Program Outcomes for Children

PHYSICAL HEALTH
Outcome Component 4: Is Physically Fit
 

Introduction

Physical fitness is made up of five basic components:  cardiovascular fitness, flexibility, muscular strength and endurance, and body composition.  Physical fitness can be improved through regular aerobic activity of appropriate duration and intensity (Corbin, Pangrazi, 1992; Tamborlane, 1997). 

Physical fitness is a crucial marker of children’s overall physical well-being.  For both children and adults, aerobic physical activity — an important pre-condition to physical fitness — affects both physical development and mental health.  People who are more physically active tend to be more healthy and suffer from fewer mental health problems than people who are less active.  Improved physical fitness also increases self-esteem in many children and adults (Harrow, 1997). 

Although most of the literature on physical fitness for children is associated with school and physical education classes, many of the lessons learned are also relevant for community-based programs that strive to plan well-balanced programs for children. Children’s physical fitness is a major concern to both educators and health care providers.  Both groups agree that children need to maintain a significant level of physical activity in order to be physical fit.  Two national health objectives included in Healthy People 2000 acknowledge the importance of school physical fitness to the overall health of children (Pate et. al, 1995).

American children today are less physically fit, on average, than children of earlier decades.  Many children today engage in fewer active physical activities, such as running, bicycle riding, and team sports, and more sedentary activities, such as watching television or movies and playing video or computer games (Papalia & Olds, 1995).  This decrease in physical activity concerns many professionals because children who lead more sedentary lifestyles are more likely to be obese.  Childhood obesity is increasing rapidly in the United States.  An estimated 10 to 25 percent of American children are substantially overweight, and childhood obesity is on the rise (Tamborlane, 1997).  Childhood obesity is a concern because childhood obesity increases the likelihood of adulthood obesity, which in turn increases the risk of health problems such as heart disease (Klesges, Shelton & Klesges, 1993; Warburton & Sleap, 1992; Brustad, 1996). 

Educators have identified several reasons why children today may be less physically fit:  1) Fewer children participate in physical education classes in school; 2) Many children are less active in winter months; 3) Many children watch substantial amounts of television — the average American child watches 28 hours per week; 4) Many children spend much of their leisure time using computers and playing video games, and 5) Regular exercise is not a family activity (Comstock, 1993; Klesges, Shelton & Klesges, 1993; Papalia & Olds, 1995).

Well-balanced community-based programs can help improve children’s physical fitness by providing regular opportunities for children to engage in aerobic physical activity.  Many adults’ exercise habits become established during childhood.  Including physical activities that children enjoy encourages children to make physical activity a regular part of their lives (Tamborlane, 1997).  Children who feel self-conscious about their physical skills may be more likely to engage in individually-paced physical activities such as running, walking, bicycle riding, jumping rope, or swimming.  Children who enjoy physical activity are much more likely to develop life-long exercise habits, which will increase their physical fitness (Sallis & McKenzie, 1991; Pate, Small, Ross, Young, Flint & Warren, 1995).
 

Suggested Indicators

The following are some appropriate indicators of positive program outcomes for children in the area of physical fitness, based on the NCEO model (Ysseldyke & Thurlow, 1993), as adapted for community-based programs by the Children’s Outcome Work Group.  The appropriateness of any given indicator for your program evaluation depends on the age of the children you serve, the setting, and the goals and activities of your particular program.

A caution must be applied to the third indicator listed below.  Physical activity is a necessary precursor to physical fitness; however, physical activity measured at one point in a child’s life does not necessarily predict long-term physical fitness.  To be effective, physical activity should be measured at regular intervals over an extended period.  Measures of physical activity should be evaluated in combination with other indicators of physical fitness, such as muscle strength or cardiovascular fitness.
 

• Percent of children who are in the expected range of cardiovascular fitness, flexibility, muscle strength, and endurance for their age
• Percent of children with an appropriate ratio of body fat to lean muscle mass for their age
• Percent of children who actively engage in developmentally appropriate physical activities at least three times per week

Summary

Statistics suggest that American children, as a group, are less physically active and more likely to be overweight than in previous years.  Because physical activity and physical fitness are important predictors of overall physical health, many community-based State Strengthening projects provide encouragement and regular opportunities for children to engage in regular physical activity.  Such programs strive to help children increase their physical fitness, learn to enjoy physical activities, and build lifelong exercise habits that will increase overall physical fitness in childhood, adolescence, and adulthood.

Providing regular opportunities for physical activity may be a particularly important component of State Strengthening community-based projects.  Because one focus of the State Strengthening initiative is to increase computer literacy, many children in community-based projects spend significant time working on computers.  Opportunities for regular physical activity are needed to provide an important balance to this time spent in primarily sedentary activity.
 

References

Brustad, R. J.  (1996).  Attraction to physical activity in urban school children:  Parental socialization and gender influences.  Research Quarterly for Exercise and Sport, 67, 316-323.

Comstock, George.  (1993).  The medium and the society: The role of television in American life.  In G. L. Berry and J. K. Asamen (Eds.), Children and Television. Newbury Park, CA: Sage Publications.

Corbin, C. B. & Pangrazi, R. P.  (1992).  Are American children and youth fit?  Research Quarterly for Exercise and Sport, 63, 96-106.

Harrow, M.  (1997).  Validation of a questionnaire to assess physical activity of children ages 4-8 years.  Research Quarterly for Exercise and Sport, 68, 259-268.

Kann, L., Collins, J. L., Pateman, B. C., Small, M. L., Ross, J. G., & Koble, L. J.  (1995).  The school health policies and programs study (SHPPS): Rational for a nationwide status report on school health programs.  Journal of School Health, 65, 291-294.

Klesges, R. C., Shelton, M. L., & Klesges, L. M.  (1993).  Effects of television metabolic rate:  Potential implications for childhood obesity.  Pediatrics, 91, 281-295.

Pate, R. R.;  Small, M. L.;  Ross, J. G.; Young, J. C.; Flint;  & Warren, C. W.  (1995).  School physical education.  Journal of School Health, 65, 312-318.

Papalia, D. E. & Olds, S. W. (1995).  Human Development (6th ed.).  New York: McGraw-Hill.

Sallis, J. F. & McKenzie, T. L.  (1991).  Physical educations role in public health.  Research Quarterly for Excerise and Sport, 62, 124-137.

Warburton, P. & Sleap, M.  (1992).  Physical activity levels of 5-11-year-old children in England as determined by continuous observation.  Research Quarterly for Exercise and Sport, 63, 238-245.

Ysseldyke, J. E., & Thurlow, M. (1993, October). Developing a model of educational outcomes (NCEO Report No. 1). Minneapolis, MN: University of Minnesota, College of Education, National Center on Educational Outcomes.
 

MEASURES: Is Physically Fit

The following standardized assessments are provided as examples of measures that may be useful for evaluation of community-based programs.  This listing is not comprehensive and is not intended as an endorsement of any particular measure.  Some of the assessment instruments that follow are copyrighted and require specific levels of training to administer.  Prices of measures are subject to change.  In deciding to use any standardized measures or checklists, it is important to review specific items and subscales to decide how well they fit your program.

In many cases, physical fitness can also be assessed using secondary data.  Many school physical education programs regularly measure children’s physical fitness using age-appropriate standards such as those established by the President's Challenge Physical Fitness Awards Program.  Those records may provide easily available information about children’s levels of physical fitness.  The major disadvantage to such secondary measures is that State Strengthening projects must rely on the school’s timetable for follow-up assessments of physical fitness; thus, good baseline measures may not be available before the project begins.   Using a combination of existing measures and program assessments with standardized measurement tools may provide a more accurate picture of a State Strengthening project’s effects on children’s physical fitness.
 

1.  Children’s Activity Rating Scale (CARS) J. Puhl, K. Greaves, M. Hoyt, & T. Baranowski
Date:  1990

Subtests:   None

Available Through:

Puhl, J., Greaves, K., Hoyt, M., Baranowki, T.  (1990).  Children’s activity rating scale (CARS): Description and evaluation.  Research Quarterly Exercise Sports, 61, 26-36.

Target Audience:

  Children ages 3-6 years 

The CARS is an observational measure of children’s physical activity that can be used in various locations, including the child’s home, child care centers and community-based programs.  In order to measure children’s physical fitness accurately, observers must be carefully trained.  This is a good measure for assessing the relationship between physical fitness and health among children.

2.  Behaviors of Eating and Physical Activity for Children’s Health Evaluation System   (BEACHES)  T. L. McKenzie, J. F. Sallis, P. R. Nader, T. L. Patterson, J. P.  Elder, C. C. Berry, J. W. Rupp, C. J. Atkins, M. J. Buono, & J. A. Nelson
Date:   1991 

Subtests: 

Five physical activity categories; five dietary behavior categories

McKenzie, T. L., Sallis, J. F. , Nader, P. R., Patterson, T. L., Elder, J. P., Berry, C. C., Rupp, J. W., Atkins, C. J., Buono, M. J., & Nelson, J. A. (1991).  BEACHES: an observational system for assessing children's eating and physical activity behaviors and associated events.  Journal of Applied Behavioral Analysis, 24, 141 - 151.

Target Audience:

Children ages 4 - 8 years

The BEACHES scale provides an index of children’s dietary habits and physical activity levels.  The measure can be administered in many different locations, including the child’s home, school or child care center, and in community-based programs.  Requires observation of child’s activity level at several different points in time to produce an accurate measure.

Physical Health Outcomes

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