Association between high school physical education and physical activity in Missouri students

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Background The United States Centers for Disease Control and Prevention (CDC) recommends that adolescents engage in 60 min of physical activity (PA) daily. However, the average PA levels of adolescents are far below those recommendations. Physical education (PE) develops the knowledge, skills, and attitudes necessary for a healthy lifestyle and is recognized by the Community Preventive Services Task Force as an evidence-based strategy to increase PA among adolescents. However, few states mandate the recommended PE class time, and policies vary widely between states. Missouri’s PE policies are below the national recommendations. Analyzing Missouri specific data will be insightful in guiding state specific policies.Purpose To determine if PE attendance in Missouri high schools is associated with PA levels, and if sport participation moderates the relationship between PE attendance and PA levels.Methods This study used data from 2021 and 2023 Youth Risk Behavior Surveillance System (YRBSS) including items on self-reported PE attendance, PA, and sport participation. Two ordinal regression models were created; the first explored the association between participation in PE and PA. A second model built on the first by adding the interaction effect between PE and sport participation to determine if sport participation moderates the association between PE and PA.Findings A complete case analysis resulted in a total sample of 1424 high school students from Missouri. The odds of being more physically active increased as additional days of PE attendance were reported. The second regression model shows similar results as the first while identifying a diminishing return on PA levels for those who participate in both PE and sports. This analysis identifies a strong association between PE participation and increased levels of PA among Missouri high school students, particularly for students who do not play sports and are at higher risk of lower levels of PA.Conclusion This study supports the need for high school PE policies to be aligned with the national recommendation of required daily PE to provide a structural intervention that improves the levels of PA engagement and health of our young people.Impact Statement This analysis provides Missouri-specific evidence that PE participation is associated with higher PA levels among high school students, especially those who do not play sports. These findings strengthen the evidence for aligning Missouri’s PE policies with national recommendations and highlights PE as a key strategy for promoting structured PA opportunities for youth.

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