Monday, September 28, 2009
Wednesday, September 9, 2009
This was not written as a blog entry. It was written as an op-ed piece for a newspaper. However, 4 major newspapers have rejected it, but I would like someone to read it, so I am sharing it with you. I wrote this piece because even before the health reform debate devolved into a depressing spectacle of shouting and fear-mongering, almost noone was talking about how reforms might actually improve health. Use your freedom of speech to make your views known on this critical national issue.
Where is Health?
Where is health in the debate over health care reform? The mass media debate is almost completely about improving health care coverage, reducing health care costs, and paying for the increased coverage. There is a great deal of media attention to the proposed public option for insurance, and we hear a lot from hospital groups, insurance companies, and the pharmaceutical industry about what the proposals would do to their businesses. But people’s health is virtually absent from the mass media debate; an afterthought at best. Every so often there is a passing mention of prevention or enhanced primary care, but no explanation of what that might mean.
Where is health in the Congressional debates? Believe it or not, health is present in discussions of preventing disease to both control health care costs and improve the health of Americans. Did you know that in the Senate three committees are working on health reform and one of those is focused on prevention and public health? I’m guessing you did not know that. I’ve been looking for reports on their work, and I don’t find them in the mass media.
Where is health on the minds of the American people? Surprise, it’s the number one priority for health reform. A May 2009 Trust for America’s Health poll of 1014 US voters identified prevention as the top priority of six health reform proposals that included universal health care coverage and prohibiting insurance companies from denying coverage based on pre-existing conditions. What’s more, 76% of voters supported investing more money in prevention, and that included at least 70% of Republicans, Democrats, and Independents.
Why is the public debate on health care so discrepant from the public’s interest in health improvement? This is a question that needs to be answered by media organizations, but here is my guess. The debate is being driven by money, health care industry money. Hospitals, insurance companies, pharmaceutical companies, medical device makers, medical testing companies, and physician groups are the beneficiaries of the current system that spends $2 trillion annually. They are on the receiving end of the unrelenting rise in health care costs. They have something to lose if Americans become healthier, so I imagine they are sending the most letters and emails to news organizations and lobbyists to Capitol Hill. Their primary concern is the financial health of their companies, so excuse them if they don’t talk much about the health of the American people.
Who is representing the voice of the American people who want a health system that helps them stay healthy and prevent disease? Almost nobody. There are public interest groups and foundations that are trying to make their voices heard and find some scraps for prevention, but they are no match for the lobbying activities of giant health care industries. If you are one of the 76% of American voters who wants health reform to create a health system that invests much more in prevention, you are going to have to speak for yourself. Express your opinion to your representatives and to news outlets.
But as we prepare to speak our minds, let’s be clear about what prevention really is. In the health care debate, prevention usually refers to mammograms, prostate screening, and cholesterol testing. These are worthy but not at the heart of making people healthier. Prevention can summed up by “3four50”. This means that 3 behaviors (smoking, inactivity, poor diet) contribute to four leading diseases (heart disease, cancers, diabetes, and lung disease) that in turn are responsible for 50% of all deaths in the world, more in the
Wednesday, September 2, 2009
Wednesday, August 5, 2009
Thursday, July 30, 2009
Wednesday, July 22, 2009
In August 1989 the SPARK study began, with funding from the National Heart, Lung, and Blood Institute. Our goal was to create a national model of physical education designed to respond to children’s health needs. We wanted to not only get kids active, but “turn them on” to activity and build the physical and behavior-change competencies they needed to remain active and healthy.
Twenty years later, I can say we succeeded beyond my wildest expectations! The SPARK and M-SPAN studies provided some of the evidence that led The Community Guide to strongly recommend enhanced physical education as an evidence-based intervention. We now have a suite of physical activity and school health programs to help young people remain active. There is a network of talented trainers across the country who provide hundreds of enthusiastically-received trainings every year. We have shown that when teachers learn to use SPARK, they keep using it for years. Most importantly, well over 1 million children benefit from SPARK every day. I often say SPARK is the most fulfilling experience of my career.
Of course, I was just a catalyst for what SPARK has become. Thom McKenzie is the architect who built a fabulous program. Paul Rosengard is the mastermind behind the blossoming of SPARK into a powerful force for improving health throughout the nation (and hopefully, soon, the world). It is a rare combination of skills to go from being an award-winning coach to a PE innovator to directing the phenomenal growth of SPARK, while maintaining quality and our strong reputation the whole time.
Recently, the SPARK staff and the master trainers got together to celebrate SPARK’s 20th birthday. It was a special occasion for me for many reasons. I really enjoyed paying tribute to Thom, Paul, and all the fabulous staff. It was a special treat to recognize SPARK employee numero uno, Kecia Carrasco. She was number one then, and she is number one now. We are all blessed that she is still devoting her considerable talents to SPARK. And it wouldn’t have been a SPARK party without a lot of fun activities. The master trainers led us in 3 great dances under the
With all that the SPARK team has accomplished, it is not nearly enough. While SPARK was growing, so was the obesity epidemic. It is very fortunate that we created some solutions for this problem, because concern about childhood obesity is certainly driving much of the interest in what we can provide. But still most schools do not have evidence-based activity-focused physical education. Most after-school, preschool, and recreation programs are not active enough. We have much more to do. But “with a little help from our friends” we will “come together” and SPARK the “revolution” that is needed to get every child active so they can be healthier and happier.
Wednesday, July 8, 2009
Nope – this ATM is the SPARK Annual Trainers Meeting and it’s one of those special things that sets SPARK apart from other organizations. Each year, SPARK brings its top trainers to
SPARK is a training organization at heart, because we know from research that the most efficacious of what we refer to as the “essential components” (i.e., curriculum, staff development, follow up support, and equipment) is the teacher training. And, if you can change (for the better) the way a teacher teaches, then you have a chance to impact many children over time. So, SPARK invests to find the best presenters, train them well, and support their ongoing development.
Each SPARK program (Early Childhood, After School, Physical Education K-2, 3-6, Middle and High school, and Coordinated School Health) has a Lead Trainer. The Lead Trainers mentor their flock and gather feedback on how to improve their program’s content, instruction, and equipment lists.
Trainers begin as novices and once they complete an extensive training program, they can advance to Certified, Master, and Elite levels. Today, SPARK is proud to have more than a dozen trainers with over a decade worth of experience conducting SPARK workshops. And in this case, experience matters.
So, the next time you’re ready to deposit or withdraw money from your ATM, think about our ATM. Yours might have a lot of cash stored inside, but ours is priceless.
Thursday, June 25, 2009
“It was 20 years ago today, Dr. Sallis taught the band to play.”
Can you believe it, SPARK is 20 years old! Back in June 1989, Drs. Sallis and McKenzie received funding to start the original research project. Their very first employee was Kecia Carrasco, who began as the office manager; and today, Kecia is SPARK’s Fiscal Manager. One of the two first PE specialists hired, B.J. Williston, is still contributing to SPARK content as a co-author of our K-2 and 3-6 manuals, and she’s working on the next edition of SPARK Middle School PE. We have over 10 trainers that have been conducting SPARK workshops for more than a decade, and many other employees that have been “SPARKing” for over 5 years. Jim and Thom hired me in August 1990 to be the Head Teacher in the research study, and it has been a great ride.
All of us “SPARKers,” past and present – hope you’ll continue to be a part of our growing family. Speaking for Jim, Thom, and all of us on the SPARK team – THANK YOU for a great 20 years.“Dr. Sallis’ lonely SPARKclub band.”
Thursday, June 18, 2009
I was recently asked to propose a short list of indicators of a “healthy neighborhood.” The list was to be considered by the San Diego Childhood Obesity Initiative, which is a wonderful coalition working hard to improve environments and policies to support children’s health. I thought others might be interested in the list, so I am sharing it here.
The items represent my understanding of likely physical or built environmental influences on diet, physical activity, and sedentary behaviors. Many of the items are consistent with evidence. I believe the general concepts are sound, but the specific numbers and distances are best guesses. For present purposes I added a few priority indicators for healthy schools and homes.
Healthy food access
- Supermarket or other source of affordable fresh fruits and vegetables within ½ mile of homes
- No more than 2 convenience or liquor stores within ½ mile of homes
- No more fast food than sit-down restaurants within ½ mile of homes
- Community garden within 1 mile of homes
- Weekly farmer’s market within 1 mile of homes
Facilities for active recreation
- Park with play equipment in good working order within ½ mile of homes
- Parks have walking paths
- Daily youth activity programs for free or sliding scale fees in all parks
- Private recreation facility with sliding scale fees within ½ mile of homes
- Nearest school activity facilities is open for public use
Designing for active transport
- Sidewalks on every street in neighborhood
- Pedestrian aids (crosswalks, signal) at intersection with nearest busy street
- Street pattern creates direct routes from homes to nearby destinations
- Nearest shopping area has sidewalks and safe pedestrian crossings
- Public transit stop within ½ mile of homes
Healthy school environments
- Evidence-based physical education offered daily
- Markings on preschool and elementary playgrounds to stimulate active play
- Sidewalks, marked crosswalks, and traffic calming within ¼ mile of each school to facilitate safe walking and biking
- Salad bars with multiple raw food choices daily in every cafeteria
- Only healthy foods provided at school
- Convenience stores and fast food restaurants are not within ¼ mile of schools
- No food advertising in schools
Healthy home environments
- No televisions in children’s bedrooms
- Only healthy foods out on the counter for snacking
- Sports and activity supplies available for both indoor and outdoor play
- A bicycle or skateboard for every child
Tuesday, June 9, 2009
Wednesday, June 3, 2009
The conference was terrific. It was attended by 1,000 dedicated professionals, a nice mix of university pedagogy people, elementary and middle school practitioners, and a smattering of high school folks. All of them appeared to love their jobs, and yet, they experience some of the same challenges we do in the states (e.g., lack of administrative priority for PE, not enough elementary specialists, classroom teachers responsible to instruct PE but lacking some of the resources to actually do it, secondary people who place coaching first instead of teaching, just to name a few).
So while there were many similarities, there were some differences. What we refer to as Standards, they call Outcomes. Their provinces seem to have more autonomy when it comes to receiving funding then our states do, the weather is (generally speaking), colder more often, so outside activities are less frequent. And, I couldn't help but notice that the % of overweight teachers appeared to be far lower than ours. I give them credit for walking the talk.
I presented a session called, "SPARK's Greatest Hits," but the surprise was that our greatest hits consisted of our unique teaching strategies rather than the terrific activities we're known for. I incorporated a variety of content and instruction examples into 3 main themes:
1. Talk Less
2. Disguise and Differentiate
3. Modify Traditional Sports
One of our SPARK trainers there, Dan Cooney, led a session called, "Disguising Fitness." It was a dynamic sampling of activities from elementary through middle school and the attendees had a great time "playing up a sweat."
The handouts are posted on this website http://www.sparkpe.org/MovingMountains.pdf
If you are one of the very nice people I met at the conference, or at Mt. Royal College in Calgary, where I presented on several topics the day prior to leaving for Banff, I hope you'll stay in touch with us at SPARK and take advantage of all the resources we have to offer.
If you're one of the unfortunate few that hasn't visited Canada for vacation or for professional growth, I strongly recommend planning a trip one day. I think you'll find the people are more than accommodating, the physical educators are top notch and happy to share ideas, and the scenery (especially in Banff) is something very special.
Thanks to my new Canadian friends for a great trip, and special kudos to my fantastic hosts, Bill McGregor and Harry Deboer of School Specialty Canada, who made it all happen.
"Oh Canada, We Stand on Guard for Thee!"
Wednesday, May 27, 2009
By Dr. Thom McKenzie
Forty-three years ago this week (1966) I received my first degree, a Bachelors of Physical Education. I had mastered a very excellent program, and I had wonderful teachers. They ensured that I was physically fit, physically skilled, current academically on exercise physiology, kinesiology, and other subjects, and that I had practice and feedback on managing and instructing students. I was ready for my first job as a high school teacher and coach, and I did well at it.
My teacher preparation program taught me nothing at all about promoting physical activity or changing human behavior (Skinner was still being entertained by rodents in his laboratory). But that was OK because it was the sixties and sedentary living was not yet a problem. There were no global obesity and diabetes crises and the term diabesity had not yet been coined. I was not at all concerned with getting my students active outside the gym, because they did this automatically. Most walked to school, many did physical labor at home, and the only screen time to worry about was during fly season in the summer.
In my current job as a researcher I spend more time observing what happens in gyms than directing what goes on there. Teachers are still doing pretty much what I did over 40 years ago, although they now face much larger classes and more disruptive students. I find most are pretty well prepared. Unfortunately their preparation has been aimed primarily at facing the challenges that I encountered long ago, not the challenges of today.
In a scientific study using direct observation we found that PE teachers in six states spent only about 20 seconds of each class prompting or encouraging their middle school students to be active outside of class (McKenzie et al., 2006). In addition at AAHPERD this spring, I conducted a very unscientific poll of physical educators and teacher educators. Of the over 40 higher education institutions represented, only two offered current physical education majors courses in behavior analysis/behavior modification and none provided coursework in social marketing.
Even when offered daily, PE provides only a small proportion of the 60 minutes per day recommended by health authorities. According to NASPE Standard 3, a physically educated person “participates regularly in physical activity.” PE teachers cannot help students meet this objective unless they have been prepared to promote physical activity beyond their gym walls. It is time for PETE (Physical Education Teacher Education) programs to become unstuck from the sixties. In the interim, it is up to district staff development programs to help teachers acquire the new skills that are needed to assist students to avoid a lifetime of sedentary living.
McKenzie, T. L. (2007). The preparation of physical educators: A public health perspective. Quest, 59, 346-357.
McKenzie, T. L., Catellier, D. J., Conway, T., Lytle, L. A., Grieser, M., Webber, L. A., Pratt, C. A, & Elder, J. P. (2006). Girls’ activity levels and lesson contexts during middle school PE: TAAG baseline. Medicine & Science in Sports & Exercise, 38(7), 1229-1235.
Wednesday, May 13, 2009
Can PE contribute optimally to both educational and health goals? There is a clear illustration that public health’s priorities for PE are not shared in the PE field. The public health concern is that PE is the only required time for physical activity that affects almost all students on a regular basis. Remember that almost all of the school day is enforced sitting. It is essential to ensure that opportunity for activity and health promotion is not missed. The Healthy People health promotion objectives for the
The 50% MVPA objective was announced in 1990, repeated in 2000, and is likely to remain in the 2010 editions of Healthy People. CDC’s Community Guide recommends “enhanced” or highly active PE as an evidence-based intervention to promote physical activity. The public health community is strong in its support for PE. However, to my knowledge, no state education department, no PE professional organization, and no school district has adopted the 50% MVPA objective as a requirement or official goal.
This situation demonstrates the need for ongoing dialog between education and health departments at the national, state, and local levels, to work together to achieve multiple aims through excellent PE. Because improved PE would benefit health, perhaps part of PE’s funding should come from the health sector. There are several examples of this approach being effective, so it is a model that could be expanded.
Wednesday, May 6, 2009
Physical education is at the intersection of at least three major academic thoroughfares. PE has roots in exercise and sports science and represents a primary means of applying the science. PE is itself a pedagogical field and is practiced within educational systems. The public health field claims PE as a health intervention that is of increasing value due to the childhood obesity epidemic. Major intersections are often centers of culture and commerce, but the turf surrounding PE is often contested.
These are my personal observations of how the various fields view PE, though they are necessarily over-generalized. Over the decades PE programs in universities have split from exercise science departments because they could not reconcile the science and application missions. This may not be too unfortunate, because neither the scientists nor the PE practitioners tried too hard to bridge the gap between science and practice. Because all states have some kind of school physical education requirements, education departments in universities and state governments have no choice but to accommodate PE. However, there is a notable lack of enthusiasm for PE on the part of the education establishment. The federal Department of Education provides little leadership or support for PE. Many state education departments refuse to hire a physical education coordinator. After 100 years in the schools, PE is not considered a core subject and education departments remain unsure what to do with PE. The percentage of students taking PE has declined in recent years.
In my view, of the three disciplines, public health has the highest level of interest in PE, because it is part of coordinated school health and physical activity has many physical and mental health benefits. The obesity epidemic has only heightened interest in PE, because obesity is seen as a crisis needing urgent attention. But public health’s interests in PE are often not reciprocated. PE professionals seem much more interested in gaining status as a core academic discipline than in ensuring PE is optimized to benefit children’s health. Is it possible for PE to improve its status within education while improving children’s health? I will touch on this in my next entry.
Thursday, April 23, 2009
Why am I interested in improving physical education? Two main reasons. The first is professional. I am very aware of the need for excellent, daily, active, fun PE and the long way we have to go to get there. The second is personal, and that’s what I want to write about today. As a kid growing up in the 1950s and 1960s I enjoyed many of my PE experiences, but I also experienced just about every kind of “PE malpractice” you can think of. I was often picked last for teams, running and pushups were used as punishment, we seemed to play dodge ball mainly to amuse PE teachers’ twisted sense of humor, and I spent countless hours “playing right field” but mainly looking for 4-leaf clovers. In junior high and high school we played the same team sports each year, but I never really learned how to play them better. I don’t remember doing any particular skill, exercise, or activity frequently enough to improve. When we were active I had fun, and it was great being outside to escape classroom boredom, but I didn’t understand the point of it.
When I understood the important role PE COULD play in getting children active and prepared for a lifetime of activity, I also became motivated to help kids avoid my negative experiences. I have learned from Thom McKenzie, Paul Rosengard, and other visionaries and dedicated teachers and researchers that PE can be active, educational, and fun.
When we designed the original SPARK study, our goal was to create and evaluate a program that could be a model of health-related PE used around the country. Happily, that has come to pass in many ways. The SPARK story, going from a modest research project to a program improving the lives of more than 1 million children per day, has certainly been my most gratifying professional experience. I am grateful to the people who have worked at SPARK and the many around the nation who have adopted and implemented the program for all these years. I am humbled to have played a role in this wonderful program that so many children learn from, benefit from, and enjoy every day. It has been a long way from my inauspicious start in PE.
Friday, April 17, 2009
You might remember our precocious 11 month old (now) female labradoodle Scout from a recent blog entry (“Man’s Best Friend – and Personal Trainer”). Her beautiful long hair (reminiscent of Farrah Fawcett in the 70’s) was recently shorn (like a sheep on the Australian plain) during her first visit to the groomer. We dropped our Rastafarian looking “big dog” and 3 hours later, picked up a French poodle looking “skinny chick.”
We were shocked – (Scout, we hardly knew ye) and from the way Scout acted the rest of the weekend, so was she.
Personally, as much as I love dogs (and all critters for that matter), I have a problem having a poodle. I know, I know, it’s not supposed to be about looks and superficiality (“Oh, that’s the cutest dog I’ve ever seen,” I’d hear and smile with a sense of fatherly pride.) but about love, loyalty, and companionship. So why do I feel I need to adopt a Rottweiller to compensate?
Scout and I used to be most popular pair on the trail (“What kind of dog is that? Love her hair!)” at the yogurt store (“Can I pet your dog -- oh her hair is so soft!”) and at dog beach (It that a boy or a girl? Her coat is so pretty and long I can’t tell.”) Now, we’re ignored like two door to door salesmen with vacuum cleaners in toe.
I know, I know, it’s only hair and it will grow back -- eventually. Scout is still the same sweet dog I know and love. I’ll get over it and try and dig deeper; even move below the shallow surface and my 8th grade mentality (Wendy’s descriptor for my current attitude).
But for now, if you happen to see Scout and I out for our run, you can call us,
The Hairless Pairless in
Wednesday, April 8, 2009
I’m just back from 6 rigorous days at the AAHPERD Convention in
I was also reminded that lots of physical educators are unaware of how many others are attempting to get moving. For example, in October the Centers for Disease Control and Prevention released the first ever National Guidelines for physical activity. These guidelines describe the types and amounts of physical activity that offer substantial health benefits to Americans. These follow the Surgeon Generals Report on Physical Activity by 12 years (in 1996), and are a BIG deal!
The 2008 Physical Activity Guidelines for Americans can be found at http://www.health.gov/PAGuidelines/
Briefly for children and adolescents, the guidelines call for 60 minutes or more of physical activity (PA) daily. Most of this should be of moderate- or vigorous-intensity, and include vigorous intensity at least 3 days a week. Additionally the activity should include muscle-strengthening PA at least 3 days a week and bone-strengthening PA at least 3 days a week.
These guidelines were derived for a thorough review of the evidence related to physical activity and health. This evidence is summarized (if 683 pages can be considered a summary) in a document titled Physical Activity Guidelines Advisory Committee Report 2008. It is also available free from Health and Human Services
Based on these new Guidelines, a National Plan for Physical Activity is being developed. This national plan will not only involve Education, but 7 other Sectors:
• Public Health
• Transportation/Urban Design/Community Planning
• Mass Media
• Not for Profit Organizations
Wouldn’t it be nice if all these sectors came together to help promote physical activity? Actually they are! Each sector is producing a “White Paper” which will be presented at a national meeting in DC in early July [http://www.physicalactivityplan.org/conference2009.htm].
Daryl Siedentop, former dean and professor emeritus at The Ohio State University, will produce the white paper for the education sector. It will have 10 important recommendations regarding how schools can be helpful in promoting physical activity. Stay tuned to see if your school program is aligned with these recommendations. If not, perhaps you will need to “