Stepping Up to Better Health

By: Elizabeth Zeppernick, M.Ed., BCBA, LBA

It is widely accepted that regular physical activity can improve physical and mental health, reduce risk of illness and increase life expectancy.  It is recommended that children be moderately to vigorously active for a minimum of 60 minutes per day (CDC 2022) but most children in our country do not meet this minimum (Levi et al., 2014; Troiano et al., 2008). Habits of physical activity created in childhood and adolescence are likely to continue into the longer period of adulthood so establishing these practices early is of critical importance (U.S. Department of Health and Human Services, 2018).

Researchers Miller et al. (2022) recently studied the effect on various behavioral interventions designed to increase physical activity among school aged children. Their study is titled “Evaluating public posting, goal setting, and rewards to increase physical activity in children.”

The study took place in an elementary classroom and included fourteen participants (nine girls and five boys) between the ages of 9-12 years old.  They implemented a combination of three different interventions, evaluating them in order of how much effort and cost they required, from least to most.  Pedometers remain an accurate and relatively affordable method of monitoring activity so they were used to measure activity.  The recommended sixty minutes of activity equates to 11,000-12,000 steps per day for girls and 13,000-15,000 steps per day for boys (Tudor-Locke, Craige, Beets, et al., 2011).  Researchers monitored steps across 24 hour periods of time, four days a week by allowing the students to bring the pedometers home with them. 

During the baseline phase or starting point prior to intervention, the participants wore their pedometers but the devices were locked so they could not see their steps taken.  During this pre-intervention phase, the participants took an average of 6,900 steps per day.  

After establishing the baseline levels of activity, researchers compared three interventions which are described below:

  1. Self-Monitoring and Public Posting- In this stage the devices were unlocked so the participants were able to see their step progress throughout the day.  They were also prompted to report their steps by updating a daily journal and a line graph displayed in the classroom.  During this phase, the class average increased to 9,400 steps per day

  2. Self-Monitoring with Public Posting and Goal Setting- This stage combined the method described above but added a weekly goal based on the individual participant’s step output of the previous week.  The weekly goal was written on a small sticker that was placed by the pedometer display so that the student could self monitor their progress.  This resulted in a class average of 9,500 steps per day.  

  3. Full Package: Self-Monitoring with Public Posting, Goal Setting, and Reward- This stage combined the methods described above and added a token system where the participants were individually rewarded with a token if they met or exceeded their daily step goal. Five tokens, which did not have to be earned on successive days, could be traded in for a $5 gift card to a local store.  This intervention package led to a significant increase of steps to a class average of 11,550 per day and individual highs for 10 out of 12 participants. 

Researchers concluded that the combination of interventions was most effective in increasing activity. Another benefit of the full package of interventions is that the daily return rate of the pedometers increased to its highest levels during this phase as participants were motivated to bring the device back to school the next day.  

In summary, if children who meet or exceed the recommended daily allotment of exercise are less likely in the longterm to suffer from obesity, heart disease and even cancer (Reilly & Kelly, 2011) then interventions to improve activity levels are worthy of consideration by both parents and educators. 


Sources

Centers for Disease Control and Prevention. (2022). How much physical activity do children need?  Retrieved from https://www.cdc.gov/physicalactivity/basics/children/

Levi, J., Segal, L. M., St. Laurent, R., & Rayburn, J. (2014). The state of obesity: Better policies for a healthier America, 2014. The Robert Wood Johnson Foundation. http://stateofobesity.org/files/stateofobesity2014.pdf

Miller, B. G., Livingston, C. P., Zerger, H. M., Valbuena, D. A., & Miltenberger, R. G. (2022). Evaluating public posting, goal setting, and rewards to increase physical activity in children. Behavioral Interventions, 1-13. https://doi.org/10.1002/bin.1902

Miller, B. G., Valbuena, D. A., Zerger, H. M., & Miltenberger, R. G. (2018). Evaluating public posting, goal setting, and rewards to increase physical activity during school recess. Behavioral Interventions, 33(3), 237-250. https://doi.org/10.1002/bin.1631

Reilly, J.J., & Kelly, J. (2011). Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: Systematic review.  International Journal of Obesity, 35(7), 891-898. https://doi.org/10.1038/ijo.2010.222

Troiano, R. P., Berrigan, D., Dodd, K. W., Masse, L. C., Tilert, T., & McDowell, M. (2008). Physical activity in the United States measured by accelerometer. Medicine & Science in Sports & Exercise, 40(1), 181-188. https://doi.org/10.1249/mss.0b013e31815a51b3

Tudor-Locke, C., Craig, C., Beets, M. W., Belton, S., Cardon, G. M., Duncan, S., Hatano, Y., Lubans, D. R., Olds, T. S., Raustorp, A., Rowe, D. A., Spence, J. C., Tanaka, S., & Blair, S. N. (2011). How many steps/day are enough for children and adolescents. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 78. https://doi.org/10.1186/1479-5868-8-78



Disclaimer:  This content may contain general information relating to various conditions and treatment and is for informational purposes only.  The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Information is gathered and shared from reputable sources; however, ABLE Home Health Care, LLC, nor the author of this content, is responsible for errors or omissions of the underlying content.  ABLE gives no assurance or warranty regarding the accuracy or applicability of the content.  Readers are encouraged to confirm the information contained herein with other sources.  No individuals, including those under our active care, should use the information, resources or tools contained within the content for self-diagnosis or self-treatment.