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School-based physical education enhancements

Health Factors: Diet & Exercise
Decision Makers: Educators Local Government State Government Grantmakers
Evidence Rating: Scientifically Supported
Population Reach: 10-19% of WI's population
Impact on Disparities: No impact on disparities likely

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Efforts to expand or enhance school-based physical education (PE) include lengthening existing classes, adding new PE classes, increasing physical activity during class, training teachers, and updating PE curricula. Such efforts can be implemented via local school policies or state government standards. As of 2016, most school PE classes do not meet the US Centers for Disease Control and Prevention (CDC) recommendation that students spend 50% of PE class time engaged in moderate to vigorous physical activity (Hollis 2016).

Expected Beneficial Outcomes

Increased physical activity
Improved physical fitness
Improved health outcomes
Improved weight status
Increased self-esteem

Evidence of Effectiveness

There is strong evidence that enhancing school-based physical education (PE) increases physical activity and physical fitness among school-aged children (CG-Physical activity, Demetriou 2012, Cawley 2013, Lonsdale 2013, Sacchetti 2013, Story 2009). Enhancing or expanding PE classes as part of a multi-component school-based obesity prevention intervention has also been shown to increase physical activity and improve health (Nixon 2012, Cochrane-Waters 2011, Cochrane-Dobbins 2013).

Interventions to enhance school PE increase the amount of PE class time spent in moderate to vigorous physical activity (MVPA) (Lonsdale 2013, Bassett 2013), improve physical ability, reduce sedentary time, and decrease the rate of BMI increases for participating students compared to students in traditional PE classes (Sacchetti 2013). Lengthening school-based PE classes has been shown to lower body mass index (BMI) and reduce the likelihood of obesity among 5th graders, particularly boys (Cawley 2013).

In a study of the SPARK program, PE classes led by PE specialists or trained teachers provided students with substantially more physically active minutes per week than typical PE classes, and after 2 years, girls in the specialist-led classes maintained an advantage in cardio-respiratory endurance and abdominal strength over girls in typical PE classes (Sallis 1997). School-based physical activity interventions have also been shown to improve motor performance (Dallolio 2016), knowledge of physical activity, and, to a lesser extent, self-concept (Demetriou 2012). One study suggests that boys also improved their physical fitness test results (Dallolio 2016).

A Sweden-based study suggests additional school PE time improves muscle strength without affecting fracture risk (Lofgren 2013). Additional school PE classes over a 7 year period are associated with increased bone mass and density for girls, but not for boys (Fritz 2016).

Implementing state regulations for physical education can increase student activity levels by some measures, such as the number of minutes students are active in PE class and the number of days per week that students report exercising (Cawley 2007). In general, increases in physical activity result in small improvements in weight status (Cochrane-Shaw 2006). Although increasing physical activity in schools increases school-aged children’s physical activity and physical fitness, it has not been shown to result in significant weight changes (Harris 2009a).

Cost-benefit analysis suggests that school-based interventions to increase physical activity are associated with positive benefits (WSIPP-School PA 2017).


United States

As of 2014, ten states (Arkansas, California, Illinois, New Mexico, North Carolina, Ohio, Rhode Island, South Carolina, Texas, and Virginia) have enacted legislation or adopted resolutions to improve school-based physical education and physical activity levels (NCSL Winterfeld-Obesity prevention 2014). CDC’s 2013 Prevention Status Reports show 10 states have a mandate for the minutes per week a high school student must participate in physical education (CDC-NPAO PSR 2013).

The Carol M. White Physical Education Program provides grants to local education authorities (LEAs) and community-based organizations (CBOs) to initiate, expand, or enhance physical education programs (US ED-Carol M. White). Michigan’s Exemplary Physical Education Curriculum project team develops, tests, and disseminates materials and procedures that enable schools to promote physical activity (EPEC).


The Governor’s School Health Award (GSHA) encourages schools to adopt enhanced PE (CDC-Wisconsin school health).

Implementation Resources

AFHG-PE - Alliance for a Healthier Generation (AFHG). Physical education: Quality PE programs. Accessed on April 29, 2018
CDC DNPAO-Data - Centers for Disease Control and Prevention (CDC), Division of Nutrition Physical Activity and Obesity (DNPAO). Nutrition, physical activity and obesity: Data, trends and maps online tool. Accessed on February 22, 2018
CDC-PE 2010 - National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and Student Health (DASH). Strategies to improve the quality of physical education. Atlanta: Centers for Disease Control and Prevention (CDC); 2010. Accessed on January 10, 2018
HealthPartners-CHA - HealthPartners Institute for Education and Research. Community health advisor (CHA): Resource for information on the benefits of evidence-based policies and programs: Helping communities understand, analyze, and model costs. Accessed on October 29, 2018
LHC-Rockeymoore 2014 - Rockeymoore M, Moscetti C, Fountain A. Rural Childhood Obesity Prevention Toolkit. Leadership for Healthy Communities (LHC), Center for Global Policy Solutions, Robert Wood Johnson Foundation. 2014. Accessed on February 22, 2018
PFP-School-based PE - Partnership for Prevention (PFP). School-based physical education: Working with schools to increase physical activity among children and adolescents in physical education classes: An action guide. 2008. Accessed on February 21, 2018
SPARK - Sports, Play and Active Recreation for Kids (SPARK). Countering childhood obesity since 1989. Accessed on April 11, 2018

Citations - Description

Hollis 2016* - Hollis JL, Williams AJ, Sutherland R, et al. A systematic review and meta-analysis of moderate-to-vigorous physical activity levels in elementary school physical education lessons. Preventive Medicine. 2016;86:34-54. Accessed on February 21, 2018

Citations - Evidence

Bassett 2013* - Bassett DR, Fitzhugh EC, Heath GW, et al. Estimated energy expenditures for school-based policies and active living. American Journal of Preventive Medicine. 2013;44(2):108-13. Accessed on February 22, 2018
Cawley 2007 - Cawley J, Meyerhoefer C, Newhouse D. The impact of state physical education requirements on youth physical activity and overweight. Health Economics. 2007;16(12):1287–1301. Accessed on January 10, 2018
Cawley 2013* - Cawley J, Frisvold D, Meyerhoefer C. The impact of physical education on obesity among elementary school children. Journal of Health Economics. 2013;32(4):743–55. Accessed on January 10, 2018
CG-Physical activity - The Guide to Community Preventive Services (The Community Guide). Physical activity. Accessed on October 5, 2018
Cochrane-Dobbins 2013* - Dobbins M, Husson H, DeCorby K, LaRocca RL. School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews. 2013;(2):CD007651. Accessed on April 11, 2018
Cochrane-Shaw 2006* - Shaw KA, Gennat HC, O’Rourke P, Del Mar C. Exercise for overweight or obesity. Cochrane Database of Systematic Reviews. 2006;(4):CD003817. Accessed on January 10, 2018
Cochrane-Waters 2011* - Waters E, de Silva-Sanigorski A, Burford BJ, et al. Interventions for preventing obesity in children. Cochrane Database of Systematic Reviews. 2011;(12):CD001871. Accessed on April 11, 2018
Dallolio 2016* - Dallolio L, Ceciliani A, Sanna T, Garulli A, Leoni E. Proposal for an enhanced physical education program in the primary school: Evaluation of feasibility and effectiveness in improving physical skills and fitness. Journal of Physical Activity and Health. 2016;13(10):1025-1034. Accessed on February 21, 2018
Demetriou 2012* - Demetriou Y, Höner O. Physical activity interventions in the school setting: A systematic review. Psychology of Sport and Exercise. 2012;13(2):186-96. Accessed on April 11, 2018
Fritz 2016 - Fritz J, Duckham RL, Rantalainen T, Rosengren BE, Karlsson MK, Daly RM. Influence of a school-based physical activity intervention on cortical bone mass distribution: A 7-year intervention study. Calcified Tissue International. 2016;99(5):443-453. Accessed on February 21, 2018
Harris 2009a - Harris KC, Kuramoto LK, Schulzer M, Retallack JE. Effect of school-based physical activity interventions on body mass index in children: A meta-analysis. Canadian Medical Association Journal. 2009;180(7):719–26. Accessed on April 11, 2018
Lofgren 2013 - Löfgren B, Daly RM, Nilsson JÅ, Dencker M, Karlsson MK. An increase in school-based physical education increases muscle strength in children. Medicine & Science in Sports & Exercise. 2013;45(5):997-1003. Accessed on February 21, 2018
Lonsdale 2013* - Lonsdale C, Rosenkranz RR, Peralta LR, et al. A systematic review and meta-analysis of interventions designed to increase moderate-to-vigorous physical activity in school physical education lessons. Preventive Medicine. 2013;56(2):152-161. Accessed on February 21, 2018
Nixon 2012 - Nixon CA, Moore HJ, Douthwaite W, et al. Identifying effective behavioural models and behaviour change strategies underpinning preschool- and school-based obesity prevention interventions aimed at 4-6-year-olds: A systematic review. Obesity Reviews. 2012;13(Suppl 1):106-17. Accessed on April 11, 2018
Sacchetti 2013* - Sacchetti R, Ceciliani A, Garulli A, et al. Effects of a 2-year school-based intervention of enhanced physical education in the primary school. Journal of School Health. 2013;83(9):639-646. Accessed on February 21, 2018
Sallis 1997 - Sallis JF, McKenzie TL, Alcaraz JE, et al. The effects of a 2-yr physical education program (SPARK) on physical activity and fitness in elementary school students. American Journal of Public Health. 1997;87(8):1328–34. Accessed on February 6, 2018
Story 2009 - Story M, Nanney MS, Schwartz MB. Schools and obesity prevention: Creating school environments and policies to promote healthy eating and physical activity. Milbank Quarterly. 2009;87(1):71–100. Accessed on February 6, 2018
WSIPP-School PA 2017 - Washington State Institute for Public Policy (WSIPP). Benefit-cost results: School-based programs to increase physical activity. Benefit-cost estimates updated December 2017. Accessed on February 21, 2018

Citations - Implementation

CDC-NPAO PSR 2013 - Centers for Disease Control and Prevention (CDC). Nutrition, physical activity, and obesity: Prevention status reports (PSR). 2013. Accessed on February 22, 2018
CDC-Wisconsin school health - Centers for Disease Control and Prevention (CDC). Adolescent and school health: Wisconsin. Accessed on January 10, 2018
EPEC - Exemplary Physical Education Curriculum (EPEC). A comprehensive and flexible K-5 physical activity system. Accessed on February 6, 2018
NCSL Winterfeld-Obesity prevention 2014 - Winterfeld A. State actions to reduce and prevent childhood obesity in schools and communities: Summary and analysis of trends in legislation. National Conference of State Legislators (NCSL). 2014. Accessed on February 22, 2018
US ED-Carol M. White - US Department of Education (US ED). Carol M. White physical education program. Accessed on February 6, 2018

Page Last Updated

February 21, 2018

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