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School physical education (PE) is one of the most valuable tools for increasing physical activity and fitness among youth of all backgrounds; however, compliance with existing PE laws is low (and differential by school race/ethnic and family-income composition, contributing to health disparities), and best practices for increasing compliance remain unknown. This study proposes to examine a novel approach for increasing PE law compliance by testing a PE audit and feedback tool (adapted from a tool used by the New York City Department of Education) in Oakland, California schools to determine the effectiveness, adaptability, and scalability of this potential cost-effective approach for increasing PE law compliance and student physical activity.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PE Audit and Feedback Intervention | Experimental | Schools in this arm will receive a PE audit and feedback tool delivered by the school district's teacher on special assignment for PE, which will consist of an audit of the school's existing PE program; Feedback on ways to improve the PE program; and technical assistance to help improve the PE program. |
|
| PE Support as Usual | No Intervention | Schools in this arm will receive district-level support for PE as is typically provided by the school district. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PE Audit and Feedback Tool | Behavioral | The intervention consists of a Physical Education (PE) Audit and Feedback tool, which was adapted from work done through the PE Works program in the New York City Department of Education. A district-level PE program leader in Oakland Unified School District will deliver the tool, which consists of auditing the current status of PE in intervention schools, providing feedback on the status to help improve PE, and providing technical assistance to bring schools up to code and ensure support for PE programming. |
| Measure | Description | Time Frame |
|---|---|---|
| Scheduled Minutes of Physical Education/Week | Linear mixed effects models with random effects for school and grade were used to determine within group difference in change between baseline and follow up in scheduled minutes of physical education/week | Change from baseline (spring of year 1) to follow-up (spring of year 2) |
| Estimated Minutes of Physical Education/Week | Linear mixed effects models with random effects for school and grade were used to determine within group difference in change between baseline and follow up in estimated minutes of physical education/week based on data collected with the System for Observing Fitness Instruction Time | Change from baseline (spring of year 1) to follow-up (spring of year 2) |
| % of PE Lesson Time in Moderate to Vigorous Physical Activity | Linear mixed effects models with random effects for school and grade were used to determine within group difference in change between baseline and follow up in proportion of PE class time in MVPA based on data collected with the System for Observing Fitness Instruction Time | Change from baseline (spring of year 1) to follow-up (spring of year 2) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UC Berkeley | Berkeley | California | 94720 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40212560 | Result | Thompson HR, Nguyen C, McKenzie TL, Dzewaltowski DA, Madsen KA. A pilot cluster-randomized controlled trial of an audit, feedback, and coaching intervention on compliance with elementary physical education laws and student physical activity during lesson time. Prev Med Rep. 2025 Mar 19;53:103037. doi: 10.1016/j.pmedr.2025.103037. eCollection 2025 May. |
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Schools were randomized to intervention (n = 5) and control (n = 5) arms using block randomization, ensuring equal representation by total enrollment and proportion of low-income students enrolled across groups. School PE teachers and other teachers who taught PE, along with the school principal at each school were invited to participate in semi-structured interviews about PE at their school.
This two-year (2022/23-2023/24) cluster-randomized controlled trial involved 10 elementary schools conducted in partnership with the district's teacher on special assignment for physical education (hereafter, "Physical Education Director"). Study schools were chosen using a survey of school principals which identified schools that were noncompliant (or unsure about compliance) with California law mandating 200 min of physical education every 10 school days.
| ID | Title | Description |
|---|---|---|
| FG000 | Intervention - Physical Education Audits, Feedback, and Coaching (PEAFC) | 5 elementary schools were randomized to receive the intervention, which was adapted from a prior version using: 1) findings from another school district; 2) data collected through semistructured interviews with 20 principals from non-study schools on potential best-practices for the tool; and 3) in collaboration with the district's Physical Education Director. It consisted of five yes/no indicators of physical education quantity and quality indicators: 1) Schedule all students for physical education that meets California time requirements of the equivalent of 100 min physical education/week; 2) Hire credentialed physical education teachers and assign them with appropriate student-to-staff ratios; 3) Encourage and support teachers in participating in professional development learning opportunities; 4) Observe instruction to ensure physical education content standards and grade-level outcomes; 5) Educate school community, including teachers and parents, about physical activity and other wellness opportunities. The Physical Education Director was trained to implement PEAFC in the summer prior to Year 1 and collected audit data during Fall of Year 1 through visits to each intervention school. During these visits, he spoke with principals, physical education teachers, and classroom teachers, as well as observed physical education classes, to determine which of, and to what extent, the five audit indicators were being met. |
| FG001 | Control - PE as Usual | 5 elementary schools were randomized to the control condition, in which they received PE-related support as usual. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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PE teachers, school principals, and the district PE director participated in semi-structured interviews
| ID | Title | Description |
|---|---|---|
| BG000 | Intervention - Physical Education Audits, Feedback, and Coaching (PEAFC) | 5 elementary schools were randomized to receive the intervention, which was adapted from a prior version using: 1) findings from another school district; 2) data collected through semistructured interviews with 20 principals from non-study schools on potential best-practices for the tool; and 3) in collaboration with the district's Physical Education Director. It consisted of five yes/no indicators of physical education quantity and quality indicators: 1) Schedule all students for physical education that meets California time requirements of the equivalent of 100 min physical education/week; 2) Hire credentialed physical education teachers and assign them with appropriate student-to-staff ratios; 3) Encourage and support teachers in participating in professional development learning opportunities; 4) Observe instruction to ensure physical education content standards and grade-level outcomes; 5) Educate school community, including teachers and parents, about physical activity and other wellness opportunities. The Physical Education Director was trained to implement PEAFC in the summer prior to Year 1 and collected audit data during Fall of Year 1 through visits to each intervention school. During these visits, he spoke with principals, physical education teachers, and classroom teachers, as well as observed physical education classes, to determine which of, and to what extent, the five audit indicators were being met. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Scheduled Minutes of Physical Education/Week | Linear mixed effects models with random effects for school and grade were used to determine within group difference in change between baseline and follow up in scheduled minutes of physical education/week | 5 schools were randomized to intervention and 5 were randomized to control condition. Data collection on PE schedules took place within each school. Data were aggregated at the school level. | Posted | Mean | Standard Error | scheduled minutes of PE per week | Change from baseline (spring of year 1) to follow-up (spring of year 2) | schools | schools |
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Each school was monitored for 2 academic years, approximately 20 calendar months.
There were no adverse events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | PE Audit and Feedback Intervention | Schools in this arm will receive a PE audit and feedback tool delivered by the school district's teacher on special assignment for PE, which will consist of an audit of the school's existing PE program; Feedback on ways to improve the PE program; and technical assistance to help improve the PE program. |
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The restriction to a single district and a relatively small sample limits generalizability. Further, study randomization did not include presence of a full-time credentialed physical education teacher in the school (which was unknown/uncertain at randomization). In addition, PEAFC was based on a fully funded model initially implemented by NYCDOE. In the current district, PEAFC implementation was unfunded, which limited the physical education Director's ability to adopt NYCDOE's best practices.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Hannah R Thompson | UC Nutrition Policy Institute | 510-642-3509 | thompsonh@berkeley.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Oct 3, 2025 | Oct 3, 2025 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Oct 3, 2025 | Oct 3, 2025 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D057185 | Sedentary Behavior |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D001519 | Behavior |
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This will be a 2-group cluster-randomized clinical trial, with the school being the unit of assignment and randomization. 5 schools will receive an intervention and 5 schools will serve as controls.
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This will be an intervention delivered at the school-level to improve physical education; blinding is not possible in this study.
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|
| BG001 | Control - PE as Usual | 5 elementary schools were randomized to the control condition, in which they received PE-related support as usual. |
| BG002 | Total | Total of all reporting groups |
| Schools |
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| Participants |
| Participants |
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| Sex: Female, Male | Count of Participants | Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants | Participants |
|
| OG001 | PE Support as Usual | Schools in this arm will receive district-level support for PE as is typically provided by the school district. |
|
|
| Primary | Estimated Minutes of Physical Education/Week | Linear mixed effects models with random effects for school and grade were used to determine within group difference in change between baseline and follow up in estimated minutes of physical education/week based on data collected with the System for Observing Fitness Instruction Time | 5 schools were randomized to intervention and 5 were randomized to control condition. Data collection on PE schedules took place within each school and PE classes were randomly observed to ensure they were happening according to schedule. Data were aggregated at the school level. | Posted | Mean | Standard Error | Minutes of physical education/week | Change from baseline (spring of year 1) to follow-up (spring of year 2) | Schools | Schools |
|
|
|
| Primary | % of PE Lesson Time in Moderate to Vigorous Physical Activity | Linear mixed effects models with random effects for school and grade were used to determine within group difference in change between baseline and follow up in proportion of PE class time in MVPA based on data collected with the System for Observing Fitness Instruction Time | 5 schools were randomized to intervention and 5 were randomized to control condition. Data collection on PE schedules took place within each school and PE classes were randomly observed. Data were aggregated at the school level. | Posted | Mean | Standard Error | % minutes | Change from baseline (spring of year 1) to follow-up (spring of year 2) | Schools | Schools |
|
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| 0 |
| 16 |
| 0 |
| 16 |
| 0 |
| 16 |
| EG001 | PE Support as Usual | Schools in this arm will receive district-level support for PE as is typically provided by the school district. | 0 | 19 | 0 | 19 | 0 | 19 |
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