Increasing compliance with physical education laws to reduce health inequities

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PROJECT SUMMARY/ABSTRACT Today’s youth suffer from unprecedented levels of physical inactivity and poor physical fitness, which contribute to myriad health complications, including increased risk for cardiovascular disease. School physical education (PE) is one of the most valuable tools for increasing physical activity and improving youth fitness and shows potential for reducing related health disparities. However, despite laws in 43 states mandating that schools offer PE, compliance is extremely low in elementary schools, and disparities based on school-level student race/ethnicity and income exist. Evidence points to a lack of accountability as a major factor in low PE law compliance, but measures of accountability are inconsistent (or non-existent) across states, and best practices for increasing compliance with PE mandates remain unknown. This study proposes to examine two novel approaches for increasing PE law compliance by first, determining the impact of the New York City Department of Education’s multi-level school physical education (PE) intervention on PE law compliance and student cardiorespiratory fitness, as well as its cost-effectiveness for increasing student physical activity in order to inform replicability in other school districts. Secondly, one component of New York’s intervention – a PE audit and feedback tool – will be piloted in Oakland, CA schools to determine the effectiveness, adaptability, and scalability of this potential cost-effective approach for increasing PE law compliance and student physical activity. I am pursuing the NHLBI K01 Mentored Research Scientist Development Award to fill critical training gaps in (1) causal inference from observational data; (2) cost-effectiveness analysis; and (3) implementation science. This award will build upon my significant experience in school-based physical activity research, epidemiologic methods, and participatory action research. My long-term career goal is to develop and rigorously evaluate policy and programmatic approaches to improve youth health through physical activity. The skills I seek to obtain will be critical in achieving this goal. My detailed training plan includes formal coursework at UC Berkeley and UCSF, NIH courses, mentored experience, meetings, seminars, and directed readings. The research component of this project will provide opportunities to integrate new knowledge into practical research experience. Together, the training and protected time provided by the K01 award, combined with the rich collaborative environment and strong institutional support at the UC Berkeley School of Public Health and the Nutrition Policy Institute, will facilitate my transition into an independent investigator who can successfully compete for R01 funding. It will also provide the means to help me become a leader in the development and testing of scalable school physical activity environment and policy interventions that will reduce population risk of inactivity-related chronic diseases.