Abstract
Response to intervention (RtI) models are frequently used in schools to tailor academic instruction to the needs of students. The purpose of this study was to examine the effects of using RtI to promote physical activity (PA) and fitness in one urban elementary school. Ninety-nine students in grades 2–5 participated in up to three tiers of intervention throughout the course of one school year. Tier one included 150 min/week of physical education (increased from 90 min/week the previous year) and coordinated efforts to improve school health. Tier two consisted of 30 min/week of small group instruction based on goal setting and social support. Tier three included an after-school program for parents and children focused on healthy living. PA, cardiovascular fitness, and body composition were assessed before and after the interventions using pedometers, a 20-m shuttle run, and height/weight measurements. From pre- to post-testing, PA remained relatively stable in tier one and increased by 2349 steps/day in tier two. Cardiovascular fitness increased in tiers one and two by 1.17 and 1.35 ml/kg/min, respectively. Although body mass index did not change, 17 of the 99 students improved their weight status over the course of the school year, resulting in an overall decline in the prevalence of overweight/obesity from 59.6 to 53.5 %. Preliminary results suggest that the RtI model can be an effective way to structure PA/health interventions in an elementary school setting.
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Bai, Y., Saint-Maurice, P. F., Welk, G. J., Allums-Featherston, K., Candelaria, N., & Anderson, K. (2015). Prevalence of youth fitness in the United States: Baseline results from the NFL PLAY 60 FITNESSGRAM Partnership Project. The Journal of Pediatrics, 167(3), 662–668. doi:10.1016/j.jpeds.2015.05.035.
Bandura, A. (1998). Health promotion from the perspective of social cognitive theory. Psychology & Health, 13(4), 623–649. doi:10.1080/08870449808407422.
Barlow, S. E., & The Expert Committee. (2007). Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics, 120, S164–S192. doi:10.1542/peds.2007-2329C.
Batsche, G., Elliot, J., Graden, J. L., Grimes, J., Kovaleski, J. F., Prasse, D., & Tilly III, W. D. (2005). Response to intervention: Policy considerations and implementation. Alexandria, VA: National Association of State Directors of Special Education Inc.
Boeke, C. E., Oken, E., Kleinman, K. P., Rifas-Shiman, S. L., Taveras, E. M., & Gillman, M. W. (2013). Correlations among adiposity measures in school-aged children. BMC Pediatrics, 13(1), 99. doi:10.1186/1471-2431-13-99.
Burns, M. K., Appleton, J. J., & Stehouwer, J. D. (2005). Meta-analytic review of responsiveness-to-intervention research: Examining field-based and research-implemented models. Journal of Psychoeducational Assessment, 23(4), 381–394. doi:10.1177/073428290502300406.
Centers for Disease Control and Prevention. (2012). School health index: A self assessment and planning guide. http://www.cdc.gov/healthyyouth/shi/
Clemes, S. A., & Biddle, S. J. H. (2013). The use of pedometers for monitoring physical activity in children and adolescents: measurement considerations. Journal of Physical Activity & Health, 10(2), 249–262.
Craig, C. L., Tudor-Locke, C., Cragg, S., & Cameron, C. (2010). Process and treatment of pedometer data collection for youth: The Canadian Physical Activity Levels among Youth Study. Medicine and Science in Sports and Exercise, 42(3), 430–435. doi:10.1249/MSS.0b013e3181b67544.
Cui, Z., Truesdale, K. P., Cai, J., Koontz, M. B., & Stevens, J. (2013). Anthropometric indices as measures of body fat assessed by DXA in relation to cardiovascular risk factors in children and adolescents: NHANES 1999-2004. International Journal of Body Composition Research, 11(3/4), 85–95.
Cureton, K. J., Plowman, S. A., & Mahar, M. T. (2013). Aerobic capacity assessments. In: S. A. Plowman & M. D. Meredith (Eds.), FITNESSGRAM/ACTIVITYGRAM reference guide (4th Ed., pp. 6-1–6-22). Dallas, TX: The Cooper Institute.
Dauenhauer, B. D. (2012). Applying response to intervention in physical education. Strategies: A Journal for Physical and Sport Educators, 25(5), 21–25.
Dentro, K. N., Beals, K., Crouter, S. E., Eisenmann, J. C., McKenzie, T. L., Pate, R. R., & Katzmarzyk, P. T. (2014). Results from the United States’ 2014 report card on physical activity for children and youth. Journal of Physical Activity & Health, 11(Suppl 1), S105.
Dobbins, M., Husson, H., DeCorby, K., & LaRocca, R. L. (2013). School-based physical activity programs for promoting physical activity and fitness in children and adolescents aged 6 to 18. Cochrane Database of Systematic Reviews, 2013(2), 1–260. doi:10.1002/14651858.CD007651.pub2.
Duncan, D. F., White, J. B., & Nicholson, T. (2007). Impact of the great body shop on student health risks: A partial replication of the Robinson (1999) analysis of the Minnesota Student Survey. California Journal of Health Promotion, 5(1), 76–88.
Fedewa, A. L., & Ahn, S. (2011). The effects of physical activity and physical fitness on children’s achievement and cognitive outcomes: A meta-analysis. Research Quarterly for Exercise and Sport, 82(3), 521–535.
Fedewa, A. L., Candelaria, A., Erwin, H. E., & Clark, T. P. (2013). Incorporating physical activity into the schools using a 3-tiered approach. Journal of School Health, 83(4), 290–297. doi:10.1111/josh.12029.
Fletcher, J. M., & Vaughn, S. (2009). Response to intervention: Preventing and remediating academic difficulties. Child Development Perspectives, 3(1), 30–37. doi:10.1111/j.1750-8606.2008.00072.x.
Fuchs, D., & Fuchs, L. S. (2006). Introduction to response to intervention: What, why, and how valid is it? Reading Research Quarterly, 41(1), 93–99. doi:10.1598/RRQ.41.1.4.
Gersten, R., Beckmann, S., Clarke, B., Foegen, A., Marsh, L., Star, J. R., & Witzel, B. (2009). Assisting students struggling with mathematics: Response to intervention (RtI) for elementary and middle schools (No. NCEE 2009-4060). Washington, DC: National Center for Education Evaluation and Regional Assistance, Institute of Educational Sciences, U.S. Department of Education. http://ies.ed.gov/ncee/wwc/PracticeGuide.aspx?sid=3
Gersten, R., Compton, D., Connor, C. M., Dimino, J., Santoro, L., Linan-Thompson, S., & Tilly, W. D. (2008). Assisting students struggling with reading: Response to intervention (RtI) and multi-tier intervention in the primary grades. A practice guide (No. NCEE 2009-4045). Washington, DC: National Center for Education Evaluation and Regional Assistance, Institute of Educational Sciences, U.S. Department of Education. http://ies.ed.gov/ncee/wwc/PracticeGuide.aspx?sid=3
Gordon, R. S. (1983). An operational classification of disease prevention. Public Health Reports, 98(2), 107–109.
Hardman, C. A., Horne, P. J., & Lowe, C. F. (2011). Effects of rewards, peer-modelling and pedometer targets on children’s physical activity: A school-based intervention study. Psychology & Health, 26(1), 3–21. doi:10.1080/08870440903318119.
Hunt, L. P., Ford, A., Sabin, M. A., Crowne, E. C., & Shield, J. P. H. (2007). Clinical measures of adiposity and percentage fat loss: Which measure most accurately reflects fat loss and what should we aim for? Archives of Disease in Childhood, 92(5), 399–403. doi:10.1136/adc.2006.103986.
Institute of Medicine. (2013). Educating the student body: Taking physical activity and physical education to school. Washington, DC: National Academies Press.
Kamath, C. C., Vickers, K. S., Ehrlich, A., McGovern, L., Johnson, J., Singhal, V., et al. (2008). Behavioral interventions to prevent childhood obesity: A systematic review and meta-analyses of randomized trials. Journal of Clinical Endocrinology and Metabolism, 93(12), 4606–4615. doi:10.1210/jc.2006-2411.
Kuczmarski, R. J., Ogden, C. L., Guo, S. S., Grummer-Strawn, L. M., Flegal, K. M., Mei, Z., et al. (2002). 2000 CDC growth charts for the United States: Methods and development (No. 246). Hyattsville, MD: National Center for Health Statistics. http://www.cdc.gov/nchs/data/series/sr_11/sr11_246.pdf
Mahar, M. T., Guerieri, A. M., Hanna, M. S., & Kemble, C. D. (2011). Estimation of aerobic fitness from 20-m multistage shuttle run test performance. American Journal of Preventive Medicine, 41(4, Supplement 2), S117–S123. doi:10.1016/j.amepre.2011.07.008.
McKenzie, T. L., Nader, P. R., Strikmiller, P. K., Yang, M., Stone, E. J., Perry, C. L., et al. (1996). School physical education: Effect of the child and adolescent trial for cardiovascular health. Preventive Medicine, 25(4), 423–431. doi:10.1006/pmed.1996.0074.
McKenzie, T. L., Sallis, J. F., & Rosengard, P. (2009). Beyond the stucco tower: Design, development, and dissemination of the SPARK physical education programs. Quest, 61(1), 114–127.
McMaster, K. L., Fuchs, D., Fuchs, L. S., & Compton, D. L. (2005). Responding to nonresponders: An experimental field trial of identification and intervention methods. Exceptional Children, 71, 445–463.
Meyers, L. S., Gamst, G., & Guarino, A. J. (2013). Applied multivariate research: Design and interpretation (2nd ed.). Thousand Oaks, CA: Sage Publications Ltd.
Nakae, S., Oshima, Y., & Ishii, K. (2008). Accuracy of spring-levered and piezo-electric pedometers in primary school Japanese children. Journal of Physiological Anthropology, 27(5), 233–239.
Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA, 311(8), 806–814. doi:10.1001/jama.2014.732.
Rivard, C. W., & Neufeld, N. (2007). A comprehensive outcome analysis of a multi-site, multi-state family-based pediatric weight management program. Journal of the American Dietetic Association, 107(8), A11. doi:10.1016/j.jada.2007.05.045.
SHAPE America. (2015). The essential components of physical education. Reston, VA: SHAPE America.
Shaya, F. T., Flores, D., Gbarayor, C. M., & Wang, J. (2008). School-based obesity interventions: A literature review. Journal of School Health, 78(4), 189–196.
Sherrill, C. (2008). Response to intervention (RtI): Application to adapted physical activity. Palaestra, 24(1), 57–58.
Shore, S. M., Sachs, M. L., DuCette, J. P., & Libonati, J. R. (2014). Step-count promotion through a school-based intervention. Clinical Nursing Research, 23(4), 402–420. doi:10.1177/1054773813485240.
Simeonsson, R. J., & Pan, Y. (2013). Prevention: A public health framework. In V. Buysse & E. S. Peisner-Feinberg (Eds.), Handbook of response to intervention in early childhood (pp. 27–40). Baltimore, MD: Brookes Publishing.
Stecker, P. M., Fuchs, D., & Fuchs, L. S. (2008). Progress monitoring as essential practice within response to intervention. Rural Special Education Quarterly, 27(4), 10–17.
Stephens, T. L., Silliman-French, L., Kinnison, L., & French, R. (2010). Implementation of a response-to-intervention system in general physical education. Journal of Physical Education, Recreation & Dance, 81(9), 47–53.
Strong, W. B., Malina, R. M., Blimkie, C. J. R., Daniels, S. R., Dishman, R. K., Gutin, B., et al. (2005). Evidence based physical activity for school-age youth. The Journal of Pediatrics, 146(6), 732–737. doi:10.1016/j.jpeds.2005.01.055.
The Cooper Institute. (2013). In: M. D. Meredith & G. J. Welk (Eds.), FitnessGram & ActivityGram test administration manual. (4th Ed.). Champaign, IL: Human Kinetics.
Tudor-Locke, C., Craig, C. L., Beets, M. W., Belton, S., Cardon, G. M., Duncan, S., et al. (2011). How many steps/day are enough? for children and adolescents. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 78. doi:10.1186/1479-5868-8-78.
Vincent, S. D., & Sidman, C. L. (2003). Determining measurement error in digital pedometers. Measurement in Physical Education and Exercise Science, 7(1), 19–24. doi:10.1207/S15327841MPEE0701_2.
Wedl, R. J. (2005). Response to intervention: An alternative to traditional eligibility criteria for students with disabilities. Saint Paul, MN: Education Evolving. http://www.educationevolving.org/pdf/Response_to_Intervention.pdf
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Dauenhauer, B., Keating, X. & Lambdin, D. Effects of a Three-Tiered Intervention Model on Physical Activity and Fitness Levels of Elementary School Children. J Primary Prevent 37, 313–327 (2016). https://doi.org/10.1007/s10935-016-0430-y
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DOI: https://doi.org/10.1007/s10935-016-0430-y