Impact of State Laws Governing Physical Education on Attendance Among US High School Students, 2003 to 2017

Abstract

Purpose: This study assessed the influence of state laws governing physical education (PE) on weekly PE class attendance among US high school students. Design: Cross-sectional. Setting: 2003 to 2017 US national Youth Risk Behavior Survey (YRBS). Participants: A total of 533 468 high school students. Measures: Data on state laws governing PE came from National Cancer Institute’s Classification of Laws Associated with School Students (CLASS). Eight distinct state PE policies were scored, with higher scores denoting stronger laws. Analysis: Individual-level YRBS data were merged with CLASS data based on students’ residential state and survey year. State fixed-effect negative binomial regressions were performed, adjusting for individual-level characteristics and YRBS survey design. Results: A 1-score increase in state laws governing PE class time, staffing for PE, joint use agreement for physical activity, assessment of health-related fitness, and PE curriculum was associated with an increase in weekly PE attendance by 0.30, 0.28, 0.22, 0.20, and 0.13 days ( P < .001), respectively. In contrast, a 1-score increase in state laws governing moderate-to-vigorous-intensity physical activity time in PE, PE proficiency, and recess time was associated with a reduction in weekly PE attendance by 0.25, 0.15, and 0.09 days ( P < .001), respectively. The effects of most state PE policies on PE class attendance were larger among girls than boys. Conclusion: State PE policies differentially impacted US high school students’ PE class attendance, with larger effects on female students.

State laws governing school physical education in relation to attendance and physical activity among students in the USA: A systematic review and meta-analysis

“… 44 , 45 The remaining 17 studies that examined the influence of state laws on PE attendance and PA among students in the USA were included in the review. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31

Fig. 1 Study-selection flow diagram (PRISMA).

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“…Table 1 reports the basic characteristics of the studies included in the review. All 17 studies were conducted in or after 2007, 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 and 11 were published in or after 2012. 15 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 27 , 30 , 31 A total of 8 studies used nationally representative school- or student-level data, 15 , 16 , 17 , 18 , 20 , 21 , 23 , 24 3 studies focused on multiple states, 19 , 22 , 27 and the remaining 6 studies examined the PE laws of a single state (i.e., Alabama, California, North Carolina, Texas (covered by 2 studies), or Wyoming).…”

“…All 17 studies were conducted in or after 2007, 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 and 11 were published in or after 2012. 15 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 27 , 30 , 31 A total of 8 studies used nationally representative school- or student-level data, 15 , 16 , 17 , 18 , 20 , 21 , 23 , 24 3 studies focused on multiple states, 19 , 22 , 27 and the remaining 6 studies examined the PE laws of a single state (i.e., Alabama, California, North Carolina, Texas (covered by 2 studies), or Wyoming). 25 , 26 , 28 , 29 , 30 , 31 A total of 8 studies analyzed and reported student-level outcomes, 15 , 16 , 17 , 19 , 20 , 21 , 23 , 31 whereas the remaining 9 studies reported outcomes at the school or school district level.…”

“… 15 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 27 , 30 , 31 A total of 8 studies used nationally representative school- or student-level data, 15 , 16 , 17 , 18 , 20 , 21 , 23 , 24 3 studies focused on multiple states, 19 , 22 , 27 and the remaining 6 studies examined the PE laws of a single state (i.e., Alabama, California, North Carolina, Texas (covered by 2 studies), or Wyoming). 25 , 26 , 28 , 29 , 30 , 31 A total of 8 studies analyzed and reported student-level outcomes, 15 , 16 , 17 , 19 , 20 , 21 , 23 , 31 whereas the remaining 9 studies reported outcomes at the school or school district level. 18 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 Among the studies reporting student-level outcomes, 15 , 16 , 17 , 19 , 20 , 21 , 23 , 31 the mean and median number of students was 105,065 and 36,833, respectively.…”

“…The reason we did not cover any other outcomes, such as PA duration in PE classes or throughout the day and week, was that no 2 (or more) studies included in the review reported the same quantitative outcomes, which precluded meta-analysis. A total of 5 studies were included in the meta-analyses, 15 , 16 , 17 , 18 , 19 whereas the remaining 12 articles were excluded due to 3 reasons: (1) no studies reported the same outcome, 20 , 21 , 22 , 23 , 24 (2) neither standard error nor confidence interval (CI) of the estimated effect was reported, 25 , 26 , 27 or (3) no effect estimate was provided. 28 , 29 , 30 , 31 Study heterogeneity was evaluated by the I 2 index.…”