USING STUDENT DATA TO DRIVE SCHOOL AND COMMUNITY PHYSICAL

USING STUDENT DATA TO DRIVE SCHOOL AND COMMUNITY PHYSICAL EDUCATION/ PHYSICAL ACTIVITY POLICY Bob Rauner, Marybell Avery, Lana PetersonPressler Lincoln, Nebraska

Presenters Bob Rauner, MD, MPH Director Partnership for a Healthy Lincoln Marybell Avery, PhD Curriculum Specialist Lincoln Public Schools Lana Peterson-Pressler, NBCT PEP Grant Facilitator Elementary Physical Education Teacher Lincoln Public Schools

Lincoln (Nebraska) Public Schools Located in state capital and home of University of Nebraska 2nd largest public school district in Nebraska 36,485 students 37 elementary (K-5) schools 11 middle (6-8) schools 6 comprehensive high (9-12) schools

Lincoln (Nebraska) Public Schools Ethnicity: White 70.3% Hispanic/Latino 11.4% Black/African American 6.5% Two or More Races 6.3% Asian 4.6% American Indian/Alaska Native 0.9% Native Hawaiian/Pacific Islander 0.1%

Johns Hopkins Public Health Problem Solving Model 1. 2. 3. 4. 5. 6. 7. Define the Problem & Measure Its Magnitude Understand the Key Determinants Develop an Organized Framework for How the Key Determinants are Related Identify the Evidence-Based Interventions Prioritize the Interventions Find the Key Barriers to Implementation & Evaluation Develop a Communication Strategy

Elements of Successful Community Change 3 Basic Principles: A 3-Way Partnership between: Bottom up (grass roots efforts) Top down (support from officials, leaders, policies) Outside in (best practices from the experts) Action based on local data Community wide change in behavior is most successful if the community sees it as in its own best interest Taken from: “Just and Lasting Change: When Communities Own Their Futures,” by Daniel Taylor-Ide and Carl Taylor, 2002, Johns Hopkins University Press, Baltimore, MD.

Change is Hard!!! “Most organizations have a big, powerful constituency for ‘what is’ but almost no constituency for ‘what could be’ . remember that those on top have made it in the current system, and they see little personal value in changing what they know and can succeed in.” The Power of Positive Deviancy by Pascale, Sternin & Sternin

Collecting Data in a School System Research request procedures External vs internal research Reasons for disapproval Time (student, teacher, staff, administrator) Timing Confidentiality Parent permission IRB Exemption De-identification

Collecting Data in a School System School personnel Director of evaluation Director of curriculum Curriculum specialist Health services supervisor Principals Physical education teachers School nurses and health paras

PEP Grant Importance of Data/Need for Data Data and baseline measurements needed to justify the grant PEP Grant creates the ability to request more data: PE becomes a priority! Computing Services Evaluations Federal Programs Requests from/Information for School Board and policy makers, etc. Note: LPS PEP Grant Objective (2 of 3): Increase MVPA physical activity during the school day and in before and after school programs (partnership with CLCs). The data shows

2009 LPS Elementary Schools Percentage Overweight & Obese N 16,25 7

2009 Obesity Prevalence – PEP Grant vs. Non-PEP Grant Elementary Schools

Lincoln Elementary Schools Obesity Prevalence 5 10 15 20 % Obese 25 30 Plotted Against % Qualifying for Free/Reduced Meals 0 20 40 60 80 Percentage of Students Qualifying for Free/Reduced Meals Data Source: Lincoln Public Schools PEP Grant 2010-2011 Marybell Avery Ph.D. & Bob Rauner MD MPH 100

Correlation of Fitness and Weight Status, 4th-5th Grade Elementary Students *Fitness based on Fitnessgram PACER score 14 for girls or

Dissemination of Data/Results Follow school district hierarchy 1. 2. 3. 4. 5. Release to public Superintendent Executive committee School board Principals Teachers Prior notification to all above Permission to identify schools

Building a Case for More Data Buy in from the School Board & Superintendent Buy in from the Principals, Physical Education Staff & Nurses Support from Computing Services Support from the community

2010-2011 Lincoln Public Schools Percentage of Overweight & Obese N 24,072

Percent of 4 -8 Grade LPS Students Passing Fitness Test by Weight Status Kids Failing Fit Test: 78/321 718/2,005 1,510/2,320 1,422/7,219

2010-2011 LPS K-8 Students Overweight/Obese by Ethnicity

2010-2011 Obesity Prevalence – Title I vs. Non-Title I Elementary & Middle Schools

Lincoln Middle Schools Obesity Prevalence 10 15 20 25 % Obese 30 35 Plotted Against % Qualifying for Free/Reduced Meals 0 20 40 60 % of Students Qualifying for Free/Reduced Meals Data Source: Lincoln Public Schools 2010-2011 Marybell Avery Ph.D. & Bob Rauner MD MPH 80

Obesity Prevalence at 6th and 8th Grade 10 15 20 % Obese 25 30 35 Plotted against Free/Reduced Percentage 0 20 40 60 % Free/Reduced Lunch Status Red 6th Grade - Green 8th Grade Source: Lincoln Public Schools 2010-2011 80

Lincoln Elementary/Middle Schools Fitness Scores 20 40 60 80 % Passing Fitness Test 100 Plotted Against % Qualifying for Free/Reduced Meals 0 20 40 60 80 % of Students Qualifying for Free/Reduced Meals Data Source: Lincoln Public Schools 2010-2011 Marybell Avery PhD & Bob Rauner MD MPH 100

Percent of 3rd-8th Grade LPS Students Passing State Reading by Weight Status

4th-8th Grade LPS Students Passing State Reading Test - Fit vs. Unfit

4th – 8th Grade LPS Students Passing State Math Test - Fit vs. Unfit

Student Fitness Effect on State Math Scores Note: Base case - 6th grade non-white female after controlling for gender, ethnicity, grade, fitness, and

Student Fitness Effect on State Reading Scores Note: Base case - 6th grade non-white female after controlling for gender, ethnicity, grade, fitness, and

Policy Change – District Level Physical Education Increased graduation requirement by 33% Successful PEP grant Staff Development: Instant Activity/Increasing MVPA

Policy Change – District Level Physical Activity Required Physical Activity Time (additional recess) for all elementary students Limit “pull-outs” from physical education District wellness facilitator hired (student and employee wellness) School district wellness challenge ( 250,000 incentives for 5 yrs)

Program Change – School Level Increasing quality in Physical Education and in before/after school programs Data as incentive for increased amount of Physical Education Renewed urgency to make every PE/PA minute “count” Do both skill competence and fitness impact achievement in academic tests?

Policy Change - School Level Fit vs. Unfit Student information in decisionmaking: Provide better information for parents/students Utilize in IEP goal setting? Impact Principals’ decisionmaking? Decrease behavioral incidences?

Policy Change – Community Level School/Community level grants: walking paths, playgrounds, school gardens, outdoor classrooms Community support to incorporate wellness into long term school district strategic plan Student research Community presentations to support LPS efforts Influencing state legislation

Implications What are the new “sound bites”? Can we now say Fit students learn better Fit students achieve better on tests Quality Physical Education helps students achieve better on academic tests

Long Term Community Targets Obesity in Elementary/Middle School Students 2011: 17.2% 2015 Target: 15% Un-Fit Elementary/Middle School Students 2011: 31.6% 2015 Target: 15% “Less than 15 by 2015”

3 Views of Policy Change 1. 2. 3. Rational Incremental Garbage Can