Keeping Kids Active at Home and All Year

00:03 Hasson: A lot of times in Michigan we complain about the weather. We're like, “Oh, it's so grey”. But on the gray days, you get to see the beautiful leaves on the trees. It brings out the beauty in the trees. We can also think about different activities, so having seasonal sports, and we don't have to do the same thing every day. We can think about how do we categorize different activities for different seasons to have fun? We have fall flavors, like pumpkin and apple spices. Can we have fall activities? We have winter activities. So are there things that we can create that makes it fun and you look forward to the winter rather than thinking about “ugh the winter” and we go into hibernation. We are not bears. We're not birds. We are humans, and so we can stay active throughout the entire year. It's my job to work with teachers, work with families, work with kids to figure out how to stay motivated all four seasons, even if we don't have nice sun-shiny days every day.

01:07 Narrator: During the COVID-19 pandemic, only one in four children in the United States has been physically active at recommended levels. With researchers anticipating a percent 2-3% increase in youth obesity as a result of the pandemic, we wanted to dig deeper into the importance of keeping kids active.

Hello and welcome to Population Healthy, a podcast from the University of Michigan School of Public Health. This episode is part of a series of special editions of our podcast focusing on the ongoing Coronavirus pandemic. Rebecca Hasson is an assistant professor of Nutritional Sciences at the University of Michigan School of Public Health and an associate professor of Kinesiology. She's a pediatric exercise physiologist who, as she tells it, started out just wanting kids to have an extra 20 minutes of physical activity in the classroom. Through collaborations with colleagues in public health, she has developed school-based interventions to help students stay active through the school day and those programs also help teachers, superintendents and school boards ensure that students are reaching the many learning outcomes that they are responsible for.

02:14 Hasson: School is central to keeping children physically active, particularly during the school year, and even creating opportunities outside of the school year when there are summer school opportunities or when those facilities at school are still available for children to remain physically active. The number one thing that gets kids moving is having daily required physical education, which enables kids to accumulate about 23 minutes of health-enhancing physical activity every day. We know another opportunity that's at school is classroom physical activity breaks, so where you interrupt the teaching to infuse or integrate physical activity breaks throughout the school day in the classroom, or you actually weave it into the actual curriculum so that they are moving and learning at the same time. We know that recess provides more opportunities as well. Safe routes to school provide another 10 minutes or so to help kids be physically active, and even after school programs, particularly those that are located within the school buildings provide even more opportunities to be physically active, and play grounds in school environments do too. So almost all of the facilities, equipment, opportunities for kids to be regularly physically active occur at the school. When you think about nutrition, children, particularly children from low resource communities are consuming about 75% of their calories at school. They're usually eating both their breakfast and lunch. We have long recognized that schools provide a unique opportunity for children to engage in healthy lifestyles, and that's where they learn how to engage in healthy lifestyles, so it is critical for them to continue to be primary partners in the fight against childhood obesity and to keep our kids healthy.

04:03 Narrator: Because of the Coronavirus pandemic, most school-age children in the US are in a rather different environment now, either learning virtually from home or attending school in person with many restrictions on how they move and interact. Hasson’s focus is now on the tremendous amount of creativity that teachers, parents and kids have brought to this challenge and how her own work on physical activity in the classroom is translating to our new realities.

04:28 Hasson: As you know, back in March, all of the schools for safety reasons were ordered to close, and so everything was shifted to online. And this became very difficult to sustain many of those physical activity opportunities that we previously mentioned that were available. Children could no longer engage in activity with other kids, so the social aspect of physical activity was basically eliminated. Free play was difficult, especially in a home environment since everyone was sheltering in place. PE became virtual for some, PE was eliminated for others, and it was difficult for teachers to actually monitor the children’s skills, to evaluate them, to provide feedback in that virtual format. And then walking to and from school was eliminated. So many of the opportunities changed dramatically. There were many unintended consequences of the pandemic that created difficulties for our children, as it related to coping with stress, reduced physical activity, changes in their dietary patterns. People were looking at that, they were seeing it, and they wanted to come together to change that and create more resources to help our children in a time when they needed it the most. And that's how our program Impact, interrupting prolonged sitting, came into play.

So we had historically been working in the school, in the classrooms to interrupt prolonged sitting at school, and then we rapidly responded to the needs of schools, to the means of children across the state, and we adapted that program for the home environment. And we had many people that stepped up to the challenge to create exercise videos, create more opportunities for children to become active at home. The partners ranged all the way from the state level to individual organizations or nationwide organizations. We started working with the Detroit Pistons and the Detroit Lions, with public health organizations like Michigan Public Health Institute, with the health coordinators across the state. So all of these different organizations came together with no funding, just a love and a passion for children to provide free opportunities that were available to all students to improve their health and well-being during this very stressful time.

One of the things that we wanted to make sure that we were doing was providing a free resource, because again, as part of this pandemic, many people were losing their jobs, there is a higher unemployment rate, there is just not a time where people could be spending additional monies to keep their children moving. People came together without any monetary incentives to create a program that would be a community benefit. So I like to refer to it as the people's program.

07:22 Hasson: The number one goal of our schools is to provide increased learning and they are held accountable for their learning outcomes, and so many times the physical activity seems like it's an add on. My job is to help teachers, help principles, help superintendents, help school boards understand physical activity is essential, and it will help you reach the outcomes that you want as it relates to learning outcomes. How do we incentivize teachers? Because they already know that this is an important aspect. We have teachers always coming to us saying, “It's difficult to get my students to focus in class, how can we do that, and thinking about different classroom management strategies?”. And I always love to tell them that physical activity is probably one of the best ways to help manage the student's behaviors and help them stay on task. Some of the ways that we have helped to incentivize both children and teachers to incorporate activity breaks into their classrooms is through gamification, adding game design elements where children earn points and they earn little trophies and they get to work together for a common goal that allows them to really be successful in physical activity. And so then you get this groundswell of the students asking the teachers for physical activity, and because we see all the benefits with physical activity, the teachers want to sustain it in their programs. I've never encountered a teacher who did not want to implement physical activity in their classroom, so I don't think mandates are important, I think we just need to have a structure that helps to facilitate what the teachers already want to do. And we can do that through our wellness policy. So that provides a district accountability, and the district is saying that they support their students being physically active in the classroom. We allow for our social workers to be trained on how do they help the classroom teachers and how do they help the PE teachers? I think also providing more training to our classroom teachers on how do you do this safely, both virtually and in person.

The state of Michigan has a wonderful set up. There are about 25, 26 health coordinators all throughout the state that touch every single school, so as we are thinking about widespread dissemination, sustainability, this is a great organization because there can be in some schools, particularly low resource schools, there can be a high turnover rate of classroom teachers or even PE teachers. There can be a high turnover rate of principles. There can even be a high turnover rate of superintendents. Because MSHCA or the Michigan School Health Coordinators Association is a stable unit throughout the state, you actually have one person that is going to be there consistently over years.

10:22 Narrator: With schools playing such a big role in helping children stay active and with so many kids now doing school at home, Hasson believes that together schools, children, families, and the communities we live in can find motivation and a plan to make physical activity part of each day.

10:39 Hasson: This is a big ask from parents and children to start exercising at home. We know that parents are extremely busy right now, and they're trying to parent and work all at the same time. So what we are trying to do is create a resource that the parents can engage with the kids by being physically active, but also that the kids can do it by themselves if needed. That there are enough instructions from the PE teachers in the videos that really enable the children to be active on their own. So if the parent needs a break, they can say, “Now it's time for physical activity”. Now we would love for children to do it with the parents, and so that is where we have, again, incorporated point systems and goals. We know from the goal setting theory that when an individual sets a goal and sets a realistic goal, that they are much more likely to accomplish that goal rather than just saying, “Okay, I'm gonna just start exercising”. We also know that adding game design elements, it makes it more fun for kids. Giving them just a sticker - they get to put a sticker on their activity calendar, helps them to stay motivated. Those are more external motivations, but we've also tried to create the video so that they're fun, and we know that in physical activity, enjoyment is also a way to increase physical activity participation.

If we think about the kids motivating the parents, we can take lessons from smoking cessation. There really was this grassroots movement from the children. So as children were learning in schools that smoking is bad they would actually go back to their parents and say, “Mom, dad, grandma, grandpa, shouldn't be smoking. It's bad for our health”. And that really helped with changing smoking patterns and smoking participation in this country. I believe we can do the same thing with physical activity. Before this program even started, we would use some freely available videos that were already online and children would actually go home and start using those videos and asking their parents will they do them with them. In the beginning, the push will be coming from the parents to help motivate the children, but I think at some point in time, that motivation will switch and it will be the student or the child that is now starting to motivate their parents.

12:58 Narrator: As much of the country is entering a period of shorter and colder days that often lead to less movement, Hasson stresses the need to embrace the winter season.

13:08 Hasson: How do we get through the winter and stay active? That is a fundamental Michigan question. I'm originally from California, so that's not really a question that we ask ourselves too often, but the beauty of having four seasons is that we have four seasons. The disadvantages to having four seasons is that it can have a tremendous impact on our behavior. But as many native Michigan-ers have told me, there's no such thing as bad weather, there's only bad clothing. So we are actually having some of our PE teachers develop exercise training videos on how do you safely exercise outdoors and can you pick up a sport that is a winter sport? So snowshoeing and things of that nature. Now, some of those sports are expensive and they may not be accessible to all of our students. So we are also providing, again, at-home exercises that you can do in your own living room. You can exercise in your living room 365 days a year, and so it is not weather-dependent, it's just time-dependent and motivation-dependent. There are very few days in a year where you really cannot go outside because it's unsafe, but most of the days it’s really just a motivation factor. It's my job to help find different motivators to help people stay focused and motivated all throughout the year, and that's what we're hoping to achieve with Impact at Home, that you can still stay physically active at home through these videos.

Now, one thing to make sure of is if we are going to be staying indoors more, making sure that the air quality is good. Not all individuals have high quality clean air in their households, and so we are also providing resources to make sure that we have clean air that we are breathing indoors. Because we do know that some of our children have respiratory issues such as asthma, so we wanna make sure that it is safe for children to exercise indoors. So we're also providing more resources on that. Changing the filters and your air conditioners and heaters will be critical for exercising indoors.

For a long time, we know that kids need to be physically active, but we haven't made a concerted effort to really provide all of the different opportunities for children to be successful in this area, and I think that the Coronavirus pandemic has really brought that to light. You have all of these state-wide organizations that want to put children first and that are coming together to really help make that happen. We recently were able to acquire funding from the state through the Coronavirus pandemic COVID CARES Act to really grow this program, so that there will be 250 videos available. So that is a new video Monday through Friday, all throughout the entire year. And we have heard from teachers across the state and principles that this is exactly what they needed, that when the pandemic hit, there really weren't that many physical activity resources available for parents and for teachers to use as they're trying to teach in a home or virtual environment.

I really applaud the University of Michigan and the State of Michigan for coming together to really try to feel that gap. We're even working with Detroit Public Television to make these videos available on a TV or media platform, because even if we provide it on the internet, on a computer, a third of our students across the state do not have internet access. So how do we work together to provide a free resource to every child throughout the state? And people are really stepping up to that call. I would continue to encourage everyone who's listening to this podcast, how can you help, what are some solutions, how can you use your expertise to really provide simple solutions for complex problems, because people are willing to help and step up to that call, and I hope that you answer the call to improve the health and well-being of children and their families across the state and across the naiton.

17:21 Narrator: This has been a special edition of Population Healthy, a podcast from the University of Michigan School of Public Health. During the ongoing coronavirus pandemic, we’ll work to bring you analysis from our community of experts to help you understand what this public health crisis means for you. To stay up-to-date in between special edition episodes, be sure to check out our website publichealth.umich.edu, subscribe to our Population Healthy newsletter at publichealth.umich.edu/news/newsletter and follow us on Twitter, Instagram, and Facebook @umichsph.