The problem. In Alabama's rural communities, 40.2 percent of all children and 50.5 percent of Black children are overweight or obese, primarily as a result of a sedentary lifestyle. And, childhood obesity is particularly problematic in the Black Belt Region, named for its rich black soil and history as a cotton-growing area, a largely rural strip of land that stretches for 300 miles across central Alabama and into Mississippi
“The Black Belt Region is an area that has a long history of health disparities,” explains Leah E. Robinson, PhD, an associate professor within the School of Kinesiology at Auburn University in Auburn, Ala.
In 2010, for example, nearly 50 percent of the Black Belt’s residents were Black, the per-capita income was $15,826, and 43.8 percent of children lived in poverty.
Since joining the faculty at Auburn University in 2007, Robinson, a certified physical education teacher, has worked to combat childhood obesity by promoting the importance of motor skill development and regular physical activity participation, researching the impact of movement and physical activity on physical and cognitive health, and analyzing the impact of school health policies.
A passion for physical activity starts early. Robinson's passion for physical activity goes back to when she was a child in Parkton, N.C., near Fort Bragg. She began playing competitive sports as a young girl, and by high school she was a three-sport athlete in volleyball, basketball, and track and field. “I was never one to sit still. My parents' motto was: If you are not doing something productive, we will put you to work,” Robinson says.
In addition to playing volleyball and participating in track and field as a college student at North Carolina Central University, a historically Black university, Robinson expanded her relationship with sports into an undergraduate degree in biology and physical education. "I really fell in love with the concept of what causes the human body to move, and how the muscles and bones work together," she says.
Originally planning to go into physical therapy, Robinson interned in a clinical setting to gain some experience before pursuing a master’s program. There, she says, “I realized that physical therapy probably was not what I wanted my career path to be.”
That’s when Virginia Politano, PhD, chair of physical education and recreation at North Carolina Central University, suggested Robinson work as a summer counselor for a youth sports program held on campus. The program was designed to introduce “inner-city, low-income African-American children and youth to games, sports, and activities (tennis, golf, and swimming) that are considered nontraditional for their culture,” Robinson says.
The experience resonated with Robinson, who decided to pursue graduate education in kinesiology, the study of human movement, instead of physical therapy. A meeting with a recruiter who came to campus led Robinson to choose Ohio State University, earning her master’s degree there in 2002 and doctorate in 2007.
Making the connection with RWJF. After joining the faculty at Auburn, Robinson attended a conference where she met James F. Sallis, PhD, director of RWJF’s Active Living Research program. During one-on-one discussions, they developed the idea to analyze the impact of Alabama’s 2009 State Board of Education physical education policy on elementary schools in the Black Belt Region.
RWJF funded Robinson’s research project $72,712 through two national programs: Active Living Research and New Connections.
Active Living Research supports research on environmental and policy strategies that promote daily physical activity for children and families across the United States. The program focuses on children of color and lower-income children, two groups at especially high risk for obesity. (For more information, read the Program Results Report.)
New Connections promotes the careers of early- to midcareer scholars who represent “historically underrepresented research communities,” aiming to develop diverse leadership in health care research and policy. RWJF started New Connections in part to expose its own leaders to diverse voices and perspectives. The program’s full title—New Connections: Increasing Diversity of RWJF Programming—reflects that goal. (For more information, read the Progress Report on the program.)
The study. From January 2011 to mid-July 2012, Robinson and her collaborators investigated how well (or not) schools in the Black Belt Region implemented a 2009 Alabama State Board of Education policy that requires schools to provide children in kindergarten through 8th grade with a minimum of 30 minutes of daily physical education taught by a certified teacher.
“One unique aspect of this project is that we went to schools and got actual data on the implementation of the policy,” she explains.
During the study, physical activity was assessed using pedometer step counts and two structured tools: the System for Observing Fitness Instruction Time (SOFIT)—which collects data on student activity levels, lesson content, and teacher behavior during physical education—and the System for Observing Play and Leisure Activity in Youth (SOPLAY)—which measures activity levels, type of activity, and other data elements during recess. A total of 683 children in kindergarten through 5th grade at five elementary schools participated in the study. Nearly all of the children (99.9%) were Black and 43.2 percent were overweight or obese. Their physical activity was assessed on a Tuesday, Wednesday, and Thursday.
Some surprising findings. The research team found that these children took an average of 3,774 steps while at school, compared with national guidelines of 12,000 steps per day, of which 7,000 (for boys) and 5,000 (for girls) typically take place during the school day.
Four schools required 30 minutes of instruction by a certified physical education teacher five days a week, but cancelled or shortened classes occurred 22 percent of the time. The average class time was 23.8 minutes and included 14.33 minutes of moderate-to-vigorous physical activity.
The 5th school required instruction from the certified physical education teacher one day a week and from the classroom teacher four days a week. During the period covered by the study, however, students did not receive any physical education.
None of the schools provided recess.
Based on interviews with teachers and direct observation at the schools, teachers felt that physical activity was important, but not a priority because teachers were more concerned about preparing students for standardized academic tests. Teachers also used physical education time to take students to the restrooms, or they withheld it because of misbehavior.
Findings from the project are documented in an article entitled “School Reform: The Role of Physical Education Policy in Physical Activity of Elementary School Children in Alabama’s Black Belt Region,” in the American Journal of Health Prevention, available online.
Continued commitment to physical activity. When asked if the teachers and principals involved in the study have modified their behaviors since the results were published, Robinson says, “Unfortunately, no.” But undaunted, she has plowed ahead.
As the co-director of the Pediatric Movement and Physical Activity Laboratory at Auburn University, Robinson hopes to launch a study in summer 2014 on the impact of regular physical activity on cardiometabolic risk factors, such as cholesterol and blood glucose, and other developmental outcomes (i.e., self-regulation skills) in children.
The laboratory is a place where children of diverse racial, ethnic, and socioeconomic backgrounds come for planned movement and physical activity during the summer or after school during the school year and, at the same time, participate in research to explore the cognitive and physical health benefits of movement and physical activity.
And Robinson continues to oversee research in the Black Belt’s schools, such as a 2014 study to assess the impact of planned movement and physical activity programming on fitness and cognitive outcomes.
Robinson sums up the goal of this work: “I hope that I can show a strong link between a child’s movement and his or her physical and cognitive health. That might be the pitch parents need to fight for physical education, movement, and recess in their children’s schools and daily life.”
RWJF perspective. Launched in 2000, Active Living Research is a $31 million national program that supports research to examine how physical and built environments and policies influence the amount of physical activity Americans get as part of everyday life. Research findings help inform policy, the design of the built environment and other factors necessary to re-engineer healthy levels of physical activity into everyday life. Over the past few years, 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.
In a recent analysis, Sallis documents 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 2001.
Active Living Research seeks to translate actionable research findings into policy and practice change as rapidly as possible. “The Active Living Research program has sparked new awareness among policy-makers and community leaders in many sectors that our everyday physical activity levels depend on the presence or absence of environmental and policy supports for physical activity. In addition, a growing number of urban planners and transportation policy-makers recognize that community design is critical for health,” says C. Tracy Orleans, PhD, RWJF distinguished fellow and senior scientist.
The New Connections program continues to provide support and professional development opportunities to a network of more than 1,200 scholars from underrepresented communities.