School Poverty Level Moderates the Effectiveness of a Physical Activity Intervention

Area of Science:

• Public Health
• Pediatric Health
• School Health Programs

Background:

• Comprehensive School Physical Activity Programs (CSPAP) are crucial for promoting student health.
• Evidence-based interventions need evaluation across diverse socioeconomic school settings.
• Understanding how school poverty and funding influence program effectiveness is vital for equitable implementation.

Purpose of the Study:

• To determine if school poverty level and funding impact the effectiveness of the Health Empowers You! Comprehensive School Physical Activity Program.
• To analyze the intervention's efficacy in increasing physical activity among 4th-grade students in Georgia elementary schools.

Main Methods:

• Secondary data analysis of a multi-level, cluster-randomized controlled trial involving 40 Georgia elementary schools (2018-2019).
• Measured average daily moderate-to-vigorous physical activity as the primary outcome.
• Examined school free-reduced price lunch (FRPL) percentage and per pupil expenditures as effect modifiers using linear mixed regression models.

Main Results:

• The Health Empowers You! program demonstrated significantly greater effectiveness in schools with higher FRPL percentages (indicating higher poverty).
• The intervention's effect on physical activity was modestly, though not statistically significantly, higher in schools with lower per pupil expenditures.
• The intervention was more impactful in schools serving lower-income student populations.

Conclusions:

• The Health Empowers You! intervention is effective, particularly in lower-income elementary schools.
• This program has the potential to mitigate disparities in physical activity levels among students from different socioeconomic backgrounds.
• Findings support the widespread adoption of this evidence-based program to promote equitable physical activity opportunities.