Original Paper Biomedical Human Kinetics, 6, 33–39, 2014

DOI: 10.2478/bhk-2014-0006

Teaching healthy behaviour knowledge in primary school

physical education
Michael Hodges1, Pamela Hodges Kulinna2, Chong Lee3
1
William Paterson University, 300 Pompton Road Wayne, New Jersey; 2 Mary Lou Fulton Teachers College, Arizona State
University, Arizona; 3 School of Nutrition and Health Promotion, Arizona State University, Arizona

Summary
Study aim: To determine the effectiveness of a newly designed series of fitness segments that can be used to provide healthy
behaviour knowledge (HBK) for 5th grade Physical Education classes.
Materials and methods: 641 pupils from six intervention (n = 401) and five control (n = 240) schools were used. The interven-
tion schools received a five-week intervention of 12-minute fitness segments for each class period. A cognitive test that has
been shown to produce valid and reliable scores (28-questions) was used to assess pupils’ HBK at pre – and post – examination.
Pedometers were also used to examine physical activity levels differences. Hierarchical Linear Modeling using a two-level
multilevel model was used to investigate mean changes in HBK between intervention and control groups.
Results: Pupils in the intervention classes had 0.8-unit greater mean improvements in HBK than did control pupils (p < 0.05).
Girls also had greater mean changes in HBK than did boys (p < 0.05). There was no statistical difference between intervention
and control groups in physical activity levels.
Conclusions: This type of fitness segment can be one strategy used by teachers to aid the instruction of HBK without decreas-
ing physical activity participation in classes.

Keywords: Fitness – Strategies – PE metrics – Effectiveness – Primary

Introduction of primary schools, 15.2% of middle schools, and 3.0%

of high schools provided Physical Education for at least
3 days a week or equivalent, for the entire school year.
A large percentage of children and adolescent around Therefore, when pupils are engaging in Physical Educa-
the globe are not achieving the recommended health sus- tion class, the time should be highly active and effective
taining activity levels [1, 3, 5]. According to the U.S. Cen- as possible.
ters of Disease Control and Prevention [3], approximately
23% of children, aged 9 through 13, do not engage in any Pupils’ Healthy Behaviour Knowledge
free time physical activity. In Australia, only approximate- Physical Education classes should be teaching the
ly 31 percent of surveyed boys and girls aged 9 through whole child. As National Association of Sport and Physi-
16 met the National Physical Activity Recommendations cal Education [20] in the U.S. states, Physical Education
by accumulating at least 60 minutes of moderate to vig- programs are to develop physically literate individuals
orous physical activity on most of the days surveyed [1]. who possess the knowledge, skills, and self-confidence
Similarly, according to the 2009–2010 Healthy Behaviour to participate in activity for a lifetime. Numerous studies
in School-aged Children, one-in-five children in the Euro- have shown that pupils do not have the requisite healthy
pean Union reported that they undergone moderate-to-vig- behaviour knowledge needed to adopt healthy behaviours
orous exercises regularly [5]. In the U.S., many public and [7, 11, 13, 16]. Healthy behaviour knowledge encom-
private school have cut in-school physical activity oppor- passes the necessary knowledge needed for individuals to
tunities (e.g., recess, Physical Education), for more time live a lifetime of activity [31]. Kulinna et al. [15] exam-
on academic achievement [28], resulting in pupils having ined this issue in a primary school setting with the use of
more difficulty reaching the recommended 60 minutes health-related knowledge portfolio tasks. The authors dis-
a day of activity. In fact, in the U.S., it was found from covered that more than 50% of the 3rd to 6th grade pupils
a School Health and Policies Study [25] that only 13.7% were unable to list four aerobic and anaerobic physical

Author’s address Michael Hodges, Assistant Professor, William Paterson University, 300 Pompton Road Wayne, NJ 07470
[email protected]
34 M. Hodges et al.

activities. Brusseau, Kulinna, and Cothran [2] further ex- effectively accomplished concurrently in the Physical Ed-
amined primary school pupils’ knowledge using portfolio ucation classrooms.
tasks with two different Native American communities. Spiegel and Foulk [27] suggest that knowledge of
Pupils completed three to six health-related physical ac- physical activity and health behaviours can be the founda-
tivity behaviour portfolio tasks and results indicated that tion that encourages people to engage in more physical ac-
pupils across all grade levels held many misconceptions tivity throughout their lifetimes. This was found to contain
and misunderstandings of active and health concepts. Fur- some validity as other researchers have found individuals
thermore, researchers found only 7% of third grade pupils engaging in more activity during leisure time hours when
were able to describe why physical activity was important obtaining more healthy behaviour knowledge [6, 8, 29].
[2]. The evidence on pupil’s lack of HBK is disheartening Dilorenzo, Stucky-Ropp, Vander Wal, and Gotham found
given that these findings have been evident for almost two support for this statement, when they assembled a longi-
decades [11]. tudinal study on primary pupils. Dilorenzo et al. [8] dis-
Many intervention studies have been implemented and covered that exercise knowledge was one of a few key
successful in remedying school-aged pupils’ fundamental determinants to pupils’ physical activity participation.
lack of HBK. First, Trost et al. [30] conducted an inter- Furthermore, conceptual based Physical Education (CPE),
vention study with fourth grade pupils to increase their a model that teaches health knowledge in the classroom,
knowledge of physical activity concepts. Before the in- was also been found to positively influence physical ac-
tervention, all pupils demonstrated little understanding tivity patterns during leisure time [6]. More specifically,
of physical activity concepts as defined by researchers. Dale, Corbin, and Cuddihy [6] reported that after a year-
After the intervention, however, pupils in the intervention long program, secondary pupils significantly increased
group showed significantly greater knowledge when com- their physical activity levels as compared to pupils with
pared to the control group [30]. Palmer et al. [23] con- traditional Physical Education classes and control pupils.
ducted a study examining pupils’ knowledge and learning Therefore, one can venture to say there is a possibility that
through an internet based health program called Healthy health knowledge has an effect on a person’s decision to
Hearts 4 Kids which consisted of information regarding engage in physical activity.
cardiovascular function, physical activity, nutrition, and Based on the lack of HBK instruction in Physical
tobacco. This program aimed to increase 5th grade pupils’ Education programs, the low documented levels of HBK
knowledge about heart health. Palmer et al. [23] found among pupils, and the possible increase in physical activ-
that pupils’ health knowledge was significantly increased ity during leisure time hours caused by HBK acquisition,
along with an increase in positive attitudes toward physi- a method that successfully increases HBK instruction with-
cal activity attributed to the online health knowledge inter- out decreasing physical activity in the classroom would
vention program. be invaluable. Therefore, in this intervention study, we in-
Two other notable intervention programs occurred in vestigated a newly developed method for teaching HBK
the U.S., these two programs called Child and Adoles- during regular Physical Education lessons. We specifically
cent Trial for Cardiovascular health (CATCH) and Go examined the effectiveness of the method by observing:
for Health, focused on increasing pupil knowledge and (a) if the method designed significantly increased HBK,
physical activity during school hours [12]. The CATCH and (b) by examining the effects, if any, on pupils’ physi-
intervention was implemented in four major U.S. cities cal activity levels (with the hypothesis of no change).
and consisted of 96 elementary schools. The authors were
able to successfully increase students’ average time spent Materials and methods
in MVPA from 37.4% to 51.9% during physical educa-
tion classes [17], and marginally significant increase in
knowledge [14]. Nationally this has caught some attention This study had two groups, an intervention group that
with the Let’s Move initiative, launched by the Michelle received the HBK instructional lessons and a control
Obama, which has one step that proposes schools to be- group that did not alter their already existing curriculum
come more healthy, and incorporate nutrition education in and instruction.
physical education.
Curricular models were also been devised to aid the Participants
instruction of HBK and activity levels among pupils, such Teachers were recruited via email from one school
as, Health Optimizing Physical Education [22], Sport Play district. All Physical Education teachers at the fifth grade
and Active Recreation for Kids [21], and the Fitness for level (2 females and 5 males; 6 Caucasian, and 1 His-
Life [4]. The only downside to these intervention studies panic) agreed to participate. Six out of the seven teach-
and curricular models is that physical activity and HBK ers were traveling to two schools providing a unique study
are often taught independently of each other, and not design of having each teacher serve as the instructor for
Teaching healthy behaviour knowledge 35

both the intervention group as well as the control group Healthy Behaviour Fitness Segments
(thus taking out the teacher influence across conditions). The healthy behaviour fitness segments (HBFS) were
These instructors possessed similar qualifications as they designed to incorporate large amounts of physical activity
received a degree and endorsed in Physical Education. while instilling HBK instruction. See Table 1 for a com-
Seven-hundred and eighty 5th grade pupils (49.9% female plete description of activities and the concepts emphasized
and 50.1% male; 50.8% Caucasian, 22.1% Native Ameri- in each.
can, 10.6% Hispanic, 8.9% African American, 6.8% Asian Grounded in Cognitive Mediation Theory, researchers
American, and .8% Arab American) participated and were designed activities for primary pupils that integrate HBK
examined. during physical activity participation in classes. Cognitive
Mediation Theory shares similarities with many other criti-
Settings cal theories, such as constructivism and post structuralism,
All participating schools (6 intervention and 5 con- which view the learner as functioning and directly causing
trol schools) were located in the same school district in learning [26]. Rather than expecting learning to happen,
a suburban Southwestern USA community. The school the researchers developed a series of fitness segments with
districts’ Physical Education requirements for pupils were the goal of creating an environment that encourages pupils
one class a week for 40 minutes. All materials (e.g., signs, to think and act in ways that facilitate and apply new ideas
equipment, lesson plans, and example of videos of the fit- to previous learning.
ness segments) were provided to the teachers four days Physical Education teachers were instructed to imple-
before the start of each lesson. One day of teacher training ment the HBFS within their regular class period at their
occurred before the start of the study, informing teachers intervention school (of the two schools for each teacher,
about how to conduct and answer any questions on the fit- one school was randomly selected and assigned as the in-
ness segments tervention school). Each HBFS was expected to last ap-
The participating school district had an average free proximately 12 minutes and serve as the fitness portion of
and reduced lunch percentage of 29.19% for the entire dis- the lesson.
trict. The Physical Education department had adopted the The HBFS consists of four pupil-centered activities or-
Dynamic Physical Education curriculum model [24]. This ganized into four stations. Each activity was set to last no
multi-activity curricular model includes a four-part lesson more than 1 minute and 45 seconds. Teachers were asked to
comprising: introductory activity, fitness activity, lesson provide a brief checking for understanding segment during
focus, and game. The intervention group teachers replaced the brief 15-second transition from each activity. Partici-
their regular fitness component with the Healthy Behav- pants were encouraged to have pre-recorded music to play
iour Fitness Segments (HBFS). The study was approved during the 1 minute and 45 seconds of activity and to be
by the University, School District, and teachers, parents silent during 15 seconds of transitions. This was intended
and pupils. to serve as a guide for teachers, ensuring uniformity.

Table 1. Description and objectives of the healthy behaviour knowledge fitness segments

1. Scavenger Hunt: Partners read the map (task card) given and perform the activities as they find them laid out in
a contained area (i.e., hula-hoop. Performance Descriptors: Identifies the principles (guidelines) associated with improving
physical fitness.
2. Body Composition Avengers: Pupils are divided and positioned at opposing hula-hoops spaced by approximately 20ft.
The hoops contain 6 yellow (fat) and 6 red bean bags (muscle). The hula-hoop signifies a body and the objective is for
Pupils to have more muscle than fat in their hoops. They are to Grab only one bean bag at a time and must place them in
the hoop without tossing.
3. Taking your Heart Rate: Pupils quickly choose an activity from a selection of three different activities: (a) bowling,
(b) pattern walking, and (c) agility run. Pupils switch halfway to another activity after checking the effect that activity had
on their heart.
4. Benefit Surprise: Pupils grab one activity card from several that are scattered face down inside a hula-hoop. Each
card has a benefit associated with health-related physical fitness. They read and perform the activity; once the activity is
completed, Pupils then grab another activity and continue this process for the time allotted.
5. Roll the Dice: Pupils begin by rolling the big foam dice. If it lands on an odd number, the roller decides from either
an aerobic or muscular endurance exercise. If the dice lands on an even number, the roller chooses a weight bearing or
flexibility exercise.
36 M. Hodges et al.

There were a total of five activities, which were im- Excluded were those with missing either pretest or post-
plemented into stations and placed into five different les- test assessment and informed consent forms from parents
son segments. Therefore, teachers used the HBFS for five or student assent forms (n = 139). Descriptive statistics
class sessions and offered the pupils multiple attempts to (Means, SD) for the study participants were calculated
grasp the concepts from each lesson segment. across intervention and control groups. General linear
At the control schools, teachers did not alter their in- models, at pupil level (level-1) were used to test mean dif-
struction in any way and were expected to continue their ferences for pedometer steps and changes in HBK between
regularly assigned lesson plans as designated by the Phys- intervention and control groups. Hierarchical linear mod-
ical Education department. els, at school level (level-2), were used to compare mean
differences for changes in HBK between intervention and
Assessment Tools control groups after adjustment for gender. The outcome
PE Metrics. The fifth grade pupils’ HBK was evalu- measures for pupil level (level-1) include changes in HBK
ated using the PE Metrics Standards 3 & 4, 28-question (HBK Δ) and pupil ID. The pupil level covariate is a gen-
knowledge test (e.g., “The best choice for a vigorous phys- der and the school-level (level-2) covariate is a treatment
ical activity after school is?” with four response choices). variable (intervention vs. control). The two-level multi-
This test has previously been shown to produce reliable level models are as follows:
and valid scores in similar populations of children [19]. Level 1:
A member of the research team administered this 28-ques- HBK ∆ = β0j + β1j (Sex) + eij,
tion pencil and paper test to both participant pupil groups
before and after the implementation period. where i = 1, 2, ... pupils, j = 1 , 2, ... schools.
Pedometers. Based on instrument availability, two Level 2:
Physical Education teachers were randomly selected to β0j= γ00 + γ01 (Intervention vs. Control) + u0j β1j= γ10.
use pedometers at their respected schools, which consisted
of six, fifth grade classes (n = 53, intervention; n = 41, Full model:
control). All pupils in the classes were provided a pedom-
HBK ∆ = γ00 + γ01 (Intervention vs. Control)
eter, and expected to quickly put on the pedometer upon + γ10 (Sex) + u0j + eij.
entry into the gymnasium. Once the class was completed,
they would remove the pedometer and a research member Intraclass correlation coefficients (ICC), ρ = τ00/(τ00 +
recorder each pupils’ step count. Pedometer data were col- σ2 residual
), were also computed to estimate the proportion
lected beginning in the second week. of total variance between schools, intervention, and con-
Teacher Fidelity. During the study, trained research trol groups (τ00 = intercept). All statistical procedures were
assistants observed the PE teachers and their classes twice performed using SAS PROC Mixed models. All p-values
during the study (both intervention and control classes). were two-tailed, and values of less than 0.05 were con-
Twenty-eight unannounced observations were conducted sidered to indicate statistical significance. All procedures
and spread evenly across the five-week intervention. were performed by Statistical Analysis Systems software
The observation instrument included seven dichotomous (SAS Institute, Cary, NC).
scale items (e.g., whether the fitness lesson segments were
implemented or not, and if activities were timed appropri- Results
ately) and performed by a member of the research team to
examine if teachers were adhering to the intervention.
Healthy Behaviour Knowledge
Data Treatment and Analysis As shown in Table 2, pupils in the intervention group
Analysis included 641 participants (n = 401 interven- had higher changes in HBK than did control pupils at pu-
tion; n = 240 control) who were enrolled in the 5th grade. pil level (level-1) (HBK Δ: 2.2 vs. 1.33) (p = 0.003). There

Table 2. Descriptive statistics (X ± SD) for HBK scores and pedometer steps (level-1)

Intervention Control
p-value
Variable n Pretest Posttest n Pretest Posttest
HBK Scores
Total (n = 641) 401 14.02 ± 4.21 16.20 ± 4.22 240 13.43 ± 4.24 14.76 ± 4.63 0.003
Pedometer steps
Total (n = 79) 43 1643 ± 400 36 1577 ± 535 0.53
Teaching healthy behaviour knowledge 37

Table 3. Review of intervention Pupils’ scores by percentage per item

3 highest scoring items Subcategory Pre M ± SD Post M ± SD

(Q2) Jane wants to do something after school to
Chooses to be physically active
help her be good on the soccer team. She should. 0.40 ± 0.49 0.91 ± 0.29
outside of school.
– Practice dribbling a soccer ball.
(Q7) If Jane can pass a flexibility test, she is more
Describes characteristics of health-
likely to. 0.87 ± 0.33 0.89 ± 0.31
enhancing PA physical activity.
– Do well in gymnastics.
(Q13) A good score on a health-related fitness tests
Achieves criterion-referenced
tells you that. 0.79 ± 0.41 0.86 ± 0.35
standards.
– You have a healthy level of fitness.
3 Lowest Scoring Items Subcategory Pre M ± SD Post M ± SD
(Q11) Softball is a good. Describes characteristics of health
0.07 ± 0.26 0.09 ± 0.29
– Weight-bearing activity enhancing PA
(Q10) Which of the following is a weight-bearing
Describes characteristics of health
activity. 0.03 ± 0.176 0.15 ± 0.36
enhancing PA
– Doing curl-ups.
(Q25) When you want to become stronger, you Identifies the principles (guidelines)
should. associated with improving physical 0.16 ± 0.37 0.16 ± 0.37
– Overload your muscles. fitness

was no statistical difference in pedometer steps between was no statistical difference in a cross-level interaction be-
intervention and control groups. Many pupils underper- tween gender and treatment.
formed in specified items from the PE metrics (see Ta- Figure 1 shows the Tukey-Kramer post-hoc tests
ble 3). After reviewing the test items, question 10 and ques- for changes in HBK between intervention and control
tion 11 were the most commonly missed with only 10% of groups. Changes in HBK for intervention and control
pupils correctly answering the questions at post-test. This groups are 2.13 and 1.33, respectively. Pupils in the in-
was a slight increase from the pretest by 2%. Estimated tervention group had 0.8 greater changes in HBK than
effects of HBFS on changes in HBK in the 5th grade pu- did pupils in the control group (p < 0.05). The intraclass
pils are presented in Table 4 (school level, level-2). Pupils correlation coefficient (ICC) for schools is 0.007 indi-
with HBFS intervention had greater mean improvements cated that approximately 0.7% of the total observed vari-
in HBK than did pupils with control after adjustment for ance in changes in HBK was explained by school mean
gender (p < 0.05). Girls had ­0.55-unit greater changes in differences. There were minimal differences in variance
HBK (2.00 vs. 1.45) compared with boys (p < 0.05). There among the schools.

Table 4. Estimated effects of HBFS on changes in HBK in the fifth grade Pupils (level-2).

Estimate SE p-value
Fixed-Effect Parameter
Intercept (γ00) 1.300 0.457 0.005
Treatment (γ01) (Int vs. Control) 0.798 0.344 0.038
Gender (γ10) (Female vs. Male) 0.546 0.267 0.042
Covariance Parameter
σ2school (τ00) 0.0815 0.114 0.239
σ2 Intervention 10.373 0.737 <0.001
σ 2
Control 13.683 1.254 <0.001
σ2Residual 11.613 0.652 <0.001
38 M. Hodges et al.

3
the implementation group), making the assumption that
this concept was simply not introduced in class.
Upon, further review of the HBFS, researchers be-
2.13
Changes in HBK

2 lieve additional activities that incorporate these missed

concepts are necessary and would ensure a higher pupil
1.33 performance on the posttest. Moreover, further studies are
1 needed that revise the HBFS based on the current stud-
ies’ findings as well as investigate a longer intervention
period. Possible perceptional data on the HBFS would be
0
Control Intervention
beneficial, as according to the cognitive mediation theory,
pupil interest is a major factor controlling the learning of
Fig. 1. Mean changes in HBK (95% CI) between inter­vention novel concepts [9]. This would bring insight onto whether
and control groups (model 2) the HBFS was well liked and their interests had effect on
pupil performance.

Teacher Fidelity Conclusions

Intervention fidelity results were calculated based on
data from the intervention observations. The teachers at
their designated intervention school performed the prop- As insufficient physical activity patterns exist for youth
er lesson at the appropriate time, lasting no more than around the world, many international organizations and
15 minutes 85% of the time. At their control school Physi- World Health Organizations have called for schools and
cal Education teachers were observed to provide minimal Physical Education classes to be a place for pupils to en-
signs of HBK instruction and no signs of HBFS usage. gage in high amounts of physical activity. Therefore, in-
structional practices that teach HBK cannot have an ad-
Discussion verse effect on physical activity. The HBFS does not. The
HBFS provides teachers with a new strategy for teaching
HBK while maintaining high amounts of physical activity.
Our major finding from this study was that pupils with
HBFS lessons had a significant increase in HBK scores. References
This increase of HBK was not seen to sacrifice physical
activity when compared with control pupil counterparts.
Healthy Behaviour Knowledge Improvement Strategy 1. Australian National Children’s Nutrition and Physical
The HBFS was found to provide teachers with one Activity Survey (2007) Children’s Nutrition and Physical
strategy to increase the HBK among primary pupils in Activity Survey: South Australian Findings.
Physical Education without sacrificing physical activity. 2. Brousseau T.A., P.H. Kulinna, D.J. Cothran (2011) Physi-
Pupils at posttest scored on average 18 out of 28 on the cal activity content knowledge of Native American chil-
PE Metrics exam compared to the prestest of 12 out of dren. The Physical Educator, 68: 66-77.
28. Although the increase was slight, the results were sig- 3. http://www.cdc.gov/healthyyouth/health_and_academ-
nificantly greater and significantly different then the con- ics/pdf/pape_executive_summary.pdf
trol group pupils. Thus, this strategy will help to contrib- 4. Corbin C.B., R. Lindsey (2006) Fitness for Life. 5th ed.
ute to increasing learning and provides some progress in Human Kinetics, Champaign.
this area. The researchers have speculated a few reasons 5. Currie C., A. Zanotti, D. Morgan, M. Currie, C. deLooze,
as to why the pupil performance on the posttest was un- O. Roberts, O. Samdal, R.F. Smith, V. Barnekow (2012)
derachieved. First, the implementation period may have Social determinants of health and well-being among young
been too short. The duration of the study lasted five weeks, people. Health behaviour in school-aged children (BSC)
offering pupils only five HBFS (once a week Physical study: International report from the 2009/2010 survey.
Education classes). Second, the PE Metrics cognitive as- Health Policy for Children and Adolescents, 6(1): 252.
sessment may not be an appropriate assessment tool, as 6. Dale D., C.B. Corbin, T.F. Cuddihy (1998) Can conceptu-
there are a wide-range of subcategories possibly making it al Physical Education promote physical active lifestyles?
difficult to make sense of all HBK concepts. Pediatric Exercise Science, 10: 97-109.
It was found that many concepts from the PE Metrics 7. Desmond S.M, J.H. Price, R.S. Smith, D. Smith,
remained unlearned (e.g., question 10 and 11 assessed pu- P.W. Stewart (1990) Urban black and white adolescents’
pils’ knowledge on weight bearing activities, which only physical fitness status and perceptions of exercise. Jour-
showed an increase of approximately 1% at post test for nal of School Health, 60: 313-314.
Teaching healthy behaviour knowledge 39

8. Dilorenzo T.M., R.C. Stucky-Ropp, J.S. Vander Wal, Standards for Physical Education, 2nd edition. American
H.J. Gotham (1998) Determinants of exercise among alliance for Health, Physical Education, Recreation and
children: A longitudinal analysis. Preventive Medicine, Dance, Reston.
27: 470–477. 21. Sallis J.F., T.L. McKenzie, J.E. Alcaraz, B. Kolody,
9. Doyle W. (1977) Paradigms of research for teacher effec- N. Faucette, M.F. Hovell (1996) The effects of a 2-year
tiveness. Review of Research in Education, 5: ­163-198. Physical Education program (SPARK) on physical activ-
10. Fox K.R., S.J. Biddle (1998) The use of fitness tests: ity and fitness in primary school pupils. American Jour-
Educational and psychological considerations. Journal of nal of Public Health, 87: 1328-1334.
Physical Education, Recreation and Dance, 59: 47-53. 22. Sallis J.F., T.L. McKenzie, M.W. Beets, A. Beighle,
11. Hopple C., G. Graham (1995) What children think, feel, H. Erwin, S. Lee (2012) Physical Education’s role in
and know about physical fitness testing. Journal of Teach- public health: Steps forward and backward over 20 years
ing in Physical Education, 14: 408-417. and HOPE for the future. Research Quarterly for Exer-
12. Kahn E.B., L.T. Ramsey, R.C. Brownson, G.W. Heath, cise and Sport, 83: 125-135.
E.H. Howze, K.E. Powell, P. Corso (2002) The effective- 23. Palmer S., G. Graham, E. Eloise (2005) Effects of a web-
ness of interventions to increase physical activity. A sys- based health program on fifth grade children’s physical
tematic review. American Journal of Prevention Medi- activity knowledge, attitudes and behaviour. American
cine, 22: 73-107. Journal of Health Education, 36: 86-93.
13. Keating X.D., L. Chen, J. Guan, L. Harrison, B. Dauen- 24. Pangrazi R.P, A. Beighle, D. Pangrazi (2009) Promoting
hauer (2009) Urban minority 9th grade pupils’ health-re- Physical Activity and Health in the Classroom. Benjamin
lated fitness knowledge. Research Quarterly for Exercise Cummings Pearson, San Francisco.
and Sport, 80: 747-755. 25. http://www.cdc.gov/healthyyouth/shpps/2006/factsheets/
14. Kedler S., D.M. Hoelscher, C.S. Barroso, J.L. Walker, pdf/FS_PhysicalEducation_SHPPS2006.pdf.
P. Cribb, S. Hu (2003) The CATCH Kids Club: A pilot 26. Solmon M.A. (2006) Learner Cognition. In: D. Kirk,
after-school study for improving elementary students’ D. Macdonald and M. O’Sullivan, (eds.) Handbook of
nutrient and physical activity. Publich Helath Nutrition, Physical Education. London, UK. SAGE Publications
8: 133-140. DOI: 10.1079/PHN20004678. Ltd, pp. 226-240.
15. Kulinna P.H., (2004) Physical activity and fitness knowl- 27. Spiegel S.A., D. Foulk (2006) Reducing overweight
edge: How much 1–6 grade pupils know? International through a multidisciplinary school-based intervention.
Journal of Physical Education, 41: 111-121. Obesity, 14: 88-96.
16. Liang M.T., H.T. Dombrowski, T.W. Allen, C.O. Chang, 28. Thomas K.T. (2004) Riding to the rescue while holding
J. Andriulli, M. Bastianelli, S.D. Norris (1993) Do medi- on by a thread: Physical activity in the schools. Quest,
cal pupils’ knowledge and attitudes about health and ex- 56: 150-170.
ercise affect their physical fitness? Journal of American 29. Thompson A., J.C. Hannon (2012) Health-related fitness
Osteopathic Association, 93: 1020-1024. knowledge and physical activity of high school pupils.
17. Luepker R.V., C.L. Perry, S.M. Mckinlay, P.R. Nader, The Physical Educator, 4: 71-88.
G.S. Parcel, E.J. Stone, C.C. Johnson (1996) Outcomes 30. Trost S.G., A.M. Morgan, R. Saunders, G. Felton,
of a field trial to improve children’s dietary patterns and D.S. Ward, R.R. Pate (2000) Children’s understanding of
physical activity. The Child and Adolescent Trial for Car- the concept of physical activity. Pediatric Exercise Sci-
diovascular Health CATCH collaborative group. Journal ence, 12: 293-299.
of the American Medical Association, 13: 768-776. 31. Zhu W., M. Safarit, A. Cohen (1999) The National Health-
18. National Association for Sport and Physical Education Related Physical Fitness Knowledge Test: FitSmart Test
and American Heart Association (NASPE) (2012). Shape User Manual (High School Edition). Champaign, Human
of the Nation Report: Status of Physical Education in the Kinetics.
USA. American Alliance for Health, Physical Education,
Recreation and Dance, Reston.
19. National Association of Sport and Physical Education Received 26.02.2014
(NASPE) (2010) PE Metrics: Assessing National Stan- Accepted 29.05.2014
dards 1-6 in Primary School. American alliance for Health,
Physical Education, Recreation and Dance, Reston. © University of Physical Education, Warsaw, Poland
20. National Association of Sport and Physical Educa-
tion (NASPE) (2004) Moving into the Future: National