Reaching Kids Where They Are — Classroom-Based Interventions to Increase Physical Activity

By Amy Lansky, PhD, MPH, director of the Community Guide Office, Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention

In this post, the author describes recommendations from the Community Preventive Services Task Force (CPSTF) for classroom- and school-based interventions to increase physical activity. Communities may implement these recommendations to achieve Healthy People 2030 objectives and engage in the Centers for Disease Control and Prevention’s (CDC) Active People, Healthy Nation^SM Initiative.

As described in a blog post last October, Healthy People 2030 and The Community Guide work together to support health professionals and improve the health and safety of our nation.

The U.S. Department of Health and Human Services (HHS) manages both Healthy People 2030 and The Community Guide. For more than 26 years, the Healthy People initiative and The Community Guide have collaborated to prioritize health objectives and identify evidence-based approaches to achieve them.

Throughout our lives, regular physical activity is one of the most important things we can do for our health. During childhood and adolescence, regular physical activity (CDC 2021):

• Improves strength and endurance
• Helps build healthy bones and muscles
• Helps control weight
• Reduces risk of depression
• May improve cardiovascular health

In the second edition of the Physical Activity Guidelines for Americans, HHS recommends that young people ages 6 to 17 years participate in at least 60 minutes of physical activity daily.

In 2020, CDC launched Active People, Healthy Nation^SM with the goal to help 27 million people in the United States be more physically active. The initiative uses CPSTF-recommended intervention approaches, including school-based programs. As noted in CDC’s Healthy Schools Guidance and Comprehensive School Physical Activity Program Framework, schools are uniquely situated to help kids be more physically active. When in session, students spend an average of 7 hours at school each day (NCES 2008).

What the Community Preventive Services Task Force Recommends

CPSTF recommends two classroom-based interventions to increase physical activity: physical activity breaks and physically active lessons. These evidence-based recommendations are based on published systematic reviews^1,2 that were selected and rigorously evaluated by a team of specialists in systematic review methods and physical activity research, practice, and policy.

• Classroom-based physical activity breaks engage students in moderate-to-vigorous physical activity between classroom lessons. Evidence from a systematic review of 22 studies shows these interventions increase students’ physical activity during the school day and improve their attentiveness during lessons immediately following the breaks. These interventions supplement other school programs and policies to promote physical activity, such as recess breaks.
• Teachers implementing classroom-based physically active lessons integrate moderate-to-vigorous physical activity into academic lessons taught in or outside of the classroom. Evidence from a systematic review of 42 studies shows interventions increase physical activity during the school day and improve educational outcomes as well as students’ attentiveness to lesson content.

Participating teachers are trained to lead physical activity breaks or integrate physical activity into academic lessons. Many also receive integrated lesson plans or examples and videos or web links to age- and classroom-appropriate exercises and dance routines. Classroom-based physical activity interventions do not require a lot of resources, and they offer teachers the flexibility to fit breaks or lessons into their regular schedules.

Achieve Healthy People 2030 Objectives

In my previous blog post, I noted ways that decision-makers might use CPSTF recommendations to improve health and safety in their communities — and drive progress toward Healthy People’s national objectives and targets.

Schools and communities interested in increasing physical activity among students may use these two CPSTF recommended classroom-based intervention approaches to increase physical activity and help achieve the following Healthy People 2030 objectives:

• Increase the proportion of adolescents who do enough aerobic physical activity — PA‑06
• Increase the proportion of children who do enough aerobic physical activity — PA‑09

Ready to Get Moving?

Explore these HHS resources and share them with local decision-makers:

• Physical Activity Guidelines for Americans
• Increasing Physical Education and Physical Activity: A Framework for Schools [PDF - 3.3 MB]
• Strategies for Classroom Physical Activity in Schools [PDF - 3.5 MB]

Learn about other school-based intervention approaches that CPSTF recommends to increase physical activity. Schools may want to implement more than one intervention:

• Interventions to Increase Active Travel to School
• Enhanced School-Based Physical Education  
• Meal or Fruit and Vegetable Snack Interventions Combined with Physical Activity Interventions in Schools

Stay Up to Date

CPSTF has more than 250 active recommendations and findings across 21 public health topics that cover a range of health issues.

Keep up with what’s new by subscribing to receive emails from The Community Guide. Choose topic areas of interest to you, and we’ll notify you about new recommendations, implementation resources, and Community Guide in Action stories that feature communities and decision-makers across the country who have used CPSTF findings and recommendations to improve health in their communities.

We also encourage you to engage with us on Twitter @CPSTF or contact us with comments or questions.

COVID-19 is a rapidly evolving situation. When working in different community settings, including schools, follow CDC guidance   to help prevent the spread of COVID-19.

References:

¹ Masini, A., Marini, S., Gori, D., Leoni, E., Rochira, A., & Dallolio, L. (2020). Evaluation of school-based interventions of activity breaks in primary schools: A systematic review and meta-analysis. Journal of Science and Medicine in Sport, 23, 377-384.

² Norris, E., van Steen, T., Direito, A., & Stamatakis, E. (2020). Physically active lessons in schools and their impact on physical activity, educational, health and cognition outcomes: A systematic review and meta-analysis. British Journal of Sports Medicine, 54, 826-838.