Increasing compliance with physical education laws to reduce health inequities

项目总结/摘要 今天的年轻人遭受着前所未有的身体不活动和身体健康状况差的痛苦， 导致无数的健康并发症，包括增加心血管疾病的风险。学校体育 体育教育（PE）是增加体育活动和改善青少年健康的最有价值的工具之一， 显示出减少相关健康差距的潜力。然而，尽管43个州的法律规定， 学校提供体育，小学的遵守率极低，学校水平的差异 学生种族/民族和收入存在。有证据表明，缺乏问责制是PE低的主要因素 遵守法律，但问责措施在各州不一致（或不存在）， 提高遵守PE要求的做法仍然未知。本研究旨在探讨两个 通过首先确定纽约市的影响， 教育部学校体育多层次干预对学校体育法规遵从性的影响 学生心肺健康，以及其成本效益，增加学生的身体活动， 以告知其他学区的可复制性。第二，纽约发言的一个组成部分是： 体育审计和反馈工具-将在奥克兰，加州学校试点，以确定有效性， 这种潜在的成本效益高的方法的适应性和可扩展性，以提高PE法律合规性， 学生体育活动。我正在追求NHLBI K 01指导研究科学家发展奖，以填补 在以下方面存在严重的培训差距：（1）从观察数据进行因果推断;（2）成本效益分析;以及（3） 执行科学。这个奖项将建立在我在学校为基础的体育活动的重要经验 研究、流行病学方法和参与性行动研究。我的长期职业目标是发展 并严格评估通过体育活动改善青少年健康的政策和方案方法。 我寻求获得的技能将是实现这一目标的关键。我的详细培训计划包括正式的 课程在加州大学伯克利分校和加州大学旧金山分校，美国国立卫生研究院课程，指导经验，会议，研讨会，并指导 读数。该项目的研究部分将提供机会，将新知识融入 实践研究经验。总的来说，K 01奖提供的培训和保护时间， 在加州大学伯克利分校公共学院丰富的合作环境和强大的机构支持下， 健康和营养政策研究所，将促进我过渡到一个独立的调查员谁可以 成功获得R 01融资。它还将提供帮助我成为领导者的手段， 开发和测试可扩展的学校体育活动环境和政策干预措施， 减少与非活动有关的慢性病的人口风险。

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.