Tennessee Department of Education

Tennessee Department of Education Office of Coordinated School Health Physical Activity/Physical Education Annual Report 2011-2012 School Year

Tennessee Department of Education Office of Coordinated School Health Annual Physical Activity/Physical Education Report 2011-2012 School Year Valuing physical activity in schools is reflective of a long standing American tradition: Give about two (hours) every day to exercise; for health must not be sacrificed to learning. A strong body makes the mind strong. Thomas Jefferson The Office of Coordinated School Health is responsible for monitoring the implementation of Tenn. Code Ann. 49-6-1022: (a) In accordance with 49-6-1022, it shall be the duty of each LEA to integrate a minimum of ninety (90) minutes of physical activity per week into the instructional school day for elementary and secondary school students. Opportunities to engage in physical activity may include walking, jumping rope, playing volleyball or other forms of physical activity that promote fitness and well-being. The Tennessee Department of Education s Office of Coordinated School Health (OCSH) works with every school district in the state to address all aspects of student health with special emphasis on reducing Tennessee s childhood obesity rates. Encouraging adequate physical activity and providing physical education for all students are one of the central tenets of the Coordinated School Health (CSH) model. The CSH model is prevention focused. With prevention being the focus, as Tennessee students age our state s health costs will not rise as dramatically as projected. According to Robert Wood Johnsons Trust for America s Health 2012 Tennessee Issue Brief, reducing Tennessee s body mass index rate by 5 percent could lead to state health care cost savings of more than $4 billion in 10 years and $13.8 billion in 20 years. Currently, this report states if Tennessee s obesity rates continue on their current trajectories, by 2030, the obesity rate could reach 63.4 percent. www.tennessee.gov/education/schoolhealth Page 2

According to the latest data from the U.S. Centers for Disease Control and Prevention (CDC), in 2011, 29.2 percent of adults in the state were obese. By 2030, obesity-related health care costs in Tennessee could climb by 17.8 percent if prevention strategies are not implemented. (Trust for American s Health) Coordinated School Health state grant funds are used by school districts to provide schools with physical activity/physical education equipment, physical activity/physical education curriculums, teacher professional development, walking trails, climbing walls, fitness rooms and student fitness assessment systems/tools. The Office of Coordinated School Health oversees state physical education standards as set forth in Tennessee Curriculum Standards (USDHHS & USDA, 2008) and the Tennessee Physical Activity Policy (TDOE, 2005). U.S Physical Activity Guidelines for Children and Adolescents According to the Centers for Disease Control and Prevention, children and adolescents need 60 minutes (1 hour) or more of physical activity each day. Aerobic activity should make up most of a child/adolescent's 60 or more minutes of physical activity each day. This can include either moderate-intensity aerobic activity, such as brisk walking, or vigorousintensity activity, such as running. Children/adolescents should include vigorous-intensity aerobic activity at least 3 days per week. Physical activity should include muscle strengthening activities, such as gymnastics or push-ups, at least 3 days per week as part of a child/adolescent's 60 or more minutes. In addition, physical activity should include bone strengthening activities, such as jumping rope or running, at least 3 days per week as part of a child/adolescent's 60 or more minutes. (CDC Physical Activity Guidelines for Children) Tennessee s physical activity law enables schools to supplement the one hour per day national recommendation by ensuring students receive at least 90 minutes per week of physical activity during the school day. www.tennessee.gov/education/schoolhealth Page 3

Positive Link Between Physical Activity/Physical Education and Academic Performance According to the publication, School-based Physical Activity, Including Physical Education, and Academic Performance, Centers for Disease Control and Prevention (U.S. Department of Health and Human Services, 2010), when children and adolescents participate in the recommended level of physical activity at least 60 minutes daily multiple academic benefits accrue. Substantial evidence shows physical activity can help improve academic achievement (including grades and standardized test scores) as well as have an impact on cognitive skills and attitudes including enhanced concentration and attention and improved classroom behavior. Also, research indicates increasing or maintaining time dedicated to physical education may help, and does not appear to adversely impact, academic performance. Specifically, this report states: Physical education: Devoting time to physical education may have a positive relationship to academic achievement or may not negatively affect it. There are also favorable associations with cognitive skills and attitudes. Physical activity breaks and activity offered throughout the day: Offering breaks for physical activity may be associated with decreases in classroom misbehavior, increases in cognitive functioning including memory and concentration, and academic achievement. Recess: Offering students recess has been associated with improved cognitive skills such as time on task, attitudes, and academic behavior. One study found that overall classroom behavior was better for students who had at least 15 minutes of recess every day. Extracurricular activities: Providing extracurricular activities like intramural sports, interscholastic sports, and other physical activity outside of regular school time was found to have a positive association with academic performance, including higher grades and grade points averages, as well as lower high school dropout rates. (School-based Physical Activity, Including Physical Education, and Academic Performance, Centers for Disease Control and Prevention (Atlanta, GA: U.S. Department of Health and Human Services; 2010) Another meta-analysis report, Physical Activity and Performance at School: A Systematic Review of the Literature Including a Methodological Quality Assessment (Angelika Singh et al., Archives of Pediatrics and Adolescent Medicine, Vol. 166, No. 1 (January 2012), links physical activity with academic performance. The authors conclude by stating According to the best-evidence synthesis, we found strong evidence of a significant positive relationship between physical activity and academic performance. The findings of one high-quality intervention study and one high-quality observational study suggest that being more physically active is positively related to improved academic performance in children. (Singh et al., 2012) Substantial evidence shows physical activity can help improve academic achievement (including grades and standardized test scores) as well as have an impact on cognitive skills and attitudes including enhanced concentration and attention and improved classroom behavior. www.tennessee.gov/education/schoolhealth Page 4

Increased Student Physical Activity/Physical Education Leads to Better Health Outcomes According to the Centers for Disease Control and Prevention, regular physical activity: Helps build and maintain healthy bones and muscles: Helps reduce the risk of developing obesity and chronic diseases, such as diabetes, cardiovascular disease, and colon cancer; and Reduces feelings of depression and anxiety and promotes psychological well-being. (Physical Activity Guidelines Advisory Committee Report. Washington, DC: U.S. Department of Health and Human Services, 2008.) Long-term consequences of physical inactivity include: Overweight and obesity, which are influenced by physical inactivity and poor diet, can increase one s risk for diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status; (Dietz, 2012); and Physical inactivity increases one s risk for dying prematurely, dying of heart disease, and developing diabetes, colon cancer and high blood pressure. (Physical Activity Guidelines Advisory Committee Report. Washington, DC: U.S. Department of Health and Human Services, 2008.) Overweight and obesity, which are influenced by physical inactivity and poor diet, can increase one s risk for diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Tennessee Physical Activity Compliance Rates in Schools During the 2011-2012 school year, 84 percent of all Tennessee school systems reported to the Office of Coordinated School Health they were in compliance with the 90-Minute Physical Activity law for all students. The state compliance rate has decreased from 89 percent in 2008-2009 to 84 percent in 2011-2012. Elementary schools reported the most compliance (96 percent) followed by middle schools (88 percent) and high schools (75 percent). www.tennessee.gov/education/schoolhealth Page 5

Percentage of Public School Systems that Integrate a Minimum of Ninety (90) Minutes of Physical Activity Per Week into the Instructional School Day for All Students, 2011-2012 School Year Type of School Number of School Systems/Special Schools Percent of all School Systems/ Special Schools (N=139) Elementary Schools 133 96% Middle Schools 122 88% High Schools 104 75% All Schools in School District 117 84% Source: Tennessee Department of Education - Office of Coordinated School Health, Annual School Health Services Data and Compliance Report 2011-2012 and 2008-2009 Coordinated School Health Annual Data and Compliance Report Tennessee s physical activity law compliance rate as reported by districts decreased from 89 percent in 2008-2009 to 84 percent in 2011-2012. Types of Physical Activities Used in Schools to Meet the Physical Activity Requirement Types of activities reported as used most often in schools to meet the physical activity requirement was recess (80 percent), walking either indoors or outdoors (74 percent), activities using balls (kickball, basketball, etc.) (63 percent), teacher directed physical activity (55 percent) and exercises (55 percent). Additional types of activities used most often include marching band (41 percent), running/jogging (21 percent), strength training (20 percent) and intramurals (13 percent). www.tennessee.gov/education/schoolhealth Page 6

Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. www.tennessee.gov/education/schoolhealth Page 7

School Percentage using Walking Between Classes to meet the 90- Minute Physical Activity Requirement Walking Between Classes to Meet State Physical Activity Requirement by Type of School Elementary Schools When asked what percentage walking between classes was used in elementary schools to comply with the 90 Minute Physical Activity law 82 percent of all school systems reported no schools used walking between classes while 16 percent of all school systems reported a quarter of their schools used this strategy. District Percentage Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. www.tennessee.gov/education/schoolhealth Page 8

School Percentage using Walking Between Classes to meet the 90- Minute Physical Activity Requirement Middle Schools In middle schools 49 percent of all school systems reported never using walking between classes to meet the physical activity mandate while 32 percent indicated a quarter of their schools used this strategy, 7 percent said half of their schools used this strategy and another 7 percent said all their schools used this strategy to meet the physical activity law. District Percentage Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. www.tennessee.gov/education/schoolhealth Page 9

School Percentage using Walking Between Classes to meet the 90- Minute Physical Activity Requirement High Schools In Tennessee high schools walking between classes is used much more frequently to meet state physical activity requirements with 30 percent of all schools do not count walking between classes to meet the physical activity requirement, 21 percent of districts use this strategy in three-quarters of their schools and 19 percent of districts reported they use walking between classes to meet the physical activity law in all their schools and another 19% of districts utilized it in a quarter of their schools. District Percentage District Percentage Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. www.tennessee.gov/education/schoolhealth Page 10

Reported Barriers Inhibiting Compliance with Physical Activity Law by Type of School Elementary School Barriers The most often cited barrier to implementing physical activity in elementary schools is teachers/principals concerned about decreased academic time (56 percent), lack of consequences for non-compliance to the law (27 percent), difficulty in monitoring compliance with the law (19 percent) and lack of time available for implementation (19 percent). Additional areas of concern were lack of funding available for resources to support physical activity (13 percent), lack of appropriate space for physical activity (13 percent) and untrained teachers leading classroom physical activity(10 percent). Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. www.tennessee.gov/education/schoolhealth Page 11

Middle School Barriers The most often cited barrier to implementing physical activity in middle schools is teachers/principals concerned about decreased academic time (52 percent), lack of time available for implementation (46 percent), lack of consequences for non-compliance to the law (42 percent), and difficulty in monitoring compliance with the law (21 percent). Additional areas of concern were lack of principal support (15 percent), funding available for resources to support physical activity (12 percent), lack of appropriate space for physical activity (12 percent) and all other responses (12 percent). Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. www.tennessee.gov/education/schoolhealth Page 12

High School Barriers The most often cited barrier to implementing physical activity in high schools is teachers/principals concerned lack of time available for implementation (72 percent), decreased academic time (69 percent, lack of consequences for non-compliance to the law (55 percent) and difficulty in monitoring compliance with the law (39 percent). Additional areas of concern were lack of principal support (32 percent), all other responses (32 percent), lack of appropriate space for physical activity (27 percent) and lack of funding available to support physical activity (23 percent). Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. See Appendix A for complete list of survey questions. The most often cited barrier to implementing physical activity in Tennessee schools is teachers/principals concern about lack of time available for physical activity implementation, decreased academic time and lack of consequences for non-compliance with the law. www.tennessee.gov/education/schoolhealth Page 13

Innovative Methods Schools Use to Comply with the Physical Activity Requirement As of November 2012 the most common types of innovative methods used by schoool systems to ensure compliance with the 90-Minute Physical Activity Law were use of walking tracks (50 percent), physical activity information provided to parents/guardians (35 percent) and use of CSH grant funded mini-grants to support classroom physical activity (34 percent). Since the implementation of Coordinated School Health in all Tennessee school districts, CSH district coordinators have used CSH state grant funds and/or community partners to provide 289 schools with walking tracks, 207 schools with in-school fitness rooms for students, 93 schools started Safe Routes to School partnerships, and 352 schools now have new and/or updated playgrounds. (Source: Tennessee Department of Education Office of Coordinated School Health, 2007-2012 CSH District Continuation Applications) Additional innovative methods used by school systems include annual physical activity training for teachers/principals, student-led physical activity events, principal-led physical activity events, integration of physical activity with academics and use of rock climbing walls and ropes courses. Source: Tennessee Department of Education Office of Coordinated School Health, Physical Activity/Physical Education CSH Coordinator Survey, November 2012. Since the implementation of Coordinated School Health in all Tennessee school districts, CSH district coordinators have used CSH state grant funds and/or community partners to provide 289 schools with walking tracks, 207 schools with in-school fitness rooms for students, 93 schools started Safe Routes to School partnerships, and 352 schools now have new and/or updated playgrounds. www.tennessee.gov/education/schoolhealth Page 14

Physical Activity and Physical Education in Tennessee Compared to US Rates CDC Youth Risk Behavior Survey In 1991 the Center for Disease Control and Prevention developed the Youth Risk Behavior Surveillance (YRBS) survey, a national survey system to monitor the prevalence of youth behavior that most influences health. The priority health risk behaviors that contribute markedly to the leading causes of death, disability, and social problems among youth and adults in the United States include tobacco use; unhealthy dietary behaviors; inadequate physical activity; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases including HIV infection; and behaviors that contribute to unintentional injuries and violence. High school students reported the following weighted YRBS data related to physical activity: Percentage of students who were physically active for a total of at least 60 minutes per day on 7 of the past seven days Between 2005 and 2011 the percentage of Tennessee students who reported being physically active for a total of at least 60 minutes per day on five or more of the past seven days increased from 34 percent to 47 percent. Males reported a significantly higher rate of physical activity at 60 percent compare to 34 percent for females. All races reported increased physical activity levels. Tennessee is close to the national average in this category. Percentage of students who were physically active for a total of at least 60 minutes per day on 7 of the past seven days 40 30 20 10 0 US TN males females white black hispanic 2005 0 25.7 18.3 33.3 23.6 31.4 26.5* 2011 13.8 14.2 11.1 17.4 11.7 19.2 18.6 * Hispanic data was collected during CDC s 2007 YRBS survey administration www.tennessee.gov/education/schoolhealth Page 15

Percentage of students who attended physical education (PE) classes daily in an average week when they were in school The rate of Tennessee students reporting they attended daily physical education classes in an average week declined from 30 percent in 2005 to 23 percent in 2011. More males reported attending daily physical education classes than females however males experienced a sharper decline in participation from 2005 to 2011. The most significant decrease was reported by black students whose participation rate declined from 31 percent in 2005 to 18 percent in 2011. In 2011 Tennessee (23 percent) was significantly behind the national average (52 percent) for percentage of students reporting they attended daily physical education classes. Percentage of students who attended physical education (PE) classes daily in an average week when they were in school 60 50 40 30 20 10 0 US TN males females white black hispanic 2005 0 29.7 34.4 25 28.7 31.3 35.1* 2011 51.8 23.2 25.9 20.6 25.7 17.8 21.2 * Hispanic data was collected during CDC s 2007 YRBS survey administration Percentage of students who attended physical education (PE) classes on one or more days in an average week when they were in school Since 2005 the percentage of high school students reporting they attended physical education classes on one or more days in an average week when in school increased slightly from 37 percent in 2005 to 41 percent in 2011. More male students (44 percent) reported attending classes than female students (37 percent). Many more black (49 percent) and Hispanic students (52 percent) than white students (37 percent) reported attending physical education classes on one or more days in an average week when they were in school. Tennessee ranks below the national average (Tennessee 41 percent compared to U.S. average of 52 percent) in this category. www.tennessee.gov/education/schoolhealth Page 16

Percentage of students who attended physical education (PE) classes on one more days in an average week 60 40 20 0 US TN males females white black hispanic 2005 0 37.2 43.2 31.3 35.6 41.6 55.7* 2011 51.8 40.7 44.4 36.9 36.9 49 52.4 * Hispanic data was collected during CDC s 2007 YRBS survey administration Percentage of students who watched three or more hours per day of TV on average school day The percentage of high school students reporting they watched three or more hours of TV on an average school day decreased from 41 percent in 2005 to 35 percent in 2011. Male and female students reported similar viewing rates however black (58 percent) and Hispanic (41 percent) students report much higher levels of TV viewing compared to their white (26 percent) student counterparts. Tennessee ranks near the national average on percentage of students watching TV on school days. 80 60 40 20 Percentage of students who watched three or more hours per day of TV on an average day 0 US TN males females white black hispanic 2005 0 41.4 42.5 40.7 33.1 67.3 44.5* 2011 32.4 35.1 36.1 34.2 26.1 58.3 41 * Hispanic data was collected during CDC s 2007 YRBS survey administration www.tennessee.gov/education/schoolhealth Page 17

Percentage of students who played video or computer games or used a computer for something that was not school work three or more hours a day in an average school day The percentage of Tennessee high school students who played video or computer games or used a computer for something not related to school work for three or more hours a day in an average school day increased from 23 percent in 2007 to 30 percent in 2011. Male students (34 percent) were more likely to be engaged in this activity compared to female students (26 percent). Black students (38 percent) reported a much higher rate than white (27 percent) and Hispanic students (26 percent). Tennessee compares similarly with the national average. Percentage of students who played video or computer games or used a computer for something that was not school work three or more hours a day on an average school day 50 40 30 20 10 0 US TN males females white black hispanic 2005 0 23.1 26.8 19.3 21.4 26.7 32.7* 2011 31.1 30.3 34.1 26.4 27.2 38.3 25.6 * Hispanic data was collected during CDC s 2007 YRBS survey administration Between 2005 and 2011 the percentage of Tennessee students who reported being physically active for a total of at least 60 minutes per day on five or more of the past seven days increased from 33.7 percent to 47.2 percent. Although Tennessee high school students reported a decrease in watching 3 hours or more TV per school day decreased since 2005, the amount of time students spent on video games or non-school computer activities increased at a similar rate. www.tennessee.gov/education/schoolhealth Page 18

CDC School Health Profiles Survey CDC s School Health Profiles is a system of surveys assessing school health policies and practices in states, territories, and large urban school districts. Profiles surveys are conducted biennially among representative samples of middle and high school principals and lead health education teachers. 2010 Selected Physical Activity/Physical Education Data from School Health Profiles TN % U.S. Median Percentage of schools in which students could not be exempted from taking required physical education for enrollment in other courses, high physical fitness competency test score, and participation in school or community sports, other school activities, vocational training, or community services activities 54.8 65.4 Percentage of schools that taught 12 key physical activity topics in a required course 55.6 56.6 Percentage of schools that taught about developing an individualized physical activity plan 71.0 77.1 Percentage of schools in which those who teach physical education were provided with key materials for teaching physical education 72 71.6 Percentage of schools that offered opportunities for all students to participate in intramural activities or physical activity clubs 60.7 62.8 Percentage of schools in which children or adolescents use the school s indoor physical activity or athletic facilities for community-sponsored physical activity classes or lessons 68.0 81.3 Percentage of schools that provided parents and families with health information to increase parent and family knowledge of physical activity 56.2 44.5 Source: CDC School Health Profiles U.S. and Tennessee 2010 www.tennessee.gov/education/schoolhealth Page 19

Tennessee Department of Education School Health Services Data The Tennessee Department of Education s Office of Coordinated School Health surveys public and private school systems annually to monitor compliance with state school health laws and to assess the scope of school health services provided to Tennessee students. This survey, Tennessee Annual School Health Data and Compliance Report, provides the following physical education data. Physical Education During the 2011-2012 school year, 32 percent of all school systems/special schools reported they provided daily physical education for all students with a certified physical education teacher. Daily physical education participation has declined 35 percent from 2006-2007. In 2006-2007 school systems/special schools reported 49 percent provided daily physical education whereas in 2011-2012 the rate decreased to 32 percent. Percentages decreased when comparing types of schools with 40 percent of all elementary schools providing this resource compared to 33 percent of all middle schools and 24 percent of all high schools. Number and Percent of School System/Special Schools Providing Daily Physical Education for All Students with a Certified Physical Education Teacher 2011-2012 Type of School Number of School Systems/ Special Schools Percent of all TN School Systems/ Special Schools (N=139) Elementary Schools 55 40% Middle Schools 46 33% High Schools 33 24% All Schools in School District 44 32% Source: 2011-2012 Tennessee School Health Services Annual Report Only 32% of all Tennessee school districts/special schools report they provided daily physical education for all students with a certified physical education teacher. www.tennessee.gov/education/schoolhealth Page 20

Physical Activity Law Compliance Rates Among Urban School Districts Among Tennessee s nine urban school districts (districts serving 25,000 or more students) the rate of compliance with the 90 Minute Physical Activity Law is 96 percent for the 2011-2012 school year. This is an increase from 94 percent reported for the 2009-2010 school year. Average urban elementary compliance rate for 2011-2012 school year averaged 99 percent, middle school averaged 95 percent and high schools averaged 92 percent. The nine urban school districts include Hamilton County Schools, Knox County Schools, Memphis City Schools, Metropolitan Nashville Public Schools, Montgomery County Schools, Rutherford County Schools, Shelby County Schools, Sumner County Schools and Williamson County Schools. Overall Summary and Recommendations Schools play a pivotal role in their capacity to support the development of life-long habits of physical activity behaviors among their students. By developing and implementing physical activity policies and practices for students, schools can create environments supportive of not only the development of healthy American adults but also increase student academic outcomes. Therefore, CSH Coordinators, teachers, coaches, school administrators and school district officials need to take a leadership role in implementing the following strategies in Tennessee schools. CDC School Health Physical Activity Guidelines The Centers for Disease Control and Prevention (CDC) synthesized research and best practices related to promoting physical activity in schools culminating in the development of several guidelines. The guidelines serve as the foundation for developing, implementing and evaluating school-based physical activity policies and practices for students. (Sarah M., 2011) Each of the guidelines is accompanied by a set of implementation strategies developed to help schools work towards achieving each guideline. To access the CDC strategies click on the underlined copy. After each strategy is a short vignette from Tennessee school districts illustrating how some Tennessee schools are already implementing national strategies. www.tennessee.gov/education/schoolhealth Page 21

Although the ultimate goal is to implement all guidelines in Tennessee, not every strategy will be appropriate for every school, and some schools, due to resource limitations, might need to implement the guidelines incrementally. practices. Use a coordinated approach to develop, implement and evaluate physical activity policies and Knox County Schools Knox County Schools, an urban district serving over 57,000 students, utilizing the Coordinated School Health model to develop, implement, strengthen and evaluate physical activity policies and practices. This systematic approach includes a healthy school team in 80 schools, a School Health Advisory Council (SHAC) consisting of school and community leaders, a Youth Health Board and a district coordinator and staff to guide the efforts. Healthy School Teams (HSTs) utilize the Centers for Disease Control and Prevention s School Health Index to assess the environment and practices that support physical activity for students, staff and the community. HSTs examine practices that include the availability of recess, structure physical activity time, quality physical education and adequate facilities and spaces to encourage movement. As a result of School Health Index assessments, HSTs have created action plans for improving playground spaces, eliminating practices that deny students of physical activity as well as adding walking tracks and work out rooms for students and staff. Schools are now focusing not only on increasing physical activity time during the school day, but also providing opportunities to move before and after school. The district Coordinated School Health (CSH) Office collaborates with HSTs to gather data to keep all stakeholders informed regarding district progress toward evidence based physical activity practices. Through regular reports, the district office is able to determine the school s physical activity plan, average recess times and increases in physical education/activity minutes. This information is shared annually with the SHAC and the Youth Health Board as directed by the district s wellness policy. These advisory boards seek resources and provide solutions for barriers for increasing physical activity. Schools utilize physical activity reports, cardiovascular assessments, and Body Mass Index screening results to advocate for increasing physical education time. Since 2009-10, the percent overweight (85.0-94.8 BMI percentile) and obese (>95.0 BMI percentile) students screened has dropped from 38% to 33.8% in Knox County Schools. The CSH district office provides support for the infrastructure through annual training of team leaders, individual sessions for new team leaders and school recognition programs highlighting best practices. Professional development is provided to classroom teachers to assist them with integrating physical activity with core subjects. The CSH office provides staff wellness opportunities to develop healthy role models and increase the likelihood of movement during the school day. www.tennessee.gov/education/schoolhealth Page 22

Establish school environments that support physical activity. Lebanon Special School District The Lebanon Special School District recognizes the importance of establishing school environments that promote physical activity. Implementing the Coordinated School Health (CSH) model, Healthy School Teams (HSTs) were established in every school, focusing on the eight components of CSH. Healthy School Teams develop yearly action plans and goals to improve student health and increase academic achievement. These action plans have yielded several successful programs addressing physical activity at the elementary and middle school levels through the support of administrators in the Lebanon Special School District. Elementary K-5 Walking Field Trips Students that complete 30 miles throughout the school year in addition to recess, earn a one mile walking field trip to Don Fox Park in the spring. Spring Olympics Physical Education teachers use the Presidents Challenge to select students to represent their school and compete in the LSSD Spring Olympics. Fundraisers Fun Run, 5K Roar Run Incentive Program nine week school-wide Positive Behavior Events promote physical activity (Dance Dance Revolution, inflatable obstacle course, activity stations) Get Fit after school fitness program (extended contract) Basketball boys/ girls basketball program for grades 4 and 5 ING Kids Rock Physical education teachers organize weekend trainings with students and complete the 1-mile in Nashville Middle School 6-8 ESPN classes 50 minutes in the gym for activities that relate to subject matter (math, geography, etc) Friday Reward students earn weekly rewards on Fun Fridays for completing all of their work for the week and not receiving an office referral (games, dancing, basketball, volleyball, etc.) Activity Logs students keep an activity log to increase physical activity after the school day Get Fit after school fitness program (extended contract) Run 4 Water 26 miles in 26 days Incentive Program nine week school-wide Positive Behavior Events (fitness stations, walk to the park) www.tennessee.gov/education/schoolhealth Page 23

Wilson County Schools Wilson County School District has implemented a two-pronged approach to improving the school environment's capacity to support physical activity. The Coordinated School Health (CSH) Coordinator secured a federal PEP grant for $707,000 and other in-kind resources that enabled CSH staff to organize the building of walking trails at 11 of 12 elementary schools. The same grants were used to equip and develop fitness centers at the middle and high schools. The physical improvements to school properties and purchased equipment by themselves could not bring a sustainable, positive change for our school communities. The second prong of Wilson County School s efforts involves programming. The walking trails have been utilized for many purposes including, a kid's marathon team in the spring, a faculty walking club, the Blue Cross/Blue Shield's Walking Works For Schools program, and the Wilson County Fall Kid's Marathon. This gives valued function to the walking trails with most of it extending beyond the school day. Furthermore, exercise bikes and elliptical machines housed in the middle and high school are utilized for after school fitness clubs for both students and staff. cornerstone. Implement a comprehensive physical activity program with quality physical education as the Franklin Special School District All elementary schools in the Franklin Special School District (FSSD) have daily physical education (PE) for all students. The elementary school teachers in the FSSD are leaders in the physical education community at both the state and national levels, often serving as demonstration sites for current techniques and methods of teaching. Elementary physical education classes in the FSSD integrate elements from the classroom to deepen and solidify the students academic learning, all while developing lifetime physical skills. Sports skills, cognitive development skills, lifetime wellness activities, study of the human heart, learning about proper nutrition and development of social skills are all areas of concentration in the physical education classes at the elementary and middle school levels. The FSSD strongly supports the PE programs at all schools in the district. Facilities, staffing, equipment, sports teams, and special events such as the Music City Marathon are avidly supported by the administration and central office personnel. The FSSD has committed itself to celebrating the whole child. The commitment is reflected in the staffing of at least two full time physical education teachers at each school. It is the belief of the FSSD that a child s physical health is important to their academic www.tennessee.gov/education/schoolhealth Page 24

development and ongoing learning. As one elementary PE teacher stated The research shows that healthy children are better learners and the FSSD is committed to providing daily, quality physical education. Implement health education that provides students with the knowledge, attitudes, skills and experiences needed for lifelong physical activity. Bradley County Schools Students receive health education throughout Bradley County schools via classroom teachers, physical education teachers, cafeteria staff, school nurses, school counselors, afterschool staff and outside agencies. As with any curricula, program, or paradigm shift, quality ongoing professional development is provided to ensure success. Bradley County Schools use planned sequential curriculum for grades K-12 (Michigan Model curriculum) as a great place to start health education activities and are taught by any of the above mentioned school staff. In addition, Bradley County Schools are implementing a planned, sequential physical education curriculum (SPARK) to work in conjunction with the school s health education goals. Both curricula support the need for lifelong healthy eating and physical activity. Supplemental programs such as OrganWise Guys are implemented in elementary school settings where classroom instruction time is heavily valued. Health education pacing guides for school nurses and physical education teachers promoting monthly health topics is provided to ensure a school is communicating the same message multiple times each month throughout the school year. Bradley County School s classroom teachers support physical activity and healthy eating by creating a healthy classroom which includes action based learning, brain breaks, and stability balls for students. School nurses support health education via classroom instruction, bulletin boards, morning shows, and family health nights. School Nutrition staff support Go Slow Whoa nutrition education in the cafeteria and host healthy food events. Physical education teachers support health education by helping students find activities they enjoy and will practice for a lifetime such as rock climbing, high/low ropes climbing, indoor/outdoor cycling, archery, walking, and fishing. Students learn to assess their own health by participating in Fitnessgram testing and receiving individual student health report cards. Students in Bradley County Schools receive physical activity feedback via heart rate monitors, pedometers and fitness logs. Afterschool community partners such as the YMCA teach Catch Kids Club nutrition and physical activity programs and promote family fitness. Health education comes in many forms throughout the school but, it is the coordination that creates an effective experience for each student. www.tennessee.gov/education/schoolhealth Page 25

Provide students with health, mental health and social services to address physical activity and related chronic disease prevention. Stewart County Schools Stewart County School System through the Coordinated School Health (CSH) model has developed strategies to assess student needs as it relates to every aspect of their health. For example, after health screenings a parent will receive a referral letter with a request of how they followed up on the concern. Then a follow up phone call is made by someone such as a Family Resource Director. During the call, services can be discussed such as assisting with making appointments to filling out an application for insurance. Having a nurse, counselor and mental health case worker in every school has also benefited this process as it provides for another resource to connect families to services they need. Many health factors increase the risk of children being bullied, teased or socially isolating themselves. Having each of these stakeholders on a Healthy School Team (HST) also allows for services to not be overlapped and therefore providing the security many children need and ensures resources are available for identification, follow-up, and treatment. This provides opportunities for agencies to come together and reinforce consistent messages. Other strategies in place: Daily physical activity and morning and afternoon programs that address physical activity and educational gaps Newsletters with a variety of information from nutrition to safety as well as resources in the area Positive Behavior Support which is a three (3) tiered model of teaching and assessing behavior while analyzing the data related to it Health Councils and Drug Prevention Coalitions System Safety Committees and School Resource Officers in every School Having a CSH Coordinator connecting all of these services through the CSH model improves education as it allows schools, families and communities to work together to promote success for all students. www.tennessee.gov/education/schoolhealth Page 26

Partner with families and community members in the development and implementation of physical activity policies, practices and programs. Rutherford County Schools Rutherford County Coordinated School Health (RCCSH) has been very successful in implementing new physical activity programs in our schools with the support of our community partners. RCCSH has partnerships with 38 organizations in the county. These partners help us in numerous ways including, but not limited to, donations, letters of support and volunteer work. Some of our major partners are United Way of Rutherford County, the Richard Siegel Foundation, Middle Tennessee State University, the Nashville Predators Foundation and Middle Tennessee Medical Center. The Richard Siegel Foundation supplied funds to construct four walking tracks at our elementary schools in addition to purchasing 20 bikes for a middle school bike safety course. The Wellness Center at Middle Tennessee Medical Center, donated $18,000 worth of fitness equipment for a student/teacher fitness center at one of our middle schools. United Way and the Predators Foundation both donated funds to construct additional walking tracks at two elementary schools. Students at Middle Tennessee State University volunteer their time to help with school health screenings and track construction. In a large district with forty-five schools, the continued support of these community members is invaluable and the Coordinated School Health Coordinator instrumental in making these connections. Provide a school employee wellness program that includes physical activity services for all school staff members. Pickett County Schools Pickett County school staff wellness initiatives have been a part of the Coordinated School Health (CSH) program each year. It is crucial to model wellness for our students as well as promote staff morale while providing opportunities to work together. Pickett County Schools is a small system without a lot of outside resources but have expanded our capacity to provide staff wellness through partnerships with UT Extension and the Pickett County Health Department. Some staff wellness programs that have included physical activity components include the following: Staff completed a Take Action fitness plan in which 29 members (46%) of our teaching staff participated in a walking and eating healthier program. www.tennessee.gov/education/schoolhealth Page 27

Staff participated in Working Our Way to Wellness, a program coordinated by CSH, our Public Health Educator and UT Extension, that addressed nutrition and physical fitness. Staff lost over 100 pounds combined. Each week participants received information about nutrition and the benefits of physical activity. Staff partnered with UT Extension in Walk Across Tennessee and formed teams that competed to walk enough miles to cover the state. Coordinated School Health (CSH) placed fitness balls and treadmills in each school for staff use during free time and after school hours. Also, CSH created a student fitness room in our elementary and high school that is available to all staff after school hours. Employ qualified persons and provide professional development opportunities for physical education teachers as well as staff members who supervise recess, cafeteria time and out-of-schooltime. Coffee County Schools Coffee County Schools utilizes qualified teachers in Physical Education and Health/Wellness and provides professional development opportunities for these teachers through attendance at the annual TAHPERD (Tennessee Association for Health, Physical Education, Recreation, and Dance) state conference. Additional professional development is provided for these teachers as well as elementary classroom teachers in the TAKE 10! curriculum. This curriculum provides teachers with lessons that incorporate 10 minute movement activities in the classroom and are aligned with state standards. One of our elementary physical education teachers is a TAKE 10! trainer and is available to provide professional development in our system at the request of principals. In addition, training has been provided for physical education teachers, health/wellness teachers, counselors, and school nurses in the comprehensive Michigan Model (MM) for Health curriculum. The MM curriculum addresses Tennessee Health Standards for PreK-2, 3-5 and grades 6-8 and Lifetime Wellness Standards for grades 9-12. Additional professional development training in MM will be provided by Tennessee T.A.L.K.S., a Center for Disease Control (CDC) Division of Adolescent School Health (DASH) funded program housed at Middle Tennessee State University (MTSU). Tennessee T.A.L.K.S. is a partnership between DASH and Tennessee Department of Education (DOE) and the Office of Coordinated Schools Health (OCSH). In 2011, S.M.A.R.T. (Stimulating Maturity through Accelerated Readiness Training) was implemented in all elementary schools after training was provided to all elementary PE teachers and most PreK and K teachers. S.M.A.R.T. is a comprehensive program that provides children with the readiness skills they need to excel in learning and beyond. S.M.A.R.T. is based on the principle that movement anchors learning. The large motor movements, visual and auditory activities are performed daily in PE and in the classroom. Funding for participation in the TAHPPERD, TAKE10! and Michigan Model is provided by www.tennessee.gov/education/schoolhealth Page 28

Coordinated School Health at the state and district level. The S.M.A.R.T. training was funded by Coordinated School Health, Title 1, PreK, and Special Education at the district level. Coffee County Schools also provide school based mental health services at two elementary and one middle school through a partnership with Centerstone Mental Health Services. The partnership provides mental health training 101 for school faculty and school based mental health services for qualifying students and families. Centerstone therapists provide counseling services at school and work with the classroom teacher, school counselor, school principal and student and family to improve student academic outcomes and school climate. Services are provided before, during or after the school day to accommodate individual needs and continue year-round for the student through home visits by the therapist. Coffee County Schools mental health team provides information to other districts statewide through presentations at Tennessee School Counselor and Administrator Leadership Institute in 2012 and through regional Coordinated School Health Professional Development sessions. Conclusion Implementing and sustaining school-based physical activity policies and programs will make a powerful contribution toward a healthy future for students in Tennessee. By adopting these guidelines, schools can help ensure all students have the opportunity to attain their maximum educational potential and pursue a lifetime of good health. www.tennessee.gov/education/schoolhealth Page 29