Utilizing Physical Activity in the Classroom



Supporting Health and Wellness in High Schools

Margaret Stetsko

Master of Science in Education Program

Northwestern University

August 2006

Table of Contents

Rationale……………………………………………………………….……...3

Research Project Question Development………………….…..…..…….…3

Literature Review…………………………………………………..….…..…5

Data Collection………………………………………………………..…….27

Ethics Statement……………………………………………………..….…..29

Data Analysis and Interpretation…………………………….…..…….....30

Figure 1.1 – Q-Sort Prompt Ranking……………………..…...……31

Figure 1.2 – I get bored or tired during class……………......….…41

Figure 1.3 – I like to sit in class and listen………………......…..…41

Figure 2.1 – I feel stupid when I am playing sports….………..…49

Figure 2.2 – I use Math everyday……………………......................50

Figure 2.3 – I like the way I feel when I am active…….….….…..50

Conclusion…………….…………………………………………....….…...56

References……….……………………………………….….……….…..…63

Appendix A……………………………………..………….……………....67

Appendix B………………………………………………………………....69

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Appendix C………………………………………………………………....84

Appendix D…………………………………………………….…………..86

Appendix E…………………………………………………….…………...88

Rationale

I first began to think about researching school involvement in student health while watching a national news report on the obesity epidemic in America. The reporter outlined several of the problems that excess weight and inactivity can have on a person’s health. The program also outlined some ways that people can make positive changes to their lives. I immediately began to think about how to best educate Americans on making positive health decisions. I believe that educating youth is the best place to start for encouraging healthy habits, and I believe that schools are one of the best places for that education. I believe that the health issues in America that are related to diet and exercise are partially a cultural issue. People’s habits in this culture are not likely to change without sufficient education and motivation.

Research Project Question Development

My project did not begin with the topic of promoting student health. Initially, I was interested in researching the International Baccalaureate (IB) program and the IB degree. I have always been passionate about teaching a world-wide perspective to students, and I thought that researching the IB program was ideal for determining how to encourage students to take an international perspective towards their education. While I am still very interested in this topic, the research began to become difficult in determining exactly what my question was. I knew that I was interested in international education, but I could not determine exactly what I wanted to find out, or how the IB programs in the United States had implications regarding the IB programs overseas.

I probably would have stuck with my original topic if I had not been inspired by the news program I saw on the obesity epidemic. Health and physical fitness has played an important role in my life, and it has taken me a long time to get to the point where I feel as though I have adequate knowledge and motivation for being the healthiest that I can be. I also worry about the health of those around me, and struggle with the best way to encourage positive changes in my loved ones’ lives without being hurtful. That is part of the reason I think healthy habits are best if learned at a young age – unhealthy habits are hard to break.

One of the most difficult issues with choosing this topic was that I had to determine a researchable question. I knew that I wanted to look at how schools can help encourage good habits, but I also knew that it would be hard to determine what constitutes a habit. There is no way to know whether a person will continue to act the way they do in their youth. Furthermore, there are difficulties in defining health, as there are many components tied to health. Physical fitness and nutrition were the two areas that were most important to me, but these two areas are still very broad when looking at a variety of issues in schools that could affect student behavior. I knew from the start that I did not want to limit my study to physical education and health classes alone, as I see those as places that provide information, but do not necessarily provide an environment for forming habits outside the classroom. That is how I got the idea to look at health and physical education in classrooms outside of health and physical education.

Moving the focus of my question to places outside of physical education and health classes widened my project, but I believe that is an important component. In fact, I wanted my project to look at places in the school outside of all classrooms. While this provided potential problems in having too wide of a topic, I thought that it was extremely important. As I stated in my Rationale section of this project, I believe that the health problems in America are partially cultural. I also believe that schools are a sub-culture in America. Students are profoundly affected by the entire environment in which they learn, not just by the classroom. I wanted to consider the entire school environment in my research.

For a while, my project question focused on just lessons in the classroom, and I wanted to look specifically at Math. However, as I actually began to collect data, I never stopped looking at the school-wide environment. I realized as I collected data that the larger environment had never left my point of interest. Therefore, I settled on the following question for my research project: “What changes can be made in high school classrooms and the high school environment in order to promote student health?”

Literature Review

Introduction

Students learn far more than math, science, reading, literature and language in schools. Students learn how to take care of themselves. Schools provide an education on life, not just academic subjects. One example of this extension of education is health and general well being. Schools provide not only the curriculum for health and physical education, but also an environment in which students can make decisions based on what they learn in those subjects. Given the amount of time that children and adolescents spend at school, it is possible that they are learning more of their health habits in school than they learn at home.

America is facing a health crisis. The evidence that our country is in need of change is abundant. Medical costs are increasing rapidly as more people with diseases stemming from obesity are in need of treatment. More specifically, the health problems related to obesity are beginning at younger ages. In a Congressional Subcommittee on Education Reform, U.S. House Representative Michael N. Castle cited a report by the National Institute for Health Care Management stating that the number of overweight and obese young Americans doubled between 1990 and 2000 (2004). Researchers are pessimistic. Given the current trends, the outlook does not look good for the future of America’s health. Through the domain of the American health crisis, this project aims to look at how current health trends in America directly impact children and adolescents.

In analyzing the effect that our culture has on children and adolescent health, the school environment plays a key role in determining the future of these issues and the degree to which health trends will impact today’s youth. A school with soda machines, candy machines, french fries and nachos for lunch might dissuade students from making health choices. If teachers and administrators emphasize the importance of math tests or AP credits over the importance of daily physical activity, students are less likely to make health their priority. While health is ultimately up to the individual, a school environment might influence students to make positive choices based on the opportunities surrounding them. The second domain of this project is school environment. This project will look at examples of existing school health programs, and will consider the role that educators and the school environment might play in addressing national health issues.

Currently, many schools across the nation are restructuring their Physical Education courses. These positive changes in physical education curriculum are gaining a lot of media attention, especially in light of this American health crisis. Still, the burden of teaching a healthy life is typically left in the hands of the health educators and the physical educators. By doing this, educators are suggesting that the disciplines of health are only meant for health subject courses. Education researchers have explored the effects of combining curriculum in other academic areas. For example, students study Economics in History, Calculus in Physics, and Literature in Foreign Language. Therefore, the final domain of this project is integrated curriculum, as the goals for physical health could be a priority for all educators.

It should be noted that the contents of health and physical education are broad. Therefore, this project will focus primarily on nutrition and physical activity. There are many additional topics for adolescent health, such as alcohol and drug use, sexual health, social and emotional health, and so on. This project will also limit the discussion of nutrition education in terms of making healthy food choices, but will not address the complexities of issues such as anorexia and bulimia in teenagers. Furthermore, a great deal of the research on these topics does not differentiate between primary and secondary education, and often generalizes findings to both populations. While the main concern of this project is education in a secondary setting, research on programs in primary education is included. The primary education programs may serve as guidelines and a frame of reference for what may or may not work for adolescent programs.

The American health crisis

Health statistics regarding Americans and recent trends in obesity are startling. For the first time in our Nation’s history, some states are reporting over 20% of the adult population as obese. The medical definition of obese is based on a person’s Body Mass Index (BMI), which is a number determined by calculating weight in kilograms divided by the square of height in meters. A BMI of 18.5 up to 25 commonly refers to a healthy weight, a BMI between 25 and 30 refers to overweight and a BMI of 30 or higher refers to obese (The Endocrine Society, 2006, Obesity Basics section, chart). For most people, being 30 pounds over the recommended weight range for your height constitutes obesity. A limitation in using the BMI as an indicator of health is that is does not account for increased muscle mass (Taras and Potts-Datema, 2005). In addition, some researchers use a more limited weight range when discussing children’s health issues because children’s weight ranges are actually smaller than adult weight ranges. The BMI does not reflect this smaller overall weight range. Despite a few inconsistencies of this measurement, the BMI is a relatively reliable indicator of a person’s health in relation to their weight.

The effects of excess weight reach far. People who are overweight or obese often suffer a number of related health problems. According to the Surgeon General, one out of every eight deaths in America is caused by an illness directly related to overweight and obesity (Surgeon General, 2003, paragraph 5). In fact, obesity contributes to the number-one cause of death in our nation: heart disease. Excess weight is also linked to diabetes, some cancers, sexual health problems, sleep apnea, asthma, depression and a variety of social issues. (Taras and Potts-Datema, 2005).

Our nation’s weight problems are also taking a major toll on our economy. According to a study sponsored by the Centers for Disease Control and Prevention (CDC), obesity-related medical expenditures in the United States reached $75 billion in 2003 (U.S Congress, 2004). One example of a costly weight-related disease is diabetes. In a recent report, the surgeon general suggests that excess weight has led to an increased number of people living with Type II diabetes, since this disease is often caused by excess weight. People with Type II diabetes also suffer additional health problems, such as eye diseases, cardiovascular problems, kidney failure, and early death. Given the number of people living with diabetes and its associated medical problems, each year, this condition costs America an estimated $132 billion (U.S. Congress, 2004).

There are trends in childhood and adolescent health that suggest that the situation may become even worse. According to the CDC, childhood and adolescent obesity rates (ages 6-19) have increased 4-fold in the past two decades (Taras & Potts-Datema, 2005). For the first time ever noted, people are developing Type II diabetes in their youth. According to Dr. Kenneth Cooper, an expert in health and physical fitness, “The Baylor College of Medicine has even reported that children who develop Type II diabetes before 14 years of age may be shortening their life span by 17 to 27 years” (U.S. Congress, 2004). Given the current costs of treating adults with obesity-related illnesses, our country can expect those costs to increase as this generation of youth reaches adulthood.

Despite the negative impact of overweight lifestyles, the damage is not always permanent. According to the American Obesity Association (AOA), “Weight loss of about 10% of body weight, for persons with overweight or obesity, can improve some obesity-related medical conditions including diabetes and hypertension.” (AOA, 2006, paragraph 1). While the current trends are pessimistic, change is still possible. This health crisis is capturing the attention of the media and therefore becoming perceptible to Americans. In addition, the federal government is on board and is working to make changes for the benefit of the American health and economy. Between the Childhood Obesity Prevention Act, the Child Nutrition bill, the School Nutrition Association, Child Nutrition and WIC Reauthorization Act of 2004, the involvement of the U.S. Department of Agriculture, the National Alliance for Nutrition and Activity, the U.S. Department of Health & Human Services, the Centers for Disease Control and Prevention, and any of the hundreds more organizations dedicated to this cause, the government is actively searching for solutions to cure the American obesity epidemic.

Part of the problem of addressing this issue is pinpointing what exactly needs to change. Experts debate whether the biggest problem in our culture is poor diet, or whether the biggest problem is a lack of physical activity. Medical experts now know more than ever about the combination of genetic, social, metabolic, and environmental factors that play a role in a person’s weight. Still, the issue frequently returns to the fact that many people are eating too much and moving too little. An article by the Associated Press (2006) recently stated that some experts are blaming soda and sugar-sweetened beverages for weight gain, as a study found that one of every five calories in the average American diet is liquid. “The nation’s single biggest ‘food’ is soda, and nutrition experts have long demonized it” (Associated Press, 2006). The soda blame is only one theory, however, and many schools have recently begun to ban the soda machines all together. Other theories include an increased consumption of fast food, larger portion sizes and families who fail to make time to sit down and eat meals at home.

There are some areas in which our nation has had success in terms of nutrition health. The U.S. Food and Drug Administration has recently mandated that all nutrition information includes a breakdown of fats, including how much trans fat is in the food. Trans fat is often included in packaged foods in order to increase their shelf life. Trans fat, along with saturated fat, is known to raise low-density lipoprotein (LDL) cholesterol levels, which contributes to health problems such as cardiovascular disease. The government is making an effort to get more information out to people regarding the food they are consuming. However, these efforts will have little effect if people are not also learning the importance of nutrition labels and also learning how to read those labels. Part of the reason that current health trends are continuing to decline is that the major information providers of our country, particularly schools and the media, may not be providing adequate information or positive influence.

Lack of physical activity could be an equal or greater contributor to America’s health problems. This generation appears to be more sedentary than ever. According to the CDC, two out of three Americans are not active at recommended levels (CDC, 2006, paragraph 1). Furthermore, a study by the University of Hong Kong and the Department of Health found that being inactive could be more hazardous for a person’s health than smoking (News Target, 2006, paragraph 1). According to this study, 20% of all deaths of people older than 35 were a result of a lack of physical activity. Some research is also suggesting that physical activity might be more significant than weight in terms of a person’s health. In a study published by the Annals of Epidemiology, Carlos J. Crespo, Dr.P.H., associate professor of social and preventive medicine in the University at Buffalo's School of Medicine and Biomedical Sciences, states,

Our findings confirm that, independent of other known risk factors, such as hypertension, high cholesterol and smoking, physical activity exerts positive health benefits independent of body weight. The benefit may derive from the fact that regular moderate physical activity, no matter how much you weigh, appears to stimulate the immune system, improve insulin sensitivity and increase bone density, among other positive effects. These findings send a strong message that everyone should strive to be active in some way (Senior Journal, 2006, paragraph 5).

Even though the health benefits of physical activity are clear, many adults still choose not to exercise.

The number of sedentary adults is likely to increase as children and adolescents are failing to develop active life habits. According to Casazza and Ciccazzo (2006), the CDC has reported that less than 50% of adolescents are physically active on a regular basis. The benefits that children and adolescents could receive from an active lifestyle are not only long-term, but could also affect their immediate lives. Dr. Kenneth Cooper of the Cooper Institute conducted a study of 953,000 children aged fifth grade through ninth grade for the National Association for Sports and Physical Education and found that, “physically active children had improved self-esteem, were better able to handle adversity, and had better problem-solving skills” (U.S Senate, 2005). According to a literature review conducted by Taras and Potts-Datema (2005), “overweight and obese children are more likely to have low self-esteem and [have] higher rates of anxiety disorders, depression and other psychopathology” (p. 292). Many children and adolescents are failing to learn behaviors and practices that are paramount to their adult lives. What is unclear is where the breakdown of information dissemination is occurring.

Healthy School Environments

One way to combat obesity in America is to create healthier living environments. As schools are a direct extension of children and adolescents’ living environments, educators might address health issues with their students not only through curriculum, but also through the school campus as a whole. Some ideas of what constitutes a healthy school environment is an environment in which lessons address topics of nutrition and physical fitness, where a variety of quality lunch items are offered which meet students’ dietary needs and where teachers and administrators go out of their way to emphasize student wellness as a priority.

One barrier against creating healthy school environments could be the failure to communicate to teachers and administrators the relevant findings in health-related topics and the failure to emphasize teachers’ roles in environmental programs. In addition, while there has been a great deal of research conducted in relation to the adolescent health crisis, little research has evaluated programs beyond health courses and physical education. Teachers could use their position as leaders to promote a higher awareness of health issues to all students in all class environments. Clark and McCormack (2006) of the American School Health Association claim, “There is considerable need to build the base of evidence-based knowledge regarding school health programs and to provide an environment in which school health research is of high quality, yet meaningful and useful” (p. 38). A lot of the research about school health programs is inconclusive, or fails to provide sound evidence of the program’s success or failure. Most programs implemented today are still in an experimental stage, and there is little organization to coordinate research in regards to the effectiveness of these programs. Still, the direction of the research on these issues is changing. Taras and Potts-Datema (2005) recently reviewed a small sample of the existing literature on how obesity affects student performance at school. Their general conclusion was that, “despite the current lack of understanding about the directionality of the association between obesity and poor school performance, the fact that there is an association may be adequate to influence change in school policies and practices” (p. 292). The research is clear that the environments need to change, but little research shows what changes could be most effective.

There are many challenges that a school faces in trying to create or maintain a healthy learning and living environment. Despite efforts, the Department of Agriculture has found that scarcely any school-age children and adolescents meet all scientific recommendations for a sound diet (U.S. Senate, 2004). Healthy diets include foods that are high in nutrients, low in saturated and trans fats, and that provide a good source of energy. While the failure to choose healthy foods may be a result of availability and personal preference, it is also likely that many Americans lack the general knowledge of how their food choices affect their health. Schools, in particular, are paramount to addressing this problem, as many sources have indicated that the food provided at schools is sometimes the best a child has all day (U.S Senate, 2004; NANA, 2006; NASBE, 2006). According to Karen Johnson, the former School Nutrition Association President and Director of Child Nutrition Programs in Yuma, Arizona, “The current Federal reimbursement rate for a free lunch is $2.24 per meal with an additional 17 cents in USDA commodities. It is very challenging and often impossible to produce a nutritious meal for that amount of money” (U.S Senate, 2005, p. 6). As a result, a lot of the nutritional value is compromised in government programs. These school lunch programs are under a lot of scrutiny, and these programs continue to face the challenges of limited funding.

Lunch is not the only nutrition issue in schools. The option of vending machines and a la carte options affects students’ diets. According to Johnson, “It is the shortfall in the Federal reimbursement rate that has in great part led to the introduction and expansion of other food items through a la carte lines and vending operations.” (U.S Senate, 2005, p. 6). In fact, schools are hesitant to eliminate soda machines when these companies are providing such a large source of revenue for the schools. The question remains, however, that even if the school is able to offer nutritious options, will these be the options that students choose? Dr. Kenneth Cooper, who is best known as the father of aerobics, has mused “You could put all the vending machines at the bottom of the ocean. It will have no effect on the obesity problem” (U.S. Congress, 2004, p. 47). Cooper believes that the issue has more to do with changing children’s habits by educating them on the right choices.

The key issue with students’ health and the school environment is that students spend the majority of their waking time at school. According to research collected by the U.S. Department of Health and Human Services entitled Healthy People 2010, “Research suggests that parents who understand proper nutrition can help children in preschool choose healthful foods, but they have less influence on the choices of school-aged children” (Healthy People 2010, Focus Area 19). In other words, schools might be the number one place for children and adolescents to learn healthy habits. According to a survey by the Healthy People 2010 report, in 1994, only 69 percent of States and 80 percent of school districts required nutrition education for students in at least some grades from kindergarten through 12th grade (Healthy People 2010, Focus Area 19). Given that Illinois is the only State that mandates four years of physical education in high school, little has changed since then. School is the environment where students could have a great deal of opportunity to explore a variety of health-related issues, and some schools are failing to provide this opportunity.

Physical Education is one arena in which some schools have been having a great deal of success. Illinois is not only a model for physical education because of mandatory PE, but also because it is the home state of Phil Lawler and the PE4Life program that was piloted in his school district. Lawler’s ideas, and his school program, emphasize fitness over raw athletic ability. His program uses new technology to help students monitor their personal fitness levels and every student keeps their own fitness portfolio beginning in Junior High. To date, Lawler’s School District has spent $450,000 on high-tech P.E. tools for junior and senior high school students. What is unique about Lawler’s program in terms of the school environment as a whole is that students create health portfolios that ascend with them from year to year. Therefore, their success in any given year of physical education does not end with the conclusion of that course.

Lawler’s program has been mimicked at schools all over the nation, many of which are bragging about their success. One prime example is Tim McCord’s school district in Pennsylvania. His school implemented the PE4Life program in a small blue-collar town of 6,000, where funding is often an issue. His program has utilized creative outreach strategies such as receiving a $12,000 donation from a local health insurance provider to upgrade the technology offered in their school’s physical education classes. Some of these technologies include heart rate monitors, body fat calculators and arcade dance machines. McCord personally believes that there is a connection between the PE4Life program and a perceived reduction of bullying and fighting in their schools (U.S. Congress, 2004, p. 46). This is a prime example of how changes in a school could potentially affect the health of the entire school environment, as well as the outlying community.

PE4Life means working together with the whole community. In Titusville, the local hospital conducts an annual health fair at our middle school. Senior citizens exercise in our high school fitness center during the day. The PE department and the central blood bank conduct blood drives to support our hospital three times a year (U.S Congress, 2004, p. 19).

School environments extend to students’ home environments and, therefore, a mindful school incorporates the rest of the community in the educational process. The dedication of families and the community helps to reinforce the health lessons that students are learning while at school.

Positive programs outside academic curriculum have been implemented in schools as well. Natural Ovens Bakery, an organic baking company, has implemented a lunch program in schools all over Wisconsin. Natural Ovens hires and trains the cooks for a school, and then provides the menus and prepares the lunches. Menus include natural, organic foods that are low in sugar, low in fat, and have a balanced amount of carbohydrates and protein. Unbalanced meals that are too high in carbohydrates and other sugars often cause people to have short spurts of energy immediately followed by extreme tiredness. One aim of the Natural Ovens menus is to provide healthy foods in order to positively affect learning behaviors. The pilot school has reported many positive effects of this program, especially as it is a school specifically designed for students with behavioral disorders. Says principal LuAnn Coenen, "I can't buy the argument that it's too costly for schools to provide good nutrition for their students. I found that one cost will reduce another. I don't have the vandalism. I don't have the litter. I don't have the need for high security” (Natural Ovens, 2006, Section 3). According to Natural Ovens President, Dr. Barbara Reed Stitt, the cost for turning around a school lunch program is an additional $20,000 per year for five years.

Another similar and very famous example of nutrition in schools is the work of Jamie Oliver in England, who is popularly known as the Naked Chef. Oliver has started programs all across England that offer affordable, natural and organic foods for schools. With a recent study finding one in four English children to be obese, it is clear that they are suffering from similar problems as the United States (Feed Me Better, 2006, “Why FMB”). Oliver’s manifesto, which he calls “Feed Me Better” (2005), includes making the profession of cooking at schools a more respectable and well-trained position. Oliver has claimed, “training will keep [the cooks] motivated, in touch with each other, and up-to-date with new nutritional advice, healthy menus and kitchen management skills, (Feed Me Better, 2006, “Manifesto for Change”). Oliver also advocates for a school-wide approach to food education he advocates for teaching kids how food is grown, where it comes from, how it varies throughout different cultures, how foods affect people, and he believes that classroom curriculum could be used to do this.

Another example of how lunch programs are moving toward a healthy school environment is a program implemented by the U.S. Department of Agriculture and Forestry called the Fruits and Vegetables Program. The program was initiated as part of the 2002 Farm Bill and the idea was to provide free fruits and vegetables that are available all day, anywhere in the building. The purpose was to provide students with an alternative to vending machines, and to make these alternatives appealing by eliminating the cost. In a 2005 Senate hearing on school nutrition programs, Senator Tom Harkin reported that at the schools he visited in Iowa –- one of the eight States to provide this program – students were eating a variety of the fruits and vegetables provided, and the teachers claimed students were calmer and better behaved (U.S Senate, 2005). Keeping students satiated, and using foods that are low in refined sugars could be contributing to students’ attentiveness. There was no research conducted as to the exact effectiveness of this program, but a similar program, the Michigan Farm-to-School Program, has made additional claims as to the importance of fruits and vegetables in schools. The purpose of Farm-to-School is to connect schools with local farms, in order to simultaneously support local economies as well as provide nutrition to schools. In a 2004 survey evaluating the potential effectiveness and limitations of this program, the research team suggests that nutrition education can be supplemented by providing an environment where students can apply classroom-taught skills (Izumi, Ostant, Moss and Hamm, 2004). Students not only learn about healthy foods, but they are provided a lunch environment where they can choose those foods. In addition, the schools provide a viable way to address local economic issues.

Any of these programs outside of health and physical education curriculum are examples of school and community wide efforts to address health problems of children and adolescents. The federal government has recognized the importance of having comprehensive programs in schools that move outside the boundaries of the content of subject-specific lessons. In the Child Nutrition and WIC Reauthorization Act of 2004, the U.S. Congress established a requirement that all schools with a federally-funded meal program must develop and implement wellness policies that address nutrition and physical activity by the start of the 2006-2007 school year (NANA, 2006). The government has defined a wellness policy as a policy that includes goals for nutrition education, physical activity, and nutrition guidelines for foods available on the school campus (U.S Senate, 2005). The exact contents of the policy are left up to school administrators, teachers and members of the local school community.

The government purposefully left the guidelines for developing these policies lenient, so that local communities could address local needs through these policies. Therefore, these policies may be lacking in tried practices, prioritization of issues, rubrics for assessment and implementation plans. Still, the National Alliance for Nutrition and Activity has developed a model school wellness policy that schools can use as a resource for developing their own policies that provide guidance toward addressing these issues (2006). Additionally, the National Association of State Boards of Education has made a policy guide for healthy schools as well. NASBE claims that their policy guide complements the Center for Disease Control’s school health guidelines and provides scientifically reliable information on what constitutes an effective health program (2006). As with any research in education, the determination that a program is effective is dependent upon many factors that may not necessarily apply to all schools. Still, it is encouraging that the policy-makers who are involved with wellness policies are relying on research to guide the direction of schools’ health policies. Another encouraging fact, as emphasized by NANA, is that in order to develop these policies, schools are needing to conduct baseline assessments of their existing environments. These assessments may provide additional research for future studies on the effectiveness of these policies and a measurable way to track the overall progress of American schools utilizing these policies.

Interdisciplinary Studies and Integrated Curriculum

Most of the programs outlined above highlight educational reform either within health curriculum itself or within programs in the schools independent of classes. However, there are examples of curriculum that have been implemented in schools that aims to bring health concepts into courses outside of the domain of health education. While most of this curriculum has been designed for elementary or middle school children, there may be potential to develop more ideas that could apply to high schools as well.

One example of a curriculum is Eat Well & Keep Moving (1999), which was designed as a nutrition and physical activity curriculum aimed at building lifelong healthy habits in upper elementary school students. The book focuses on classroom lessons, but lessons can also reinforce healthy practices in the cafeteria, gymnasium, home, and community (Cheung, Gortmaker and Dart, 2001). According to a 1999 study in the Archives of Pediatrics & Adolescent Medicine, the Eat Well & Keep Moving curriculum was founded in social cognitive theory, (Gortmaker et al, 1999). The purpose of the curriculum is to provide students with the knowledge and the skills to change their behaviors outside of the classroom. In the findings of this particular study, the researchers found a marginal decrease of television watching and an improved dietary intake for students that included less fat, more fruits and vegetables, increased vitamin C and increased dietary fiber. The researchers attribute a lot of these changes to the interdisciplinary approach of the curriculum (1999).

There is not complete agreement on how to define interdisciplinary studies or what they should entail. The approach in Eat Well & Keep Moving was to,

integrate the intervention into existing school structures and curricula via an interdisciplinary approach using classroom teachers. Materials were developed that fit into math, science, language arts, and social studies classes and provided links to the school food service and physical education activities (Gortmaker et al, 1999, p. 4).

The point is to extend ideas across subject lines so that students are not learning topics independent of each other. Research has shown that there are positive effects to learning across disciplines. Oliver and Schofield (2006) claim, “[making] the concept of improved health through an active lifestyle relevant to all disciplines… is not a new concept in education. Evidence exists to support the academic and social benefits of integrating general disciplines” (p. 74). To this end, the Healthy People 2010 initiative suggests,

Nutrition should be taught as part of a comprehensive school health education program, and essential nutrition education topics should be integrated into science and other curricula to reinforce principles and messages learned in the health units (Focus Area 19).

There are educators, however, who warn against modifying the existing curriculum to try and weave two disciplines together. Learning may be compromised in either subject if contents of a particular lesson are lost or confused in the integration. In addition, teachers and curriculum designers in secondary education rely a great deal on the division of academic subjects. Drake (2004) evaluates the possibility of meeting standards through these kinds of curriculum. “For secondary teachers, the organizational structure of the department is a large obstacle to collaborating with others” (p. 18). Oliver and Schofield (2006) speak more specifically on this issue, noting, “these limitations are especially applicable to physical education lessons, as content knowledge in this area is often weaker than traditional disciplines of mathematics and English,” (p. 75). A Math, for example, could teach the equation used to calculate a person’s optimal heart-rate range for exercise, but that teacher may not be completely knowledgeable on the benefits of exercising in that heart-rate zone.

In the Healthy People 2010 initiative, these interdisciplinary limitations are expressed more as an objective, stating, “Nutrition course work should be part of the core curriculum for the professional preparation of teachers of all grades and should be emphasized in continuing education activities for teachers” (Focus Area 19). Rewriting or restructuring any curriculum is a lengthy process that involves many trials. The potential for Math, History or Language teachers to adapt their curriculum to include motivation and information on the importance of nutrition and physical activity is completely dependent upon that teacher’s own content knowledge on health education as well as his or her ability to collaborate with the health and physical education instructors. While the educational benefits of interdisciplinary curriculum exist, the limitations of structure, planning, and teacher knowledge are hard to overcome.

Another example of the effectiveness of an interdisciplinary approach to health education in an elementary school was a study in which students tracked their daily steps using pedometers. In this study by Oliver and Schofield (2006), New Zealand primary school children wore pedometers for a six-week intervention period. First, the school provided pedometers to track student steps. Then, the researchers initiated an intervention during which the school offered a variety of activities aimed at increasing the number of student steps as well as limiting activities such as television watching. Their findings were that throughout the intervention period of this project, students significantly increased their daily step number. The study also questioned whether students reduced their daily caloric intake. One advantage of this particular study was that the use of pedometers made the findings measurable. Despite limitations such as the lack of a longitudinal study, this research demonstrates that integrating physical and health education into students’ lives is a valid and researchable topic. These studies could broaden to include more secondary level studies, as well as long-term studies.

The major difference between the Oliver and Schofield study and the practice of linking subject-specific curriculum is that this study measured the effects on activities and disciplines beyond the classroom content areas. One goal of interdisciplinary studies is to help students find connections between subjects and beyond classrooms, and it is just one component of what some researchers have defined more broadly as integrated curriculum. The concept of integrated curriculum in education has been around for over a century. Beane (1997) defines integrated curriculum as,

a design theory that is concerned with enhancing the possibilities for personal and social integration through the organization of curriculum around significant problems and issues, collaboratively identified by educators and young people, without regard for subject-area lines (p. 19).

Some researchers define this as teaching around themes, or as teaching toward the demands for society. For example, the face of education changed dramatically throughout the Industrial Revolution, as people realized that there were new demands to be met by workers versus intellectuals. That notion of integrated curriculum has broadened significantly over the past century, but the term is still used to demonstrate the need to teach topics that are applicable to problems, irrelevant of any predefined school subject.

Bonds (1993) even goes as far as to define this kind of curriculum as “synergistic pedagogy,” that is, “a process of teaching whereby all the school subjects are related and taught in such a manner that they are almost inseparable” (p. 3). Another way of describing this approach toward curriculum is to call the learning holistic. Holistic means emphasizing the importance of the whole and the interdependence of its parts. In the case of education, the parts are the subjects or the disciplines, and the whole is the interconnectedness of these topics. In the case of teaching students to have healthy lives, a holistic approach would be to deemphasize the health class itself, and them permeate other courses with its subject matter. For example, cover all the topics of health education by teaching how to use physical technology in technology classes, teaching the affects of nutrition in anatomy classes, teach the history of American health in social studies courses, teach the effects of health insurance and health prevention in economics classes and so on.

While some of these ideas are overwhelming in terms of evaluating existing secondary curriculum, some concepts may still be useful in small steps. For example, addressing real-world problems in courses is a way of integrating the curriculum, yet it does not require completely eliminating the existing design. The surgeon general has advocated for teaching students and adults better “health literacy,” which has been described as “the ability of an individual to access, understand, and use health-related information and services to make appropriate health decisions” (Surgeon General, 2006, paragraph 44). While this seems like an obvious goal of health education, it includes the important implication that health is the ends and education is the means. The health of our country is a social problem, and education using integrated curriculum can address that problem through health education and interdisciplinary studies.

Conclusion

The literature existing on the topics of the American health crisis, healthy school environments and the role of integrated curriculum continues to grow. As the public becomes more involved with these issues, there is a greater need for educational research on these topics. This project will look at how the American health crisis pertains to schools and to adolescents. In the domain of healthy school environments, this project will look at an example of a school where the physical education program has earned national acclaim for its success. Finally, this project will explore the possibilities and limitations of integrating physical education with one to two other high school subjects. The question of focus for this project will be: “What changes can be made in high school classrooms and the high school environment in order to promote student health?”

Data Collection

I thought that the most obvious place to start with my data collection was at a school that I had found through my Literature Review. I found a school in the Chicago suburbs that I will refer to as “Townsville High School”. Their physical education department has earned a national reputation. In addition, this school has a unique program that is called “Zero Hour PE” in which freshmen at the school who have scored poorly on Literacy tests may elect to take a 7:00 am Physical Education class that incorporates vocabulary drills into their physical activities. I wanted to see this class first-hand, as it speaks to curriculum integration, and I wanted to see what this school’s reputable physical education department looked like. Therefore, my first method of data collection was observations. I received signed consent from the assistant principal at the school to do research there.

While at Townsville, I planned initially to interview the Physical Education Department Chair, Dave S., who helped get the Zero Hour program off the ground. I prepared several questions (See Appendix A) and the interview lasted approximately forty minutes. I received signed consent from him to tape -record and transcribe his interview. In my preliminary research on the high school, I also found contact information for Michael Davis, math teacher, freshman boys’ soccer coach, director of the intramural program, and faculty leader for the Fellowship of Christian Athletes (FCA) at their school. I thought that Michael might be an insightful person to talk to as he has experiences both with Math and with students who volunteer to be active outside of school. I developed an interview protocol for Michael as well (See Appendix C) and we spoke for approximately thirty minutes. I also received signed consent from him to tape-record and transcribe the interview.

What I did not realize prior to visiting Townsville was that the Physical Education Department and the Math Department were in discussions to have a pre-algebra class that would incorporate movement and activity into the curriculum next year. Michael is the teacher they have asked to teach that course. Without even meaning to, I found myself interviewing a teacher who would be teaching a class next year that could answer so much of my Master’s Project Question. After finding this out, I met Jim Richards, the Math Department Chair, to do a quick interview with him. He happily agreed. I hoped to find out more about how the PE Department and Math Department came to work together. In addition, I was given two articles regarding using movement I the classroom. I also looked over a lesson that one of the department’s teachers had developed for integrating math and physical education based on a lesson in Prentice Hall Algebra (See Appendix E). I did not have much time to prepare interview questions for Jim, so our interview was a brief ten minutes. Once again, consent was provided to tape-record and transcribe the interview.

After doing observations and speaking to teachers, I felt that my project could benefit from having student input. That is how I decided to conduct a focus group at a local high school, “Whitfield High School”. I conducted a Q-Sort in order to initiate discussion in the focus group. I had enough tools for a ten-person Q-Sort and prepared cards that had thirty prompts, one prompt per card (see Appendix D). The prompts were statements which included topics on student interest in physical activity, student interest in Mathematics, and student knowledge of nutrition. For example, one prompt said, “I like the way that I feel when I am active,” and another said “I use Math every day”. I asked the students to sort the cards into 3 piles based on the statements that were never true for them, the statements that were sometimes true for them and the statements that were always true for them. If they had any statement remaining at that point, I applied them to the “sometimes” pile.

After collecting all the Q-Sort cards, I opened the students up to a discussion that I tape-recorded. I had hoped that the students would take more initiative in the discussion, but instead the discussion required a great deal of prompting. The Q-Sort lasted approximately five minutes and the discussion lasted approximately ten minutes.

Ethics Statement

While I believe that this topic is important and valid for research, I went into this data collection of this project with the understanding that particular aspects of this research could be difficult. First and foremost, researching students’ health and fitness is a very personal issue and I realized that not all students would be comfortable with questions regarding their personal choices. Therefore, I chose to limit my interaction with students in this study.

Furthermore, while making observations at schools is not a confrontational action, I was concerned that asking too many questions to the teachers at the schools could seem presumptuous or critical. I wanted to be sure that the teachers knew that my questions and curiosities were not meant as a criticism for the way in which their schools or departments were being run. I wanted to be sure that teachers and administrators understood that I was simply looking for a better understanding of how their classes have been run and that any comparisons made between schools and classes would simply be observations and not judgments.

My final ethical concern in this project was to be careful in making generalizations or predictions for the future. Since the program I was observing was in its first year, and since the program in Math that I discussed with Michael had not even begun, I was afraid that making too many assumptions about how the new curriculum and new scheduling ideas will affect student learning could be flat-out wrong. I also did not want to make statements about how the Pre-Algebra teacher will run his class next year, because he has not yet determined all of his lessons and I did not want to influence his choices for his classroom.

Analysis and Interpretation

For each of the three interviews, I coded the data, looking at several themes and breaking down each theme into sub-themes. For the Zero Hour PE class observations as well as the Townsville facility tour observations, I coded my notes using the same themes as in the interviews. Other, smaller themes emerged from the observations, but these were not as prevalent in the interviews. Finally, for the Q-sort conducted with the student focus group, ten students were able to participate. I took their responses to the thirty prompts and gave a value of zero for any time a student answered “Never” to the prompt. The response “Sometimes” scored one point, and the response “Always” scored two points. I then totaled these number for each of the thirty prompts based on how the students answered (See Figure 1.0 below). I then ranked these prompts from lowest to highest in order to analyze the responses. I also transcribed our discussion and coded the transcription using the same themes as in the previous two data sets.

The three themes that emerged more than any others were 1) Physical Education as a tool for academic success, 2) School-wide dedication to health and wellness and 3) Resources available at schools.

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1) THEME: Physical activity as a tool for academic achievement

Interviews

Analysis:

Each of the three interviewees mentioned the potential correlation between physical education, or just physical activity, and academic performance. My first interview was with Dave Sanders, who is the Physical Education Department Chair who initiated the Zero Hour PE Program. Dave frequently mentioned brain research and the emerging claims that physical activity affects learning. “One of the things we learned from [a Harvard brain researcher] is that anytime you do an aerobic workout you manufacture new brain cells. We didn’t know that five years ago.” The Mathematics Department chair, Jim Richards, discussed this as well. “More than a wellness awareness, it’s taking it even a step further and seeing how can we increase academic performance for these students who struggle…what we’re looking at in the math class is more ways we can get students out of their seats…create more blood flow to the brain.” Both Dave and Jim talk about physical activity in terms of academic performance.

Dave talked about how physical education may relate to other academic disciplines. He first stated that class scheduling matters. Dave talked about changes being made to next year’s Townsville schedule that will allow for students to take early hour PE classes, and then follow those PE classes with subjects they are struggling in, specifically Literacy this year and additionally Math beginning next year. The school is targeting student who are performing poorly on standardized Reading and/or Mathematics tests. The scheduling concept is to provide at least an hour of very intensive cardiovascular exercise throughout the week. Since the school provides heart-rate monitors, the teachers can gauge the physical effort of the students. Dave’s theory is that cardiovascular activity helps get students’ brains working by providing additional blood-flow to their brain and throughout their bodies, and helps them feel more alert and ready-to-learn in class.

Jim Richards also spoke about scheduling goals and referred to next year’s Pre-Algebra class as a case study. “We’re looking at the time of day they have physical activity and how it can affect their performance in their academic class.” The Pre-Algebra teacher I interviewed, Michael Davis, who also oversees the intramural program, also suggested looking at the time of day students exercise in relation to their learning. “Is there any way you can look at a student, or study a student who does an intramural before school? To me, that’d be interesting, because they have days that they’re doing intramurals and they’re up in the morning and they’re active. So what happens the rest of the day?” Dave reiterated these points, “Let’s not miss the component of getting kids ready to learn. And that readiness is, again, activity. Blood flowing to the brain. The more you sit on your butt, the less there is.” All three teachers mentioned physical activity in relation to learning in other subjects.

The second idea is that moving and learning can take place simultaneously. Dave suggested that for math lessons, students could do activities such as balancing on ladders, or playing activities that require cross-lateral movements in order to stimulate the brain. According to Dave, “Anytime you cross the mid-line of your body, and do things opposite, then that makes synapses of the brain make those connections across the lobes of the brain.” Michael also hypothesized on a connection between movement and learning. “I think I’ve become more and more aware of movement because my daughter is kinesthetic. She has to be. For her to learn better, she really has to get up, she has to be physical.” Michael talked about how he believes it is worthwhile to try new teaching methods even if those methods only reach a few students who were never engaged by other methods. Jim suggested another idea that is still in its infancy. “We’ve talked about ways of having some content video for Mathematics that students are watching while they’re cycling.”

In all three discussions involving how physical activity could have an effect on other content areas, all three teachers spoke mostly of students who have been performing below average in the content area. For Zero Hour PE, the school used the same test that they use to identify students reading below average in order to test whether the Zero Hour PE class was succeeding. Dave said the Literacy teachers found “the Zero Hour kids improved half a year more than the grade equivalent Literacy kids.” Jim said that standardized tests would be used as assessment for the pre-algebra course next year as well. “Those who are involved in the physical education class earlier in the morning will be compared to the ones who are not.”

Interpretation:

These three teachers are suggesting that physical education be used as a means to education, not necessarily an end. In other words, physical education can be used to improve other subject performance. It is not just about learning the subject of physical education itself. The programs at Townsville High School were developed to not only teach students about physical education, but to utilize physical fitness in order to improve student performance. Dave continually mentioned brain research, which leads me to believe that these programs are founded in more than just what they observe in schools, but also in broader research that may not have been previously applied to academic settings. A lot of what they anticipate about the Zero Hour PE program is not founded in educational research, but founded in brain research that has not necessarily been tested in educational settings. This point was also emphasized in my review of the literature on this subject. As cited previously from Clark and McCormack (2006), “There is considerable need to build the base of evidence-based knowledge regarding school health programs and to provide an environment in which school health research is of high quality, yet meaningful and useful” (p. 38). It seems that Townsville High School and Dave Sanders are in the beginning stages of this process, as they are trying to use scientific research to alter an academic setting.

In addition, the Zero Hour PE program is expanding for next year, and it is reaching out to the Math Department. This is not necessarily a signal that the program was completely and absolutely successful for the Literacy students. After all, the data set for the Zero Hour PE students is only fifteen students from the fall, and seven students from the spring semester. The fact that the concepts are expanding to math classes simply shows that there are at least two additional teachers at Townsville (the Math department chair, Jim Richards and the Pre-Algebra teacher, Michael Davis) who are willing to try something new and who believe that the ideas could be successful.

The improvements of students in Zero Hour literacy classes may be actual evidence that students who exercise while learning vocabulary can learn the vocabulary better. This may be evidence for how doing physical activities in conjunction with other subjects may contribute to increased retention. If this is the case, it could be due to Dave’s theory in how physical activity “gets kids ready to learn”, or it could be a result of what Oliver and Schofield (2006) referred to as a more general academic benefit of integrating disciplines. In other words, simply by introducing Literacy topics in a non-Literacy class, students might retain more knowledge because they are learning the subject in a new and innovative environment. However, it is also possible that the success of the Zero Hour students in the Zero Hour PE class is a result of those students’ intrinsic dedication. The fact that the students arrive early for this class is evidence that they might be willing to put more effort into their Literacy class than the students who do not arrive early. This could account for some of their success.

I noticed that all three teachers were talking about getting kids up and moving early in the day in order to enhance learning. Michael had ideas about intramurals. Jim had ideas about getting students up out of their seats. Dave was the one who labeled the concept by calling it “learning readiness”. In analyzing these discussions, I’ve noticed that none of these teachers were focused on teaching students the specifics about exercise. When talking about “learning readiness”, the main goal was how can exercise affect academic achievement. The goal was not how exercise can affect students’ health. This is not to say that educators are not concerned with students’ health, but it is simply to say that in these programs and these ideas, the idea is that healthy students perform well. The idea is not to simply encourage students to be healthy. In the Eat Well & Keep Moving study that I read for my research, the authors were emphasizing how integrating health and physical activity into other curricula could reinforce healthy practices. My perception at Townsville is that the teachers and administrators are more concerned with improving academic performance outside of physical education. No one ever implied that using physical education in Literacy or Math would improve students’ attitudes towards health and fitness.

Jim stated that they’ve talked about having Math content videos to watch while cycling. I interpret this to mean that understanding the Math content is the goal with that type of activity. The goal is not to improve cycling skills. Dave mentioned working with ladders or balancing while trying to learn Math concepts. Again, I interpret that to mean that learning balancing skills is not the goal. The goal is to learn complex Math concepts. Michael mentioned his daughter who has to move to learn. Again, in that situation, she would need to get up and move to improve learning, not to improve physical fitness.

What also sticks out to me in my interpretation of this interview is that the students who are being addressed are typically below-average performers in Literacy or Math classes. I wonder if the effect of physical activity on learning is limited to only certain kinds of reasoning. It is hard to interpret whether the Zero Hour program is addressed at students who are performing below average in Literacy because those are the students who need enhanced curriculum, or if it is because the same effects might not occur with students who are doing higher reasoning. I cannot tell from the Townsville program alone whether students who exercise in the morning could then do higher-level math, or use logic better. These are things that would be beneficial for students who are performing at an average or above average level.

Observations

Analysis:

While at Townsville high school, I saw several things that related to the theme of physical activity and physical education and its effect on other academic disciplines. The first thing I saw was the Zero Hour PE class itself. During that particular Monday morning, the students did an eleven-minute scooter activity where they rolled around the gymnasium and tried to match laminated vocabulary words with the word roots and their definitions. The exact rules of the game were not clear to me, as some students would occasionally stop to do either push-ups or sit-ups. The students did not complain. I saw the words “pacify”, “satiate”, “industrious”, and “acclaim” as examples. There were also sheets with smaller words such as “peace”, “sate”, and “claim.” There was both a physical education teacher and a Literacy teacher present in the gymnasium. There were 5 students in the class that day. On this particular day, the students did not match all the words with their roots and their definitions. Bob Davies, the PE teacher, said that on their best day, they can match them all in eleven minutes.

According to Bob, the students would ideally not have had their test-day on those particular words yet, but one girl in the class had already been tested. Bob said “not all the Literacy teachers are on the same page.” Bob also mentioned that the most frustrating aspect of this class this past year was that he did not have enough time with them (30 minutes). He said students were frequently late because of transportation. Next academic year, Bob is supposed to instruct the same class, but it will be for the entire first-hour and there will be 30 students.

During my day at Townsville, I had the opportunity to see some of the equipment that Dave had mentioned in his interview. This included a wall-tapping game where lights blink and the students run from a line in order to tap the lights with their opposite hand (light on left, tap with right). He said the speed of the game is the challenge. It is both aerobic, and requires hand-mind coordination. Dave also showed me the chairs that their school recently purchased for the reading lab. They have 15 ball-chairs, which are stability exercise balls that are somewhat flat on the bottom, but still require sitting with a straight spine in order to avoid rolling off of them. Dave stated that student posture is supposed to improve from these chairs and that some researchers claim that posture directly affects the spine which in turn affects learning. Dave said that some administrators initially thought students would just bounce on the chairs all day. Dave’s response, “Good. Then they’re at least being active.”

Interpretation:

The frustration that the Zero Hour PE teacher had with the time restraint tells me that this was not the only day when time mattered. In my interpretation, I would pinpoint the time factor as the biggest drawback of the Zero Hour PE class. Quite interestingly, Bob also mentioned that not all the Literacy teachers are on the same page. This corroborates the limitation of curriculum integration outlined by Drake (2004), “For secondary teachers, the organizational structure of the department is a large obstacle to collaborating with others” (p. 18). The time of day seemed to be another drawback, but also a benefit at the same time. Bob said students often missed or were late because of transportation issues. This gave them even less time some days. The benefit of that time period is that it means that the only students who were signed up were the students who were actually dedicated to being there that early (or at least their parents were dedicated to them being there early). The other benefit was that on the days of the week that they did cardiovascular exercise for Zero Hour (at least two days a week) their subsequent classes may have been affected by their heightened energy.

What seemed to be the biggest advantage was the class size. On this particular day, there were only five students. Ordinarily, for 2nd semester, there were seven students. Each student had to participate fully, and got individual attention during the vocabulary matching game. Next year he said they would have thirty kids in the first hour of the day. I wonder whether each student will be given as much individualized attention, and therefore, if they will see the same level of improvement in the students Literacy scores. The major advantage of having additional students is that they will have a larger sample to study in order to gauge the success of the program.

Seeing some of the equipment that the PE department and the reading lab had that was supposed to physically enhance academic performance, I interpret that to mean that a lot of integration between physical education and other academic areas will always depend on the availability of resources. “Resources” is one of my later themes, but it is worth mentioning here as well. In terms of using scheduling as a way to increase academic performance by putting physical activity prior to subjects where students struggle, that concept requires no additional resources. However, a lot of the ideas mentioned for integrating physical education during other academic subject, or vice versa, would require games or equipment such as heart-rate monitors. In the very least, this kind of integration would require additions, if not major changes, to curriculum. Teachers would need to be knowledgeable of the equipment being utilized and also the topics, both in physical education and the other subject areas.

Focus Group - QSort

Analysis:

In relation to the theme of physical activity and academic performance, I think that at least one Q-Sort prompt is relevant. The prompt “I get bored or tired during school” elicited a score of 13, which was higher than 17 other prompts. One student answered “Never” to this prompt. 5 answered “Sometimes” and 4 answered “Always” (Figure 1.1). Similarly, but worded differently, the prompt “I like to sit in class and listen” (Figure 1.2) scored relatively low (sixth). 5 students answered they never liked to sit in class and listen. 4 answered Sometimes, and one student answered Always.

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When I asked students in the focus group who agreed that they get tired during the school day, one student immediately shouted “ALWAYS”, and other students laughed. But my analysis is that most students could tie their tiredness directly to a particular situation at school. For example, one student said he always got tired in a particular teacher’s class. His classmate laughed and added “ALWAYS. Like, half the period [the other student] is sleeping, then out of nowhere he wakes up and is like ‘what does this mean?’” She then added that the class she gets most tired in is Biology. When I asked whether the focus group thought they got tired based on the class or based on the time of day, some said the class, some said the time and one student said “it could be both.” At least 4 of the students mentioned morning class periods as times they were falling asleep or tired. I then asked whether any students felt tired after lunch, and they said “no.”

I also asked the students more specific questions about how they would feel about incorporating more physical activity into their days. Most students responded that they prefer to be active instead of sitting and listening. One student answered that he thinks he is running around too much already during the day, since he has to run up and down stairs between classes. I also asked students what they would think about incorporating Math into PE class. They responded “we did that already,” and immediately started spouting off an inequality (which they incorrectly called an equation) for determining your maximum heart-rate zone. The inequality is 0.6(220 – a) ................
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