Physical activity is strongly linked to many important health outcomes and remains an important priority health topic for Alaskans. Physical activity was monitored in the HA2020 plan with the LHI’s 6a and 6b, focusing separately on adults and adolescents meeting the national recommendations on physical activity. Neither of the HA2020 indicators’ targets were met; therefore the HA2030 teams decided to continue to keep increasing physical activity as a priority for HA2030.

The Guide to Community Preventive Services (The Community Guide) recommends health communication campaigns that use multiple channels, one of which must be mass media, combined with the distribution of free or reduced-price health-related products.

Community-wide physical activity campaigns involve many community sectors, include highly visible, broad-based, multi-component strategies (e.g., social support, risk factor screening or health education) and may address cardiovascular disease risk factors (CG-Physical activity). There is strong scientific evidence that community wide campaigns effectively increase levels of physical activity and energy expenditure and increase knowledge about physical activity and self-reported intentions to be more physically active.

Sources:
https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies?search_api_views_fulltext=media&items_per_page=10&page=3

1. The Guide to Community Preventive Services (The Community Guide). Health Communication and Social Marketing: Campaigns That Include Mass Media and Health-Related Product Distribution. Accessed 1/7/2018;  https://www.thecommunityguide.org/findings/health-communication-and-social-marketing-campaigns-include-mass-media-and-health-related 
2. The Guide to Community Preventive Services (The Community Guide). Physical Activity: Community Wide Campaigns. Accessed 1/8/2018 https://www.thecommunityguide.org/findings/physical-activity-community-wide-campaigns
3. The Guide to Community Preventive Services (The Community Guide). Physical Activity: Social Support Interventions in Community Settings. Accessed: 1/8/2018 https://www.thecommunityguide.org/findings/physical-activity-social-support-interventions-community-settings

This is an overarching strategy, as wellness policies may have any of several evidence-based components, including:

• Active Recess
  • There is strong evidence that active recess increases physical activity for schoolchildren (Erwin 2014, Larson 2014, Janssen 2013, Howe 2012, HFRP-Sports4Kids). Active recess programs can lead to significant increases in moderate to vigorous activity; children can expend 100kcal/30 minutes of recess (Howe 2012).
• Extracurricular activities for physical activity:
  • There is some evidence that increasing access to extracurricular sports, athletic activities, and active after school programs increases children’s physical activity during leisure time, especially when offered as part of a multi-component physical activity promotion program (Verstraete 2007, Wolch 2011, Lubans 2008, Ara 2006, CFLRI-Cameron 2005, Beets 2013, CDC PRC-YMCA afterschool, Barr-Anderson 2014). However, additional evidence is needed to confirm effects.
  • Participation in extracurricular sports and activities is associated with higher physical activity levels for children and adolescents (CFLRI-Cameron 2005, Lubans 2008). Access to publicly provided recreation programs can reduce children’s risk of overweight and obesity (Wolch 2011). Overall, low income, public high school students in urban areas that participate in athletics (except football) have lower BMIs than their peers (Elkins 2004). Participation in at least three hours of sports per week appears to increase physical activity levels (Jago 2014), fitness, and total lean body mass for boys (Ara 2006).
• Homework or extra credit for PE class
  • There is some evidence that assigning homework or extra credit for physical education (PE) class increases physical activity levels for schoolchildren (Duncan 2011, Smith 2003, Gabbei 2001) and college students (Claxton 2009). Assigning PE homework as part of a multi-component obesity prevention intervention can also improve children’s fitness (Meyer 2014) and weight status (Fairclough 2013) and increase physical activity levels (Lubans 2014).
• Multi-component school-based obesity prevention interventions
  • There is strong evidence that multi-component school-based obesity prevention programs increase physical activity (Nixon 2012, Cochrane-Dobbins 2013, Demetriou 2012), and improve dietary habits (Kropski 2008, Van Cauwenberghe 2012, Cawley 2011). Such programs also improve weight status when implemented with high intensity and for long durations (Bleich 2018, Shirley 2015, AHA-Mozaffarian 2012, Khambalia 2012, Cochrane-Waters 2011, Katz 2008). However, there is significant variability in program design and effect (Brown 2009, Harris 2009a, CG-Obesity).
• Open gym time
  • Open gym time is a suggested strategy to increase physical activity levels for children and adolescents (CDC MMWR-School health guidelines 2011, KP-Thriving schools). Open gym time has been associated with increased physical activity (Mora 2012, CG-Hoonah Alaska 2012).
• Physically active classrooms
  • There is strong evidence that physically active classrooms increase physical activity levels for students and moderately improve their on-task behavior and academic achievement (Kibbe 2011, Bartholomew 2011, Barr-Anderson 2011, Donnelly 2011, Norris 2015).
• School-based physical education enhancements
  • There is strong evidence that enhancing school-based physical education (PE) increases physical activity and physical fitness among school-aged children (CG-Physical activity, Demetriou 2012, Cawley 2013, Lonsdale 2013, Sacchetti 2013, Story 2009). Enhancing or expanding PE classes as part of a multi-component school-based obesity prevention intervention has also been shown to increase physical activity and improve health (Nixon 2012, Cochrane-Waters 2011, Cochrane-Dobbins 2013).
• Screen time interventions for children
  • There is strong evidence that screen time interventions reduce sedentary screen time among children under 14 (CG-Obesity, Biddle 2014, Marsh 2014). Interventions that include nutrition and physical activity components have also been shown to increase physical activity and improve dietary habits and weight-related outcomes for participating children (CG-Obesity, Biddle 2014, Friedrich 2014). Overall, screen time interventions have small but significant effects on stationary screen use with or without nutrition and physical activity components (CG-Obesity, Biddle 2014, Friedrich 2014); additional evidence is needed to confirm effects on mobile device use.

Sources:

• Active Recess: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/active-recess
• Extracurricular activities for physical activity: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/extracurricular-activities-for-physical-activity
• Homework or extra credit for PE class: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/homework-or-extra-credit-for-pe-class
• Multi-component school-based obesity prevention interventions: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/multi-component-school-based-obesity-prevention-interventions
• Open gym time: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/open-gym-time
• Physically active classrooms: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/physically-active-classrooms
• School-based physical education enhancements: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/school-based-physical-education-enhancements
• Screen time interventions for children: https://www.countyhealthrankings.org/take-action-to-improve-health/what-works-for-health/policies/screen-time-interventions-for-children