The problem. School budget cuts across the nation along with a greater focus on academic performance have resulted in a reduction or elimination of many school physical education programs.
In 1999, California instituted a policy requiring that schools provide students in grades 1 through 6 with a minimum of 200 minutes of physical education over 10 school days. School districts out of compliance must undertake corrective actions.
In 2009, Emma V. Sanchez-Vaznaugh, ScD, MPH, associate professor in the health education department at San Francisco State University, investigated whether school district–level compliance with California physical education policies was associated with physical fitness among 5th-grade public school students in the state.
A land of opportunity. Emma V. Sanchez-Vaznaugh grew up in Chihuahua in northwest Mexico, the sixth of eight children. Though neither of her parents went to college, Sanchez-Vaznaugh completed a degree in early childhood education at UACJ, University Autonomous of Juarez City, believing that being a preschool teacher would be her life’s work.
A visit in the mid-1980s to see her brother, who had immigrated to Washington State, changed her plans.
Sanchez-Vaznaugh says she noticed a degree of gender equity in the United States that she had not experienced in her home country—“even though Mexico had revolutionaries who were women,” she says. “I was excited to see that there were a wider range of opportunities here both in employment and in the academic arena for women overall, and for someone like me who had completed four years of college.”
To gain a mastery of English, Sanchez-Vaznaugh enrolled in classes at a local community college, offered free to immigrants. Her strong new language skills qualified her to take a position as interpreter for a vocational rehabilitation agency where she helped immigrant agricultural workers who had been injured on the job to find other kinds of work that accommodated their new physical restrictions.
Getting hooked on research. After learning to speak English, the next step was to “learn to write English like a native.” Sanchez-Vaznaugh enrolled in a bachelor’s program in organizational behavior at the University of San Francisco. While there, she participated in her first research project—a survey evaluating the satisfaction of the mostly immigrant clients of a non-profit agency in San Francisco’s Mission District—and she was hooked on research.
“I saw the power of people telling their stories and experiences, quantifying that, and generating a report about what that meant,” she says.
Wanting to have an impact on policies affecting disadvantaged populations, Sanchez-Vaznaugh entered an MPH program at San Francisco State University, where she was exposed to research on the relationship between income inequality and health. She then went to Harvard’s School of Public Health to pursue a doctorate degree in social epidemiology—a field that looks at how social, psychological, political, cultural, and economic circumstances influence one’s chances for a healthy life.
Her doctoral dissertation was on the impact of immigrant status, social class, and neighborhood socioeconomic resources on obesity. Her research found that newly arrived immigrants were less likely to be obese than U.S. natives. But the body weight of immigrants, especially those with lowest education, women, and Latinos, got higher the longer they lived in the United States.
Junk food, sugary drinks, and children’s obesity rates: connecting with RWJF. While Sanchez-Vaznaugh was completing her dissertation, she learned that RWJF had launched a major set of programs aimed at reversing the rise of childhood obesity. “I thought I might be able to join their efforts by contributing to the evidence base that was needed to implement new programs,” she recalls.
In 2008, Sanchez-Vaznaugh applied for and received a grant through New Connections: Increasing Diversity of RWJF Programming, an RWJF program designed to build a diverse network of researchers from historically disadvantaged and underrepresented communities (for more information, see the Progress Report on New Connections).
Working in collaboration with RWJF’s Healthy Eating Research program, she examined whether a California policy that restricted the sale of junk food and sugary beverages in schools had an impact on the obesity rates of schoolchildren. Sanchez-Vaznaugh was particularly interested in how the policy impacted minority children, who, studies show, are at greater risk for overweight and obesity.
See the Progress Report on Healthy Eating Research.
The findings appeared in an article published in the March 2010 issue of Health Affairs. Sanchez-Vaznaugh found that overall obesity rates were increasing for children in the study prior to the policy’s enactment, but began to level out after the policy took effect.
Whether the policy “caused” children’s reductions in body weight or changed their eating patterns cannot be determined, Sanchez-Vaznaugh says. “That is one of the big issues with looking at the effects of policies. It is very difficult to measure the actual exposure to the policy.”
Governmental policies can help define the environment in which children learn to make food choices, however. “That [environment] can shape the food behaviors, influencing overweight trends in entire student populations,” Sanchez-Vaznaugh says.
Does compliance with PE requirements affect schoolchildren’s fitness? In 2009, while a post-doc fellow at the Center on Social Disparities in Health at the University of California San Francisco-Berkeley, Sanchez-Vaznaugh secured a related grant through Salud America! The RWJF Research Network to Prevent Obesity Among Latino Children, an RWJF program that seeks to fill the gap of scientific data on causes of Latino childhood obesity (see the Progress Report on Salud America! for more information on the program). Her project studied the impact of another policy—the one requiring California school districts to provide 200 minutes of physical education over 10 school days.
She found in this study that 82 percent of 5th-graders in California attended schools in districts that were non-compliant with the PE policy. She also found that African American and Latino children were less likely than White or Asian children to attend a school in a district that was compliant with the physical education requirement.
In districts that complied with the policy, children were more likely to meet or exceed the fitness standards relative to their peers in non-compliant districts. In particular, Latino children in these compliant districts were 38 percent more likely to be physically fit. A Salud America! issue brief details the findings.
Translating research to the policy realm. With additional funding from RWJF’s Active Living Research program, Sanchez-Vaznaugh has translated her research on compliance with the PE requirement into compelling, accessible language and disseminated it to children’s advocates, educators, and policy- and decision-makers in California. See the Program Results Report on Active Living Research for more information on this program.
“She has become a master at communicating research effectively,” says James F. Sallis, PhD, Active Living Research program director. “At the same time she was planning how to get her points across forcefully to the California legislature, she was planning her next study to build an even stronger case for better school physical activity policies.”
In July and October 2013, Sanchez-Vaznaugh presented her study’s findings at the California State Board of Education and the Public School Accountability Act Committee, which were considering changing the make-up of schools’ academic performance index to include new indicators that were not based on standardized testing.
“We recommended that the new index include fitness scores from data collected every year by schools—which would be easy to do—and compliance with physical education policy,” Sanchez-Vaznaugh says.
“We tried to frame our research about the importance of fitness to academic performance. That makes our findings more relevant to educators.”—Sanchez-Vaznaugh
Sanchez-Vaznaugh also provided information about the study to San Francisco city supervisors who were considering how to allocate revenues from a proposed soda tax. “We recommended that revenues be spent on physical education programs and shared some evidence from our study,” she says. “I’m happy that that is part of the proposed legislation.”
A May 2013 Institute of Medicine report, Educating the Student Body, Taking Physical Activity and Physical Education to School, also references Sanchez-Vaznaugh’s study.
Sanchez-Vaznaugh continues to look for opportunities to use research to help shape policies that affect people’s lives. In 2012 she was awarded a five-year Mentored Career Development Award—the so-called K01 grant—from the National Heart, Lung, and Blood Institute of the National Institutes of Health to look at environmental impacts on childhood obesity disparities using data from the state of California.
“The funding from RWJF was instrumental, helping me to conduct research I care deeply about and to establish a research portfolio that got me here,” she says.
RWJF perspective. Sanchez-Vaznaugh’s remarkable research trajectory is exactly what the Active Living Research national program was designed to make possible. Active Living Research is a $31 million program that supports investigator-initiated research to examine how physical and built environments and policies influence the amount of physical activity Americans get as part of everyday life. The program has focused on reversing the rise in childhood obesity, particularly in the lower-income and racial/ethnic minority communities in which childhood obesity levels are highest and rising fastest.
Research findings have been used to inform policy, the design of the built environment, and related efforts to re-engineer healthy levels of physical activity into children’s everyday lives.
In a recent analysis, Sallis documented dramatic growth in research to identify policy and environmental factors and interventions affecting physical activity at the population level and in high-risk populations following the program’s launch in 2000.
Active Living Research seeks to translate actionable research findings into policy and practice change as rapidly as possible. Says C. Tracy Orleans, PhD, RWJF distinguished fellow and senior scientist: “For instance, if we find out that adding bike paths and sidewalks or walk-to-school programs significantly increases physical activity, we want to get this information out to local residents, decision- and policy-makers as quickly and effectively as possible, so they can start using it.”
With its focus on obesity among Latino children, Salud America! is a key part of RWJF's efforts to reverse the childhood obesity. "Salud represents a really important point of entry to the Latino community that I don't think anyone else has," says James S. Marks, a senior vice president at RWJF.
When RWJF shifted its childhood obesity funding priorities away from research and toward supporting an action, advocacy, and policy agenda in 2012, it authorized Active Living Research to focus on translating its results for wider use by community leaders and advocates, and for Salud to turn that way as well. Going forward, both programs are providing online platforms where researchers, policy-makers, advocates, and practitioners can find information, tools, and resources; contribute their own stories, data, and insights; and communicate with each other in finding solutions.