Skip to content

Advertisement

  • Research article
  • Open Access
  • Open Peer Review

Effects of cardiorespiratory fitness and weight status on knowledge of physical activity and fitness, attitude toward physical education, and physical activity

BMC Public HealthBMC series – open, inclusive and trusted201818:273

https://doi.org/10.1186/s12889-018-5176-4

  • Received: 21 August 2017
  • Accepted: 16 February 2018
  • Published:
Open Peer Review reports

Abstract

Background

The purpose of this study was to examine the effects of cardiorespiratory fitness and weight status on knowledge of physical activity and fitness (PAF knowledge), attitude toward physical education (PE), and physical activity.

Methods

A total of 343 middle school students participated in the study (Age: M/SD = 12.76/.94, ranging from 11 to 14 years old). PE Metrics™ was used to measure PAF knowledge, and Attitude toward Physical Education Questionnaire and Youth Activity Profile were used to measure attitude, physical activity and sedentary behavior. Fitness and weight status were assessed using FitnessGram and converted to in Healthy Fitness Zone (HFZ) or Not in HFZ.

Results

Two-way multivariate analyses of covariance (MANCOVA; gender and grade as covariates) showed a significant group effect for cardiorespiratory fitness (ΛPilla = .07, F4,255 = 5.03, p = .001, \( {\eta}_p^2 \) = .07) but not for weight status (p = .57). PAF knowledge (F1,258 = 9.49, p < .01, \( {\eta}_p^2 \)= .04), attitude (F1,258 = 4.45, p < .05, \( {\eta}_p^2 \)= .02) and sedentary behavior (F1,258 = 6.89, p < .01, \( {\eta}_p^2 \)= .03) all favored the HFZ group.

Conclusions

The findings reinforce the importance of promoting cardiorespiratory fitness in middle school PE as students acquire attitude, knowledge, and behaviors needed for active-living.

Keywords

  • Adolescents
  • Fitness
  • Obesity
  • Physical activity
  • Physical education

Background

Teaching students for a lifetime of physical activity participation is an ultimate goal of physical education (PE) in K-12 schools [1, 2]. However, youth physical activity level is low calling for promotive effort for active-living [36]. Similarly, only a half of the students in the United States have reached the standards of FitnessGram [7, 8]. Coinciding with inadequate physical activity is the decline of health-related physical fitness (cardiorespiratory fitness in particular) [9] and the high prevalence of childhood obesity [10]. Fitness education is needed, especially in middle school years, for students to pursue knowledge, skills, attitude, and behaviors related to active-living [11]. Cardiorespiratory fitness and body weight status are important correlates of health and academic outcomes. It is well-documented that higher cardiorespiratory fitness is associated with reduced mortality risk, whereas obesity is related to co-morbidities and mortality [1214]. Furthermore, cardiorespiratory fitness may offset the negative influence of obesity on health outcomes [15, 16], as improvement in fitness among individuals with obesity may modify their health perspective even although they may not change their body composition. In addition, recent research has substantiated the linkage between fitness/physical activity with academic achievement, performance, or cognition [9, 17, 18]. In the adolescent population, cardiorespiratory fitness and body weight status are significant correlates of academic outcomes [17, 18]. In particular, fitness in boys and weight status in girls were significantly correlated with health status and academic achievement, regardless of behavioral backgrounds [18].

PE is a main channel through which students receive formal education about fitness, health-related knowledge, physical activity, and weight management [19, 20]. Despite the difficulty to change students’ fitness and weight status through one setting alone within a short period of time, school-based physical activity programming that uses PE as the hub through a coordinate approach may lead to short-term and long-term changes to physical activity level and wellness status [21]. The influences of fitness and weight status on engagement and learning in PE related settings are under-researched. Most of the studies that focused on fitness and weight status have regarded them as outcome variables. In these studies, PE-based interventions or school-based interventions in which PE was included as a component have demonstrated small to moderate effect on fitness and/or weight status [22, 23]. Fewer studies have examined fitness and weight status as independent variables. One study demonstrated that both cardiorespiratory fitness and weight status are significant correlates of self-reported physical activity in youth, but cardiorespiratory fitness seems a stronger enabling factor than weight status [24]. The less active/less fit adolescents are less likely to participate in diverse activities during adulthood due to lack of competence, limited activity options and fitness abilities, and lower level of physical activity behavior [25, 26]. Compared to youth with healthy weight, those who are overweight or obese are less active and more sedentary [27].

While it is important to equip students with competence (e.g. knowledge and skills) [19, 28], it is equally important to foster them a positive attitude toward PE and physical activity [20, 29] and promote physical activity (discourage sedentary behavior) through PE classes [6, 20, 21], as students navigate pathways toward lifetime physical activity. Prior research has shown that students’ attitude toward PE decline by age [3, 6, 29], lack a good understanding of physical activity or fitness knowledge [19, 30], and spend excessive time in sitting behaviors [5, 6]. The purpose of this study was to examine the effects of cardiorespiratory fitness and weight status on middle school students’ knowledge, attitude, and behaviors (i.e., physical activity and sedentary behavior). It was hypothesized that students with more desirable cardiorespiratory fitness and weight status would demonstrate higher level of knowledge about physical activity and fitness, more positive attitude toward PE, and higher level of physical activity but lower level of sedentary behavior.

Methods

Setting and participants

Data were collected from a public middle school in Iowa, U.S.. The school enrolled 571 students (5-8th grades) at the time of this study (it’s typical for middle or junior high schools in the state to enroll 5th grade students). The majority of the students were non-Hispanic White (85.6%) with a significant ratio of them (40.5%) eligible for free (n = 194) or reduced lunch (n = 37) and a 12.43 pupil/teacher ratio. PE instructional facility included a multi-purpose gymnasium, a matted wrestling room, a well-equipped weight room, and a 400-m outdoor track. The teachers followed the multi-activity PE curriculum that offered short units of assorted physical activities (e.g., sports, fitness, games, etc.).

All students in 6th, 7th, and 8th grades were eligible for participation in the study and a total of 343 (out of 443 students, 77.4% participation rate) students provided intact data for all measures. The final sample consisted of 6th (n = 95), 7th (n = 128), and 8th grades (n = 120) students whose average age was 12.76 (SD = .94, ranging from 11 to 14) years old. The sample was roughly even by gender (Boys: n = 164, 47.8%) with White being the predominant racial group (n = 244, 84.5%), which was typical in the state. The Iowa State University Institutional Review Board (IRB) and the school district approved of the study. The study was conducted as a natural process of the participating school’s PE program. Approved by the school’s administrators and the PE teachers, the data collection protocol was integrated into the school’s PE curriculum schedule. Research findings were shared with the PE teachers as feedback to their program evaluation. Results based on de-identified data were authorized for dissemination beyond the school. Due to the participatory research nature of this study, parental consent was waived.

Variables and instruments

Knowledge of physical activity and fitness (PAF knowledge)

PAF knowledge was assessed by the questions for middle school students from the PE Metrics™ [31]. The PAF knowledge test includes 29 multiple-choice questions with four possible choices (i.e., A, B, C, and D) which was previously validated using the Rasch Model analysis. The students’ responses were scored as 1 (correct) or 0 (incorrect) following the answer key. One question, for example, is phrased as: Mary performs stretching exercises and runs most days of the week to be able to increase her: A. Arm and shoulder strength. B. Muscle endurance and abdominal strength. C. Flexibility and aerobic endurance [correct answer]. D. Flexibility and body weight. Percentage of correct scores for each participant was computed and used in the data analyses.

Attitude toward PE

The Attitude toward Physical Education Questionnaire for Middle School Students was used to measure students’ attitude [32]. The instrument contains 20 questions with 10 items capturing the affective component of attitude labeled as “perceived enjoyment” and the other 10 capturing the cognitive component of attitude labeled as “perceived usefulness”. For example, one question asking about students’ perceived usefulness is phrased as “The games I learn in my physical education class seem important to me”. The questionnaire was previously validated using middle school samples [29, 32]. All of the items used the 5-point Likert scale for responses ranging from 1 (strongly disagree) to 5 (strongly agree). The questionnaire showed very good internal consistency for “perceived enjoyment” (Cronbach’s α = .89) and “perceived usefulness” (Cronbach’s α = .86) in the present sample.

Physical activity and sedentary behavior

The Youth Activity Profile (YAP) was used to measure students’ physical activity and sedentary behavior [33]. The questionnaire was previously validated with a middle school student sample and showed highly accurate group-level estimates of time spent in physical activity and sedentary behavior [33]. One item measuring sedentary behavior is stated as: How much time did you spend watching TV outside of school time? YAP has 15 questions measuring students’ physical activity at school, physical activity after school, and sedentary behavior.

Cardiorespiratory fitness and weight status

Cardiorespiratory fitness in this study was assessed by the 20-m PACER (FitnessGram; Cooper Institute 2010). PACER laps were converted into VO2max using the following predictive eq. [34]: VO2max = 41.77 ± (PACERlaps * 0.49) - 0.0029 * (PACERlaps^2) - 0.62 * BMI ± 0.35* Age * Gender. Body mass index (BMI) computed from weight and height was used to define weight status. Weight and height were assessed using a digital weight scale (Tanita HD-366; Tanita, Arlington Heights, IL, USA) and the Seca 213 stadiometer (Seca, Hanover, MD, USDA). Following the FitnessGram standards chart (version 9), raw scores from both VO2max and BMI were converted into achievement of the HFZ (1 = in HFZ; 0 = not in HFZ). As two independent variables, cardiorespiratory fitness and weight status served as categorical variables (fixed factors) in this study. FitnessGram has shown sound validity, reliability, and practicality in school PE [34, 35].

Data collection and processing

The data collection of the study was conducted across the 2016–2017 academic school year. Two separate batches of surveys were administered to collect demographic variables, PAF knowledge, attitude toward PE, physical activity and sedentary behavior. FitnessGram tests were administered by the PE teachers with assistance of trained data collectors. PACER is a commonly used field test in schools. The PE teachers had previously been trained to administer the test and the students were familiar with the testing procedure. To ensure data quality, a hard copy of the testing manual for PACER was delivered to the PE teachers two weeks before data collection started. The trained data collectors measured the students’ weight and height with adequate privacy and confidentiality ensured in the adjacent wrestling room. After data collection was completed, data derived from the two surveys and FitnessGram tests were entered into a Microsoft Excel spreadsheet and then a SPSS24.0 database. We matched data by students’ lunch identification numbers, which were destroyed after data were matched to maintain anonymity.

Data analysis

Descriptive analysis (mean, standard deviation) and partial correlational analysis (gender and grade as covariates) was conducted for the key variables (attitude, knowledge, physical activity and sedentary behavior), followed by inferential statistical analysis to explore group differences by gender and grade. We tested gender- and grade-based differences to identify whether they would be confounding variables for the subsequent analysis. MANCOVA was conducted to test the effects of cardiorespiratory fitness and weight status on PAF knowledge, attitude toward PE, physical activity and sedentary behavior, after controlling for gender and grade. Data were screened for violations of statistical assumptions (Box’s M test for MANOVA and Levene’s test for ANOVAs). An alpha level of .05 was used to determine significance level and partial eta square (\( {\eta}_p^2 \)) was reported for effect size.

Results

Table 1 shows the descriptive analysis results for the key variables by gender and grade. For gender difference, girls on average showed higher PAF knowledge than boys (M = 52.9% vs 49.3%), but lower levels of attitude toward PE (M = 70.34 vs 74.94) and physical activity (M = 3.31 vs 3.51). These differences were statistically significant (p < .05). Sedentary behavior level was similar between girls and boys (M = 2.56 vs 2.48). For group differences by grade, students in 6th and 7th grades on average showed a higher level of knowledge than those in 8th grade (6th grade: M = 52.0%, 7th grade: M = 55.0%, 8th grade: M = 46.5%). Students in lower grades showed more positive attitude toward PE (6th grade: M = 74.65, 7th grade: M = 73.38, 8th grade: M = 69.73) and lower sedentary behaviors than students in higher grades (6th grade: M = 2.22, 7th grade: M = 2.60, 8th grade: M = 2.69). These differences were statistically significant (p < .05). No grade differences were found for self-reported physical activity (6th grade M = 3.28, 7th grade: M = 3.47, 8th grade: M = 3.42).
Table 1

Descriptive Results of the Variables – Mean (Standard Deviation) and Percentage (%)

Variables

PAF Knowledge

Attitude

PA

SB

PACER Laps

PACER HFZ%

BMI

BMI HFZ%

Gender

 Boys

49%(18%)

74.94 (12.62)**

3.51(.77)*

2.48(.69)

35.59 (19.95)**

54.8%

22.56 (5.29)

44.2%

 Girls

53%(14%)

70.34 (13.47)**

3.31(.82)*

2.56(.83)

25.80 (15.06)**

63.9%

23.07 (5.60)

49.7%

Grade

 6th G

52%(15%)

74.65 (11.24)a

3.28(.92)

2.22(.75)ab

26.63 (15.53)

56.7%

21.99 (5.38)

47.8%

 7th G

55%(15%)a

73.38 (13.28)

3.47(.78)

2.60(.78)a

30.62 (18.73)

61.0%

22.81 (5.97)

44.7%

 8th G

47%(18%)a

69.73 (14.41)a

3.42(.72)

2.69(.70)b

33.54 (19.22)

60.4%

23.51 (4.85)

49.1%

PAF knowledge physical activity and fitness knowledge, PA physical activity, SB sedentary behavior, PACER progressive aerobic cardiovascular endurance run, HFZ healthy fitness zone, BMI body mass index. *p < .05; **p < .01. adenotes significant difference (p < .05) between two groups; bdenotes significant difference (p < .05) between the other two groups

Table 2 shows partial correlation coefficients between the variables after controlling for gender and grade. Attitude is positively correlated with PAF knowledge (r = .13, p < .05) and physical activity (r = .27, p < .01), while cardiorespiratory fitness is positively correlated with PAF knowledge (r = .20, p < .01) but negatively correlated with sedentary behavior (r = −.14, p < .05). Physical activity and sedentary behavior are reversely correlated (r = −.22, p < .01). Table 3 shows the results from MANCOVA. There were 59.6% students who achieved the HFZ for cardiorespiratory fitness and 47.1% for weight status. The two-way MANOVA examining the differences between those in HFZ and those not in HFZ for cardiorespiratory fitness and weight status showed unequal covariance matrices (Box’s M = 55.72, F30,7510 = 1.74, p = .007), therefore Pillai’s Trace (ΛPillai) values were adopted for the results [36]. The analysis showed that there were significant cardiorespiratory fitness effect on the outcome variables (ΛPilla = .07, F4,255 = 5.03, p = .001, \( {\eta}_p^2 \) = .07), but no significant effect for weight status (p = .57) in this study, after controlling for gender and grade. Subsequent tests of between-subjects effects showed that PAF knowledge (F1,258 = 9.49, p < .01, \( {\eta}_p^2 \)= .04), attitude toward PE (F1,258 = 4.45, p < .05, \( {\eta}_p^2 \)= .02) and sedentary behavior (F1,258 = 6.89, p < .01, \( {\eta}_p^2 \)= .03) were statistically different between students in HFZ group and those not for cardiorespiratory fitness, all favoring the in HFZ group. There were no significant cardiorespiratory fitness by weight status interaction effects (ps > .05).
Table 2

Partial Correlation Matrix between the Variables (Gender and Grade as Covariates)

 

1

2

3

4

5

1. PAF Knowledge

 

2. Attitude

.13*

    

3. PA

.02

.27**

   

4. SB

.02

−.12

−.22**

  

5. HFZ.PACER

.20**

.12

.10

−.14*

 

6. HFZ.BMI

.10

.08

.00

−.02

.53

PAF knowledge physical activity and fitness knowledge, PA physical activity, SB sedentary behavior, PACER progressive aerobic cardiovascular endurance run, HFZ healthy fitness zone, BMI body mass index. *p < .05; **p < .01

Table 3

Two-Way (Fitness and Weight status) MANCOVA (Gender and Grade as Covariates) Results

Source

Variables

SS

df

MS

F

p

\( {\eta}_p^2 \)

Intercept

PAF Knowledge

1.39

1

1.39

57.95

.00

.18

Attitude

27,172.76

1

27,172.76

166.65

.00

.39

PA

35.36

1

35.36

60.10

.00

.19

SB

3.63

1

3.63

7.61

.01

.03

Gender

PAF Knowledge

.01

1

.01

.42

.52

.00

Attitude

1648.77

1

1648.77

10.11

.00

.04

PA

2.78

1

2.78

4.73

.03

.02

SB

1.57

1

1.57

3.30

.07

.01

Grade

PAF Knowledge

.13

1

.13

5.37

.02

.02

Attitude

989.27

1

989.27

6.07

.01

.02

PA

.15

1

.15

.26

.61

.00

SB

4.78

1

4.78

10.03

.00

.04

HFZ.PACER

PAF Knowledge

.23

1

.23

9.49

.00

.04

Attitude

726.06

1

726.06

4.45

.04

.02

PA

1.74

1

1.74

2.97

.09

.01

SB

3.29

1

3.29

6.89

.01

.03

HFZ.BMI

PAF Knowledge

.01

1

.01

.50

.48

.00

Attitude

68.91

1

68.91

.42

.52

.00

PA

.47

1

.47

.80

.37

.00

SB

.89

1

.89

1.86

.17

.01

HFZ.PACER * HFZ.BMI

PAF Knowledge

.03

1

.03

1.12

.29

.00

Attitude

465.73

1

465.73

2.86

.09

.01

PA

.00

1

.00

.00

.98

.00

SB

.44

1

.44

.93

.33

.00

Error

PAF Knowledge

6.20

258

.02

   

Attitude

42,068.51

258

163.06

   

PA

151.81

258

.59

   

SB

123.03

258

.48

   

Total

PAF Knowledge

6.64

263

    

Attitude

45,685.97

263

    

PA

156.64

263

    

SB

132.84

263

    

PAF knowledge physical activity and fitness knowledge, PA physical activity, SB sedentary behavior, PACER progressive aerobic cardiovascular endurance run, HFZ healthy fitness zone, BMI body mass index. SS sum of squares, df degrees of freedom, MS mean of squares, F F statistic from the MANCOVA, \( {\eta}_p^2 \) = partial eta square

Discussion

The purpose of this study was to examine the effects of cardiorespiratory fitness and weight status on middle school students’ PAF knowledge, attitude toward PE, and physical activity and sedentary behavior. The hypothesis was partially confirmed in that students with healthy fitness (cardiorespiratory fitness in HFZ) showed significantly higher level of PAF knowledge, more positive attitude, and lower level of sedentary behavior than those with unhealthy cardiorespiratory fitness (not in HFZ), but weight status did not show significant effect on these variables. The results and implications are discussed below.

The results indicate that gender and grade are two demographic variables that are significantly associated with PAF knowledge, attitude, and behavior. Therefore, these two variables were controlled for in the MANCOVA when examining the effects of cardiorespiratory fitness and weight status on PAF knowledge, attitude, and behaviors. The findings suggest physical educators may structure gender sensitive and developmentally appropriate fitness education to cater for the needs and physical activity/fitness preferences of boys and girls in middle school years. Prior research has pointed out that boys and girls at different grade levels tend to have distinct attitudinal preferences when it comes to selection of physical activities for participation [37, 38]. Fitness activities/games, that fit the needs and preferences of boys and girls and that factor in students’ age/grade characteristics, will motivate students to exhibit active participation in these activities both in and outside of PE classes, which will ultimately increase the chance for bettering fitness and adopt the lifestyle of active-living.

The main finding of this study lies in that students who are physically fit (in HFZ for cardiorespiratory fitness) have shown higher level of PAF knowledge, more positive attitude towards PE, and have engaged in less sedentary behavior than those who are physically unfit, regardless of their weight status. This finding is encouraging, as middle school students’ attitude toward PE declines by age [29] and they have shown deficiency about health-related knowledge (e.g., health-related fitness, energy balance, exercising) [19, 30] and spend a significant amount of time being sedentary (e.g., screen time) [5, 6]. Holding a positive attitude toward PE and physical activity experiences and achieving a solid understanding about PAF knowledge are significant correlates of physical activity [20, 39, 40]. Therefore, purposeful fitness education with focus on enhancing cardiorespiratory fitness should be instituted in middle school PE classrooms for students to pursue knowledge, attitude, and behaviors needed for active-living [9, 11]. Exercises or physical activities of moderate (≥ 3 METS) to vigorous intensities (≥ 6 METS) for a minimum of 10 min per bout are beneficial to the cardiorespiratory system, which if practiced regularly will improve or sustain one’s cardiorespiratory fitness [15, 16, 24]. PE teachers are suggested to allot a significant duration of class time in each PE lesson on conventional aerobic exercises such as running, cycling, swimming, active sports and/or novel exercises such as high intensity interval training (HIIT) [41]. In addition, they should encourage students to engage in these activities outside of school, because adequate practice and participation are required to improve fitness [11, 42].

The findings of this study also confirm a similar conclusion observed in epidemiology research in that despite one’s weight status, fitness is an important factor underlying various outcomes in adults and youth populations [15, 16, 24]. Prior research indicate that a good level of cardiorespiratory fitness may offset the hazardous effects of weight status [15, 16, 24]. Our study reinforces the importance of conveying purposeful fitness education through middle school PE, while also addressing body composition (learning knowledge, strategies, and skills pertinent to weight management) as a secondary goal. Although it remains an important goal of fitness education to achieve a healthy body composition, to change weight or body composition is difficult and requires synergistic efforts from multiple layers of environmental factors and components [24]. The findings are promising for middle school students, especially for those who are unable to maintain a healthy weight during adolescence years. Our study did not observe any significant group differences in any of the focal variables (knowledge, attitude, physical activity or sedentary behavior) between the healthy weight group and the need improvement weight group. In other words, weight status does not necessarily interfere with students’ learning processes and outcomes in PE classes (e.g., to gain a positive attitude, acquire knowledge, and participate in physical activities). With increased engagement and learning in PE classes, students will likely enhance fitness, which will likely lead to more desirable outcomes for attitude, knowledge learning, and sedentary behavior. Further, sustained engagement in regular physical activities will increase caloric expenditure therefore changes in body composition in the long run [19].

The findings from this study should be interpreted with several limitations. First, this study utilized a correlational design. The significant associations between cardiorespiratory fitness (and weight status) and the key variables should not be interpreted as cause and effect. Second, despite the large sample size, the participants were recruited from one middle school located in a mid-western state. The findings are only generalizable to middle school students in schools of similar characteristics. Last but not the least; our advocacy of focusing cardiorespiratory fitness in school-based fitness education as curriculum priority was based upon the data reported in this study. This advocacy does not suggest that other fitness components are not important content of fitness education.

Conclusion

This study showed significant effect of cardiorespiratory fitness (not weight status) on PAF knowledge, attitude, and sedentary behavior in middle school students. The findings suggest that achieving the HFZ for cardiorespiratory fitness is associated with higher PAF knowledge, more positive attitude toward PE, and lower level of sedentary behavior. In light of the obesity and physical inactivity epidemic, fitness education with focus on cardiorespiratory fitness should become a curriculum priority in middle school PE classroom.

Declarations

Acknowledgements

None.

Funding

None.

Availability of data and materials

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Authors’ contributions

SC conceived and carried out the study, analyzed the data, drafted and revised the manuscript; XG analyzed the data and revised the manuscript. Both authors read and approved the final manuscript.

Ethics approval and consent to participate

The Iowa State University Institutional Review Board (IRB) granted approval of this study. Informed consent was waived as per the IRB approval.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors’ Affiliations

(1)
School of Kinesiology, Louisiana State University, 175C Huey P. Long Field House, Baton Rouge, LA 70803, USA
(2)
Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, 1921 Chestnut Street, Denton, TX 76203, USA

References

  1. SHAPE America. National physical education standards. Reston, VA: SHAPE America; 2014.Google Scholar
  2. Ennis CD. Educating students for a lifetime of physical activity: enhancing mindfulness, motivation, and meaning. Res Q Exerc Sport. 2017; in pressGoogle Scholar
  3. Nader PR, Bradley RH, Houts RM, McRitchie SL, O'Brien M. Moderate-to-vigorous physical activity from ages 9 to 15 years. Jama-Journal of the American Medical Association. 2008;300(3):295–305.View ArticleGoogle Scholar
  4. Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, Mcdowell M. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc. 2008;40(1):181–8.View ArticlePubMedGoogle Scholar
  5. Pate RR, Mitchell JA, Byun W, Dowda M. Sedentary behaviour in youth. Br J Sports Med. 2011;45(11):906–13.View ArticlePubMedGoogle Scholar
  6. Bassett DR, John D, Conger SA, Fitzhugh EC, Coe DP. Trends in physical activity and sedentary behaviors of United States youth. J Phys Act Health. 2015;12(8):1102–11.View ArticlePubMedGoogle Scholar
  7. Bai Y, Saint-Maurice PF, Welk GJ, Allums-Featherston K, Candelaria N, Anderson K. Prevalence of youth fitness in the United States: baseline results from the NFL PLAY 60 FITNESSGRAM partnership project. J Pediatr. 2015;167(3):662–8.View ArticlePubMedGoogle Scholar
  8. Castelli D, Hillman C, Buck SM, Erwin HE. Physical fitness and academic achievement in 3rd and 5th grade students. Journal of Sport and Exercise Psychology. 2007;29(2):239–52.View ArticlePubMedGoogle Scholar
  9. Welk GJ, Jackson AW, Morrow JR, Haskell WH, Meredith MD, Cooper KH. The Association of Health-Related Fitness with Indicators of academic performance in Texas schools. Res Q Exerc Sport. 2010;81(3):S16–23.View ArticlePubMedGoogle Scholar
  10. Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, Flegal KM. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. Jama-Journal of the American Medical Association. 2016;315(21):2292–9.View ArticleGoogle Scholar
  11. Corbin CB, Welk GJ, Richardson C, Vowell C, Lambdin D, Wikgren S. Youth physical fitness: ten key concepts. Journal of Physical Education, Recreation & Dance. 2014;85(2):24–31.View ArticleGoogle Scholar
  12. Lee DC, Pate RR, Lavie CJ, Sui XM, Church TS, Blair SN. Leisure-time running reduces all-cause and cardiovascular mortality risk. J Am Coll Cardiol. 2014;64(5):472–81.View ArticlePubMedPubMed CentralGoogle Scholar
  13. Feldman DI, Al-Mallah MH, Keteyian SJ, Brawner CA, Feldman T, Blumenthal RS, Blaha MJ. No evidence of an upper threshold for mortality benefit at high levels of cardiorespiratory fitness. J Am Coll Cardiol. 2015;65(6):629–30.View ArticlePubMedGoogle Scholar
  14. Dishman RK, Heath GW, Lee I-M. Physical activity epidemiology. Champaign, IL: Human Kinetics; 2013.Google Scholar
  15. Blair SN. Physical inactivity: the biggest public health problem of the 21st century. Br J Sports Med. 2009;43(1):1–2.PubMedGoogle Scholar
  16. Lee DC, Sui XM, Artero EG, Lee IM, Church TS, McAuley PA, Stanford FC, Kohl HW, Blair SN. Long-term effects of changes in cardiorespiratory fitness and body mass index on all-cause and cardiovascular disease mortality in men the aerobics center longitudinal study. Circulation. 2011;124(23):2483–U2348.View ArticlePubMedPubMed CentralGoogle Scholar
  17. Chomitz VR, Slining MM, Mcgowan RJ, Mitchell SE, Dawson GF, Hacker KA. Is there a relationship between physical fitness and academic achievement? Positive results from public school children in the northeastern United States. J Sch Health. 2009;79(1):30–6.View ArticlePubMedGoogle Scholar
  18. Morita N, Nakajima T, Okita K, Ishihara T, Sagawa M, Yamatsu K. Relationships among fitness, obesity, screen time and academic achievement in Japanese adolescents. Physiol Behav. 2016;163:161–6.View ArticlePubMedGoogle Scholar
  19. Chen S, Nam YH. Energy balance education in schools: the role of student knowledge. Eur Phys Educ Rev. 2017;23(1):157–70.View ArticleGoogle Scholar
  20. Chen S, Liu Y, Schaben J. To move more and sit less: does physical activity/fitness knowledge matter in youth? J Teach Phys Educ. 2017;36:142–51.View ArticleGoogle Scholar
  21. Chen S, Gu X. Toward active living: comprehensive school physical activity program research and implications. Quest. 2017; in pressGoogle Scholar
  22. Fu Y, Gao Z, Hannon JC, Burns RD, Brusseau TA. Effect of the SPARK program on physical activity, cardiorespiratory endurance, and motivation in middle-school students. J Phys Act Health. 2016;13(5):534–42.View ArticlePubMedGoogle Scholar
  23. Klakk H, Chinapaw M, Heidemann M, Andersen LB, Wedderkopp N. Effect of four additional physical education lessons on body composition in children aged 8-13 years - a prospective study during two school years. BMC Pediatr. 2013;13Google Scholar
  24. Chen S, Welk GJ, Joens-Matre RR. Testing the youth physical activity promotion model: fatness and fitness as enabling factors. Meas Phys Educ Exerc Sci. 2014;18(4):227–41.View ArticleGoogle Scholar
  25. Robinson LE, Stodden DF, Barnett LM, Lopes VP, Logan SW, Rodrigues LP, D'Hondt E. Motor competence and its effect on positive developmental trajectories of health. Sports Med. 2015;45(9):1273–84.View ArticlePubMedGoogle Scholar
  26. Logan SW, Webster EK, Getchell N, Pfeiffer KA, Robinson LE. Relationship between fundamental motor skill competence and physical activity during childhood and adolescence: a systematic review. Kinesiology Review. 2015;4:416–26.View ArticleGoogle Scholar
  27. Gao Z, Oh H, Sheng HP. Middle school Students' body mass index and physical activity levels in physical education. Res Q Exerc Sport. 2011;82(1):145–50.View ArticlePubMedGoogle Scholar
  28. Demetriou Y, Sudeck G, Thiel A, Honer O. The effects of school-based physical activity interventions on students' health-related fitness knowledge: a systematic review. Educational Research Review. 2015;16:19–40.View ArticleGoogle Scholar
  29. Subramaniam PR, Silverman S. Middle school students' attitudes toward physical education. Teach Teach Educ. 2007;23(5):602–11.View ArticleGoogle Scholar
  30. Keating XFD, Harrison L, Chen L, Xiang P, Lambdin D, Dauenhauer B, Rotich W, Pinero JC. An analysis of research on student health-related fitness knowledge in K-16 physical education programs. J Teach Phys Educ. 2009;28(3):333–49.View ArticleGoogle Scholar
  31. NASPE. PE metrics: assessing national standards 1–6 in secondary school. Reston, VA: AAHPERD; 2011.Google Scholar
  32. Subramaniam PR, Silverman S. Validation of scores from an instrument assessing student attitude toward physical education. Meas Phys Educ Exerc Sci. 2000;4(1):29–43.View ArticleGoogle Scholar
  33. Saint-Maurice PF, Welk GJ. Validity and calibration of the youth activity profile. PLoS One. 2015;10(12)Google Scholar
  34. Boiarskaia EA, Boscolo MS, Zhu WM, Mahar MT. Cross-validation of an equating method linking aerobic FITNESSGRAM (R) field tests. Am J Prev Med. 2011;41(4):S124–30.View ArticlePubMedGoogle Scholar
  35. Welk GJ, Maduro PFDM, Laurson KR, Brown DD. Field evaluation of the new FITNESSGRAM (R) criterion-referenced standards. Am J Prev Med. 2011;41(4):S131–43.View ArticlePubMedGoogle Scholar
  36. Tabachnick BG, Fidell LS. Using multivariate statistics. 5th ed. Boston, MA: Pearson; 2006.Google Scholar
  37. Azzarito L, Solmon M. An investigation of Students' embodied discourses in physical education: a gender project. J Teach Phys Educ. 2009;28(2):173–91.View ArticleGoogle Scholar
  38. Zeng HZ, Leung RW, Hipscher M, Liu W, Sylvester P. Attitude toward physical education of urban high school students. Res Q Exerc Sport. 2009;80(1):A85–6.Google Scholar
  39. Sallis JF, Prochaska JJ, Taylor WC. A review of correlates of physical activity of children and adolescents. Med Sci Sports Exerc. 2000;32(5):963–75.View ArticlePubMedGoogle Scholar
  40. Chung M, Phillips DA. The relationship between attitude toward physical education and leisure-time exercise in high school students. Physical Educator. 2002;59(3):126–38.Google Scholar
  41. Physical Activity Guidelines for Americans Midcourse Report Subcommittee of the President’s Council on Fitness, Sports & Nutrition. Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth. Washington, DC: U.S. Department of Health and Human Services; 2012. https://health.gov/paguidelines/midcourse/pag-mid-course-report-final.pdf.
  42. Beets MW, Okely A, Weaver RG, Webster C, Lubans D, Brusseau T, Carson R, Cliff DP. The theory of expanded, extended, and enhanced opportunities for youth physical activity promotion. Int J Behav Nutr Phys Act. 2016;13(1):120.View ArticlePubMedPubMed CentralGoogle Scholar

Copyright

© The Author(s). 2018

Advertisement