A Qualitative Evaluation of the Power Up for 30 Initiative in the Georgia Elementary School System 公开

Abstract

The prevalence of childhood obesity is increasing at an alarming rate. One in three children in the United States is considered overweight or obese (Ogden et al., 2014). Obesity can lead to numerous health consequences, including cardiovascular disease, diabetes, cancers and more (World Health Organization, 2016). Physical activity (PA) can combat childhood obesity, yet nearly 75% of children are not meeting the PA recommendations for their age group (American Psychological Association, 2016). Most children in the United States receive their education from public schools and spend eight hours a day at school, making it is an ideal setting for PA interventions.

Power Up for 30 (PU30) is a state-wide initiative in Georgia that encourages 30 minutes of PA outside of physical education (PE), each day among elementary school students. The purpose of this evaluation was to assess the barriers and facilitators to uptake and implementation of PU30 and PA opportunities within schools, by conducting qualitative interviews with PE teachers, classroom teachers and administrators in metro-Atlanta, Georgia.

Nineteen participants from seven elementary schools were interviewed, consisting of seven administrators, six classroom teachers and six PE teachers. Five of the participating schools were PU30-trained and two were untrained schools. Data was transcribed, coded and analyzed using thematic analysis.

Several barriers to uptake and implementation of PU30 were identified including: disconnect between different positions at trained schools, teacher and administrator turnover, limited time to attend PU30 training and space. The most prevalent facilitator to uptake and implementation of PU30 was school-wide effort to increase PA. Several barriers to PA opportunities at school were also identified including: misbehavior and classroom management, limited time and overburdened teachers, transportation and the disconnect between different school personnel. The most commonly discussed facilitators include: PE teachers, administrative support, students' enjoyment of PA, helpful resources and teacher and parent volunteers.

Several recommendations were generated to address barriers and facilitators to uptake and implementation of PU30 and PA opportunities at school including: dissemination of more PA resources and centralized access to those resources, additional support through liaison relationships with PU30-trained schools, school-wide trainings and booster sessions. There is also a need for additional research to further understand the differences in barriers and facilitators between trained and untrained schools and more exploration of the specific factors that influence uptake and implementation of school-based health initiatives.

Table of Contents

Chapter I: Introduction ..................................................................................................................1

Problem Definition ...........................................................................................................................1

Explanation of Program ...................................................................................................................1

Theoretical Framework ....................................................................................................................3

Justification ......................................................................................................................................5

Purpose and Research Questions ...................................................................................................5

Chapter II: Literature Review ........................................................................................................7

Prevalence of Obesity .....................................................................................................................7

Measurement of Body Mass Index .................................................................................................7

Health Consequences of Childhood Obesity ..................................................................................8

Contributors to Childhood Obesity ................................................................................................10

School-Based Physical Activity Interventions ...............................................................................12

Summary ......................................................................................................................................17

Chapter III: Methods ...................................................................................................................20

Study Design ................................................................................................................................20

Recruitment ..................................................................................................................................20

Participants ..................................................................................................................................21

Interview Guides ..........................................................................................................................21

Procedures ..................................................................................................................................22

Confidentiality ..............................................................................................................................23

Analysis .......................................................................................................................................23

Chapter IV: Results ....................................................................................................................25

Study Population .........................................................................................................................25

Barriers Specific to PU30 (Trained Schools) ...............................................................................26

Facilitators Specific to PU30 (Trained Schools) ..........................................................................31

General Barriers to Physical Activity Opportunities (Trained & Untrained Schools) ...................33

General Facilitators to Physical Activity Opportunities (Trained & Untrained Schools) ..............42

Differences Between Schools and Positions ...............................................................................58

Chapter V: Discussion ...............................................................................................................61

Key Findings .................................................................................................................................61

Barriers and Facilitators to Uptake & Implementation of School-based Health Programs ..........61

General Barriers and Facilitators to Physical Activity Opportunities at Schools ...........................64

Strengths .......................................................................................................................................66

Limitations ......................................................................................................................................66

Implications for the Public Health Field ..........................................................................................67

Recommendations and Future Directions ......................................................................................68

References ....................................................................................................................................73

Appendices .....................................................................................................................................84

Appendix A: Interview Guide for Trained Schools ............................................................................84

Appendix B: Interview Guide for Untrained Schools ........................................................................89

Appendix C: Consent Form ........................................................................................................ .....92

Appendix D: Codebook ....................................................................................................................95

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Education, Health Psychology, Behavioral
关键词	interviews childhood obesity qualitative research elementary school health interventions physical activity
Committee Chair / Thesis Advisor	Gazmararian, Julie A, Emory University
Committee Members	Cheung, Patricia Chungmen, Emory University
Partnering Agencies	Georgia state or local health department National or regional non-profit organization (e.g., American Cancer Society)

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