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Associations Between State Laws Governing Recess Policy with Children's Physical Activity and Health
Kimberly A Clevenger1, Frank M Perna2, Richard P Moser3
1Health Behaviors Research Branch, Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Centre Dr, Rockville, MD, 20850.
Background:
State-level laws governing recess policies vary widely across the United States. We characterize the presence of such laws and assess their associations with child-level outcomes.
Methods:
The presence of a state recess law was determined using the Classification of Laws Associated with School Students (CLASS) database. Parents of 6- to 11-year-old children reported physical activity, overall health, school absences, school-related problems, and ability to make/keep friends as part of the National Survey of Children's Health (NSCH). Logistic regression was used to compare outcomes in states with and without recess laws cross-sectionally in 2018 and between 2003 and 2011/2012 using a difference-in-differences analysis.
Results:
In 2018, 20 states had a law recommending or requiring recess. Cross-sectionally, the odds of being physically active every day (odds ratio, 95% confidence interval: 2.8, 1.2-6.5) and having no difficulty making or keeping friends (2.9, 1.2-7.2) were significantly higher for children residing in states with versus without a recess law. There were no significant associations in the difference-in-differences model.
Conclusions:
Significant cross-sectional associations in 2018 were not confirmed by a difference-in-differences analysis of two waves of the NSCH. Short follow-up time and the apparent weakness of existing state laws warrant further assessment of state-level recess law.
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