I have been taking courses for the past two years and have now passed the comprehensive exams that allow me to move onto the dissertation phase of my doctorate in Health Sciences (DHSc). My research will be independent from my teaching role; however, I would like to make you aware of the process. For my dissertation, I am researching the use of moderate to vigorous physical activity (MVPA) interventions/strategies in elementary physical education (EPE) classes. I would like to send surveys to all EPE teachers in Hampshire and possibly Hampden counties to conduct this research and am seeking your approval to conduct this survey research using these teacher’s school email accounts, retrieved from school district websites. The content of the recruitment and survey link email provided to the teachers will in no way reflect or disclose any personal identifying information nor interfere with their teaching responsibilities. Their participation in my study would be voluntary with implied consent by completing the online survey with potential consent to follow-up interview if identified on the survey. In my eleven years teaching physical education and health here in the Gateway Regional School District, it has been my mission and passion to provide the most comprehensive physical education experience for my students. By conducting this study, I hope to increase research on the current state of physical education classrooms and help guide MVPA intervention development as to what EPE teachers need for successful implementation of activity programs. Thank you for your continued support of my advanced course plan. Respectfully, Denae Kessel Dostal Dr. Rebecca Hess, Faculty Advisor, hess_ra@calu.edu STRATEGIES FOR INCREASING MVPA IN CHILDREN 101 STRATEGIES FOR INCREASING MVPA IN CHILDREN 102 1594 Cape Street Williamsburg, MA 01095 Dear Hampshire & Hampden County School Superintendents, My name is Denae Kessel Dostal. I am currently a doctoral candidate through California University of Pennsylvania’s Global Online Health Science and Exercise Leadership Program and have been a physical education teacher in Western Massachusetts for 11 years. I would like to inform you that for my dissertation, Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children, I will be sending surveys to all EPE teachers in Hampshire and possibly Hampden counties to conduct this research. I will be obtaining these teacher’s school email accounts, retrieved from school district websites. The content of the recruitment and survey link email provided to the teachers will in no way reflect or disclose any personal identifying information nor interfere with their teaching responsibilities. Their participation in my study would be voluntary with implied consent by completing the online survey with potential consent to a follow-up interview if identified on the survey. I have received the support and letter of approval to proceed from my own district superintendent, Dr. David Hopson. This research has also been approved by the California University of Pennsylvania’s Institutional Review Board. In my eleven years teaching physical education and health in the Gateway Regional School District, it has been my mission and passion to provide the most comprehensive physical education experience for my students. By conducting this study, I hope to increase research on the current state of physical education classrooms and help guide MVPA intervention development as to what EPE teachers need for successful implementation of activity programs. Respectfully, Denae Kessel Dostal DOS9983@calu.edu Dr. Rebecca Hess, Faculty Advisor, hess_ra@calu.edu STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C2 Recruitment Email and Survey Link 103 STRATEGIES FOR INCREASING MVPA IN CHILDREN 104 Dear Physical Educator, My name is Denae Kessel Dostal and I am currently a doctoral candidate in Health Science and Exercise Leadership (DHSc) through California University of Pennsylvania. I have also been a physical education teacher in Hampshire county Massachusetts for the past 11 years. For my dissertation (Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children), I am researching the use of activity interventions/strategies in elementary physical education (EPE) classes. I am inviting you to participate in this research study by completing the attached survey. Moderate to vigorous physical activity in children and adolescents creates a powerful impact on their quality of life (CDC, 2017). Physical Activity Guidelines for Americans (CDC, 2017) recommends that children and adolescents achieve sixty minutes of MVPA daily. Current reports find that only 28% of children in the United States achieve the daily activity recommendations, and that one in five school-aged children are considered obese (CDC, 2017). As physical educators we see these statistics first hand. Increased research on the current state of physical education in schools is needed to help make PE a priority, guide funding, and inform activity intervention creators what PE teachers need for successful implementation. The survey will take approximately 5-10 minutes to complete. All information will be kept confidential with no identifiable personal information disclosed. If you choose to participate, please answer all survey questions as honestly as possible. Participation is strictly voluntary. My district superintendent and school committee are aware and in support of my dissertation research and his study has been approved by the California University of Pennsylvania Institutional Review Board. Completion of this survey will indicate your willingness to participate in this study and serve as implied consent. It is my aim that data collected from the electronic survey will provide useful information on the use of MVPA strategies/interventions in EPE. If you are willing to participate in a follow-up phone interview (phase two of study) please choose the phase two option at the end of the survey. Please click on the following link to start the survey: LINK Respectfully, Denae Kessel Dostal DOS9983@calu.edu 413-265-4780 Dr. Rebecca Hess, Faculty Advisor, hess_ra@calu.edu STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C3 Recruitment Email Phase Two 105 STRATEGIES FOR INCREASING MVPA IN CHILDREN 106 Dear Physical Educator, Thank you for your willingness to participate in phase two of this research study, Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children. This phase of research, phase two, will include a phone interview using follow up questions formed from phase one data for the initial survey and will last between 15-30 minutes. By clicking the link below, you will be asked to provide potential interview times, a reliable phone number to reach you, and a consent form to be completed and return email to me at the email account below. All phone interviews will be recorded (using Tape A Call Pro) for analysis purposely only. All interview data will remain anonymous with no recorded information will not be released in any form and will be destroyed at the end of research study. Thank you for your time and consideration on this project. I look forward to talking with you. LINK Respectfully, Denae Kessel Dostal DOS9983@calu.edu 413-265-4780 Dr. Rebecca Hess, Faculty Advisor, hess_ra@calu.edu STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C4 Informed Consent 107 108 STRATEGIES FOR INCREASING MVPA IN CHILDREN Phase Two Interview Informed Consent Form You have volunteered to participate in phase two of a research study titled Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children. This study is being conducted by Denae Kessel Dostal, a doctoral candidate in the Health Science and Exercise Leadership (DHSc) program at California University of Pennsylvania. The purpose of this research study is to collect data regarding the current state of elementary physical education classrooms. You identified that you were willing to take part in the second phase of this study by participating in a semi-structured telephone interview with the researcher. This interview will query your experiences in teaching physical education and will take approximately 30 minutes to complete. The interview will be recorded using Tape A Call Pro and by taking part you consent to be recorded. Recordings will be used for data analysis only and will not be released for any further reporting. You may not directly benefit from this research; however, we hope that your participation in the study will provide useful information that will contribute to increased research in physical education curriculum, guide funding, and reveal what PE teachers need for success in their classrooms. We believe there are no known risks associated with this research study. To the best of our ability your answers in this study will remain confidential. We will minimize any risks by not using identifiable information, using only secure internet survey providers to code interview data, and destroying all interview recording/notes after conclusion of the research study. Your participation in this study is completely voluntary and you can request to end the interview at any time. Also, you are free to skip any question that you choose. If you have questions about this project or if you have a research-related problem, you may contact the researcher, Denae Kessel Dostal (DOS9983@calu.edu) or research advisor, Dr. Rebecca Hess (hess_ra@calu.edu). Approved by the California University of Pennsylvania Institutional Review Board. This approval is effective 03/20/19 and expires 03/19/20. By clicking “I agree” below you are indicating that you are at least 18 years old, have read and understood this consent form and agree to participate in this research study. Please print a copy of this page for your records. I Agree I Do Not Agree STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C5 Email Panel of Experts 109 STRATEGIES FOR INCREASING MVPA IN CHILDREN 110 Dear ________________, My name is Denae Kessel Dostal and I am currently a doctoral candidate in the Health Science and Exercise Leadership (DHSc) program at California University of Pennsylvania. I have also been a physical education teacher in Hampshire county Massachusetts for the past 11 years. For my dissertation (Physical Education (PE) Strategies for Increasing Moderate to Vigorous Physical Activity (MVPA) in School Aged Children), I am researching the use of activity interventions/strategies in elementary physical education (EPE) classes by surveying district EPE teachers in Hampshire and potentially Hampden counties in Massachusetts. I will be using a mixed-methods research design in two phases. Phase one will include an online Survey Monkey survey distributed to all EPE teachers in Hampshire County. A phase two follow up will consist of semi-structured phone interviews of willing participants from phase one. Phase two will ask questions developed from phase one data. I am writing to ask your expert input on my initial phase one survey research questions as your academic credentials and vast experience in physical education would be invaluable. I have attached a copy of my survey research questions for your review and feedback. Respectfully, Denae Kessel Dostal DOS9983@calu.edu 413-265-4780 Dr. Rebecca Hess, Faculty Advisor, hess_ra@calu.edu STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C6 Survey Questions Phase One 111 STRATEGIES FOR INCREASING MVPA IN CHILDREN Demographic Questions 1. How long have you been teaching physical education? (choose one) • 1-3 years • 4-7 years • 8-12years • 13-18 years • 19-25 years • 25+ years 2. What grade levels do you teach? (choose one) • Elementary (PK-5) • Middle (6-8) • High (9-12) • Other (please specify all grade levels) 3. What is the highest level of education do you currently hold (choose one)? • Bachelors • Masters • Masters +15 • Masters +30 • Masters +45 • CAGS • PhD • Other terminal degree (please specify) ______________. 4. What field/s of study for your highest degree? (choose all that apply) 112 STRATEGIES FOR INCREASING MVPA IN CHILDREN • Physical Education • Exercise Science/Kinesiology • Sport Management • Athletic Training • Other (please specify) _______________________. 113 5. Do you hold any of the following credentials/certifications? (choose all that apply) • Certified Personal Trainer (CPT) • Group Fitness Instructor (Aerobics, Strength, ZUMBA) • Certified Strength and Conditioning Specialist (CSCS) • Certified Spin Instructor • Certified Yoga and/or Pilates Instructor • Other (please specify) ________________________. 6. Which Massachusetts teacher’s license do you currently hold? (choose one) • Temporary • Provisional • Initial • Professional 7. Which of the following would most closely describe your teaching assignment? (choose one) • Full-time • Part-time • Itinerant • Other (please specify) __________________________. STRATEGIES FOR INCREASING MVPA IN CHILDREN 114 8. How would you classify the communities your school district serves? (choose one) • Urban • Suburban • Rural • Other (please specify) __________________. 9. Which of the following best describes your school district? (choose one) • City school • Regional school • Charter school • Other (please specify) ____________________. Curriculum and Instruction Questions 10. For PE what is your average class size? (choose one) • 10 or less • 10-15 • 15-20 • 20-25 • 25-30 • 30+ 11. How many days per week do your students receive physical education? (choose one) • 1 • 2 • 3 • 4 STRATEGIES FOR INCREASING MVPA IN CHILDREN • 115 Daily 12. How many minutes are your physical education classes? (choose one) • 30 minutes or less • 30-45 minutes • 45-60 minutes • 60+ minutes 13. Where are your physical education classes located? (choose one) • Gym • Auditorium • Lunchroom • Other (please specify) __________________________. 14. In your teaching tenure has physical education days/minutes been reduced? • Yes • No 15. In the last three years, how many PE specific professional development opportunities have you received as part of your school provided offerings? (choose one) • 0 • 1-3 • 3-5 • 5-7 • 8+ 16. In the last three years, how many PE specific professional development opportunities have you received on your own? (choose one) STRATEGIES FOR INCREASING MVPA IN CHILDREN • 0 • 1-3 • 3-5 • 5-7 • 8+ 116 17. In the past three years have you attended a state, regional, and/or national physical education conference? (choose one) • Yes • No 18. Does your school help cover the cost of professional development outside of school hours? (choose one) • Yes • No 19. In your teacher preparatory undergraduate program, were moderate to vigorous physical activity strategies discussed? (choose one) • Yes • No 20. Have you utilized any of the following curriculums within your teaching of PE? (choose all that apply) • Spark PE • Play 60 • CATCH PE • Let’s Move Active Schools STRATEGIES FOR INCREASING MVPA IN CHILDREN • SWITCH • Move It Groove It • N/A 117 21. Do you utilize any of the following strategies within your classroom: Nonelimination games, fitness focused lessons, active rest, active directions, decreased wait time, active wait time, or small group center rotations? (choose one) • Yes • No 22. What has allowed or prevented you from utilizing these strategies within your classroom? (choose all that apply) • Sufficient financial support • Lack of financial support • Sufficient provided materials • Lack of provided materials • Sufficient class time • Insufficient class time STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C7 Interview Questions Phase Two 118 STRATEGIES FOR INCREASING MVPA IN CHILDREN 119 1. Elaborate on what has promoted/prevented you from implementing MVPA curriculum and strategies within your PE classroom? 2. What has supported your implementation of MVPA strategies within your PE classroom? 3. Did your Physical Education Teacher Education (PETE) program address MVPA? If so, elaborate. If not, have you participated in any PD that has emphasized MVPA? 4. How does being a full-time, part-time, OR itinerant teacher affect your ability to implement MVPA strategies? 5. Explain your experience in receiving PE specific professional development within your teaching career? 6. Explain how/why your school’s PE minutes have changed within your teaching career? 7. How does your school budget for PE resources? 8. Have you been involved with PE curriculum design within your school district and what would you most like to see as part of a PE curriculum in your district? 9. Explain your educational background in PE? 10. Are you regularly active? What physical activities do you regularly participate in? STRATEGIES FOR INCREASING MVPA IN CHILDREN Appendix C8 IRB Materials 120 STRATEGIES FOR INCREASING MVPA IN CHILDREN 121 Institutional Review Board California University of Pennsylvania Morgan Hall, 310 250 University Avenue California, PA 15419 instreviewboard@calu.edu Melissa Sovak, Ph.D. Dear Denae, Please consider this email as official notification that your proposal titled “Physical Education Strategies for Increasing Moderate to Vigorous Activity in School Age Children” (Proposal #18-051) has been approved by the California University of Pennsylvania Institutional Review Board as submitted. The effective date of approval is 3/20/19 and the expiration date is 3/19/20. These dates must appear on the consent form. Please note that Federal Policy requires that you notify the IRB promptly regarding any of the following: (1) Any additions or changes in procedures you might wish for your study (additions or changes must be approved by the IRB before they are implemented) (2) Any events that affect the safety or well-being of subjects (3) Any modifications of your study or other responses that are necessitated by any events reported in (2). (4) To continue your research beyond the approval expiration date of 3/19/20 you must file additional information to be considered for continuing review. Please contact instreviewboard@calu.edu Please notify the Board when data collection is complete. Regards, Melissa Sovak, PhD. Chair, Institutional Review Board 122 STRATEGIES FOR INCREASING MVPA IN CHILDREN Completion Date 21-Nov-2017 Expiration Date 20-Nov-2020 Record ID 25343916 This is to certify that: Denae Dostal Has completed the following CITI Program course: All Researchers Applying for IRB Approval All Researchers Applying for IRB Approval 1 - Basic Course (Curriculum Group) (Course Learner Group) (Stage) Under requirements set by: California University of Pennsylvania Verify at www.citiprogram.org/verify/?w7b1deccd-239e-468c-b8fe-b28d710959ad-25343916 STRATEGIES FOR INCREASING MVPA IN CHILDREN 123 References Bailey, B., & K. M. (2011). Energy cost of exergaming: A comparison of the energy cost of 6 forms of exergaming. Archives of Pediatrics and Adolescent Medicine, 165(7), 597-602. http://DOI10.1001/archpediatrics.2011.15 Barney, D. & Prusak, K. (2015). Effects of music on physical activity rates of elementary physical education students. 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