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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="1.3" xml:lang="en" article-type="research-article"><?properties manuscript?><processing-meta base-tagset="archiving" mathml-version="3.0" table-model="xhtml" tagset-family="jats"><restricted-by>pmc</restricted-by></processing-meta><front><journal-meta><journal-id journal-id-type="nlm-journal-id">7801727</journal-id><journal-id journal-id-type="pubmed-jr-id">3636</journal-id><journal-id journal-id-type="nlm-ta">Eval Program Plann</journal-id><journal-id journal-id-type="iso-abbrev">Eval Program Plann</journal-id><journal-title-group><journal-title>Evaluation and program planning</journal-title></journal-title-group><issn pub-type="ppub">0149-7189</issn><issn pub-type="epub">1873-7870</issn></journal-meta><article-meta><article-id pub-id-type="pmid">33601248</article-id><article-id pub-id-type="pmc">10495871</article-id><article-id pub-id-type="doi">10.1016/j.evalprogplan.2021.101919</article-id><article-id pub-id-type="manuscript">HHSPA1923525</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Presidential youth fitness program implementation: An antecedent to
organizational change</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Barcelona</surname><given-names>Jeanne M.</given-names></name><xref rid="A1" ref-type="aff">a</xref><xref rid="CR1" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Castelli</surname><given-names>Darla M.</given-names></name><xref rid="A2" ref-type="aff">b</xref></contrib><contrib contrib-type="author"><name><surname>Cance</surname><given-names>Jessica Duncan</given-names></name><xref rid="A3" ref-type="aff">c</xref></contrib><contrib contrib-type="author"><name><surname>Pitt Barnes</surname><given-names>Seraphine</given-names></name><xref rid="A4" ref-type="aff">d</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Sarah</given-names></name><xref rid="A4" ref-type="aff">d</xref></contrib></contrib-group><aff id="A1"><label>a</label>Wayne State University, Kinesiology, Health and Sport
Studies, United States</aff><aff id="A2"><label>b</label>The University of Texas at Austin, Department of
Kinesiology and Health Education, United States</aff><aff id="A3"><label>c</label>RTI International, Center for Behavioral Health
Epidemiology, Implementation, and Evaluation Research, United States</aff><aff id="A4"><label>d</label>Centers for Disease Control and Prevention, Division of
Population Health, United States</aff><author-notes><corresp id="CR1"><label>*</label>Corresponding author at: Kinesiology, Health and
Sport Studies, Wayne State University, 656 West Kirby, Detroit, MI, 48202,
United States. <email>Jeanne.barcelona@wayne.edu</email> (J.M.
Barcelona).</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>17</day><month>8</month><year>2023</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2021</year></pub-date><pub-date pub-type="epub"><day>10</day><month>2</month><year>2021</year></pub-date><pub-date pub-type="pmc-release"><day>12</day><month>9</month><year>2023</year></pub-date><volume>86</volume><fpage>101919</fpage><lpage>101919</lpage><abstract id="ABS1"><sec id="S1"><title><italic toggle="yes">Introduction</italic>:</title><p id="P2">Grounded in organizational change theory, the purpose of this study
was to investigate the efficacy of the Presidential Youth Fitness Program
(PYFP) and its association with healthy cultures within schools.</p></sec><sec id="S100"><title>Methods:</title><p id="P500">Using a qualitative approach, data were collected through
interviews, site visits and artifacts across 374 schools. An explanatory
collective case study approach was used to identify key events related to
implementation.</p></sec><sec id="S2"><title><italic toggle="yes">Results</italic>:</title><p id="P200">Pivotal antecedents to organizational change included prolonged,
continual PD, direct support of PYFP implementation, and recognition.
Further, three key themes of leveling of the playing field, strategically
overcoming barriers, and recruiting teacher fitness champions were
identified.</p></sec><sec id="S4"><title><italic toggle="yes">Conclusions</italic>:</title><p id="P3">Creating a healthy school culture was an unexpected, but feasible
outcome stemming from the implementation of the PYFP. A collective effort,
led by physical education teachers and fitness champions and embraced by the
administration, faculty, and community, is necessary for the school culture
to unfreeze from its present status.</p></sec></abstract><kwd-group><kwd>Program evaluation</kwd><kwd>Public health</kwd><kwd>Physical fitness</kwd><kwd>Adolescent</kwd></kwd-group></article-meta></front><body><sec id="S5"><label>1.</label><title>Introduction</title><p id="P4">Despite the prevalence of childhood obesity, many physical education programs
continue to emphasize team sport participation rather than educating and modeling
healthy lifestyle qualities (<xref rid="R6" ref-type="bibr">Centeio &#x00026; Castelli,
2012</xref>; <xref rid="R15" ref-type="bibr">Institute of Medicine of the
National Academies [IOM], 2013</xref>). Given our societal interest in sport, it
should have its place within the physical education programming; however, due to the
increased rates of overweight and obesity and related chronic disease risks (e.g.,
type II Diabetes) among students, physical education places a strong emphasis on
student health and physical fitness, not just performance. In 2012, the reorganized
Presidential Youth Fitness Program (PYFP) was launched to promote health-related
fitness through school-based physical education programs. The program provides a
model for fitness education that includes the use of a health-related fitness
assessment, as well as educational and motivational tools to support teachers and
empower students to adopt an active lifestyle. The PYFP provides teachers with tools
to promote fit and active youth. Sustained positive messaging from programs like
PYFP arguably has the potential to contribute to the development of healthy school
culture. Based on this mission, the PYFP has used ongoing, content-based
professional development (PD) as a medium to transform teacher knowledge by sharing
strategies for providing quality physical education in schools. As part of a
large-scale evaluation, this paper investigates the efficacy of utilizing key
components of the PYFP as a tactic for implementing fitness education into physical
education classes as a means of creating a health-oriented culture within schools.
Grounded in the theory of organizational change, this study utilizes qualitative
methods to 1) identify key antecedents related to a school's readiness to adopt
fitness education, and 2) identify the school level changes resulting from its
implementation.</p></sec><sec id="S6"><label>2.</label><title>Perspective/theoretical framework</title><p id="P5">The study of organizational change and the processes that drive its success
date back to the early 1900s when all organizations, regardless of structure and
type, were labeled as closed or open systems (<xref rid="R13" ref-type="bibr">Hertz
&#x00026; Livingston, 1950</xref>). As a result, it was not until the late 20th
century that school organizations considered the influence of external forces like
PD as learning processes within given classroom ecologies. Further, feedback loops
influence systemic change. Today, the contemporary organizational change theory
investigates various key factors such as environment, individual motivation, and
circumstance and structural relationships, and how they relate to an organization's
ability to succeed, adapt, and change (<xref rid="F1" ref-type="fig">Fig. 1</xref>).
Armenakis and colleagues suggest that individual and collective readiness among
educators (i.e., teachers and administrators) is an essential first step in the
process of change (<xref rid="R1" ref-type="bibr">Armenakis, Harris, &#x00026;
Mossholder, 1993</xref>). When a critical mass of educators exhibit readiness,
it prompts a comprehensive call to reflect on the current social environment and
culture. Gaining an awareness of shared values and beliefs provides a framework by
which one can gain <italic toggle="yes">universal</italic> buy-in, resulting in sustainable
change.</p><p id="P6">Individual readiness begins with awareness and, when necessary, the
transformation of individual beliefs and perceptions toward change. It is the
cognitive precursor that primes behavioral actions (<xref rid="R1" ref-type="bibr">Armenakis et al., 1993</xref>). Identification of the antecedents that prompt
educators to support or resist a given change, such as implementing fitness
education into physical education, is essential. <xref rid="R9" ref-type="bibr">Connolly and Dolan (2012)</xref> posit that structural relationships are not
dichotomous; instead, individuals, organizations, and society are all
interdependent. As such, the dynamics between structures influence the successful
adoption of change.</p><p id="P7">The organizational change theory posits that all establishments have both
closed and open characteristics and therefore, we must consider equally the
infrastructure as well as the individual needs of educators when attempting to
quantify program effects. Considerations of social systems within a given
environment have long been in existence. Dunning and Sheard argued that the goals an
organization ultimately adopts are formed at the individual level (1976). Despite
the probable influence of individual beliefs within the workplace, organizational
success and setback are determined by the human capital and relationships within the
organization (<xref rid="R3" ref-type="bibr">Bechtel &#x00026; O'Sullivan, 2007</xref>;
<xref rid="R9" ref-type="bibr">Connolly &#x00026; Dolan, 2012</xref>). Accordingly,
when looking to establish successful change within an organization, one must
consider all constituents, their interactions with one another, and the current
discourse.</p><p id="P8">Once individual buy-in is initiated, as the unfreezing period, the
organizations must be willing to undergo strategic planning, which includes taking
inventory of influential inputs that influence a stagnant and ineffective practice.
The Fitness Education Index is one way that physical education teachers can take
inventory of their current practice (<xref rid="R8" ref-type="bibr">Chen et al.,
2020</xref>). The unfreezing period should be considered in three distinct
parts: disconfirmation, induction of guilt, and the creation of psychological
safety, where unfreezing is prompted by a feeling of disequilibrium and frustration
about an ineffective practice (<xref rid="R19" ref-type="bibr">Schein, 1996</xref>).
The documented reality promotes strategic planning that communicates the shortfall
and its consequences with the larger organization while offering a sense of hope and
satisfaction in changing ineffective methods (<xref rid="R19" ref-type="bibr">Schein, 1996</xref>). Sustainable change can only occur through deliberate
action plans directed at first gaining buy-in from organizational members and then
providing individuals with opportunities to learn new strategies and take continued
steps toward seeing the plan through. Organizational change is a useful framework
for educational leaders seeking to reform current school practice because it
provides an overview of attainable outcomes.</p><sec id="S7"><label>2.1.</label><title>Physical education programs and organizational change</title><p id="P9">In the fall of 2012, the PYFP was relaunched as a mechanism to promote
health-related fitness within school-based physical education programs
nationwide. The PYFP is a comprehensive fitness education program that focuses
on three key areas: (a) PD for physical educators, (b) health-related fitness
assessment, and (c) recognition of schools and students. The program adopted
FitnessGram<sup>&#x000ae;</sup> to place greater emphasis on the
identification of health risk and revised the long-standing student recognition
component associated with youth fitness testing in the U.S. to promote the
achievement of healthy levels of fitness. To initiate the PYFP implementation, a
funding opportunity was made available to public and private schools nationwide.
The funding provided schools with supplemental resources to address the three
key areas of PD, assessment, and recognition. Accordingly, this study examined
the key events of the PYFP implementation, as an indicator of the fitness
education program's feasibility to initiate school change.</p><p id="P10">Based on the theory of organizational change, the research team
constructed a logic model to articulate and justify the stated evaluation
strategy procedure (<xref rid="F2" ref-type="fig">Fig. 2</xref>). The model
outlines the variables of interest and stages in which each was investigated
from Inputs to Behavioral Outcomes and Intermediate Outcomes. In accordance with
the theory of organizational change, the inputs mirror factors aligned with the
unfreezing phase; behaviors align with the changing phase, and intermediate
outcomes can be assimilated to refreezing as sustainable change. As such, the
Inputs are comprised of the main events intended to create awareness of the PYFP
and generate a sense of fulfillment and security in the changes it promotes for
teachers, students, and schools. Further, the Behavioral Outcomes are defined by
the participants' level of action (i.e. the percent of virtual courses completed
or the use of awards) based on Input factors. Finally, the Intermediate Outcomes
capture student progress that results from changes implemented by the completion
of the inputs and behavioral factors and indicate outcomes associated with
increased fitness (i.e., the percentage of students who are in the Healthy
Fitness Zone<sup>&#x000ae;</sup> (HFZ), which are criterion-referenced standards
of fitness that represent good health by age and gender). This basis of
organizational change, identifying Inputs to first prompt Behavioral Outcomes,
and then Intermediate Outcomes exemplifies the underlying assumption of the
PYFP. That is, teachers who gain an awareness of the need for enhanced physical
education through the PYFP and the received supports, such as PD or access to
resources, will be more likely to accurately administer the
FitnessGram<sup>&#x000ae;</sup> assessments and use these evaluations to
recognize their students and to drive their instructional practice. It is
hypothesized that the use of the PYFP is an effective strategy to increase
student fitness and reduce the risk for preventable disease as it provides the
viable resources of student exposure to health-centered curriculum and teacher
access to PD on effective, evidence-based instruction.</p><p id="P11">The study of fitness has an extensive history of change and progression,
such as the creation of youth-based fitness assessment, adoption of student
recognition, and ultimately the provisions for family inclusion (see <ext-link xlink:href="https://www.hhs.gov/fitness/about-pcsfn/our-history/i" ext-link-type="uri">https://www.hhs.gov/fitness/about-pcsfn/our-history/index.html</ext-link>).
However, rising rates of overweight and obesity, lack of physical activity, and
concerns over associated health risks warrant continued research and
investigation of viable fitness education interventions. Further, the need for
national surveillance has emerged, which begins with school-level implementation
of fitness assessment (<xref rid="R14" ref-type="bibr">Institute of Medicine of
the National Academies, 2012</xref>). Finally, because little is known about
the motivational aspects of increasing studen&#x00165;s health, further
investigation of the organizational effects of using student recognition is
necessary.</p></sec></sec><sec id="S8"><label>3.</label><title>Methods</title><p id="P12">Once IRB approval was secured, this study utilized qualitative methods, as a
means for evaluation of the PYFP across varied school contexts. There is a need for
physical education research to employ rigorous methods that can uncover complex
interactions among schools&#x02019; contextual variables and how they ultimately
influence school culture and readiness for change (<xref rid="R5" ref-type="bibr">Castelli, Carson, &#x00026; Kulinna, 2014</xref>). As such, the current study
employed an explanatory collective case study approach as a way to assess key
variables related to a school&#x02019;s feasibility to adopt and implement the PYFP.
Data collection transpired over one academic year.</p><sec id="S9"><label>3.1.</label><title>Participants</title><p id="P13">Through the PYFP funding opportunity, 374 schools received materials
including the FitnessGram<sup>&#x000ae;</sup> software, student recognition
items, <italic toggle="yes">Physical Best</italic> texts, and virtual training courses. A
physical education teacher at each school was required to complete all of the
offered training. Sixty percent of the schools were elementary, 35% secondary,
and 5% K-12 schools. Student enrollment ranged from 62 to 2900, with the number
of certified physical education teachers in each school's correspondingly
extending from one (n = 180) to 28 (n = 1). The number of minutes per week of
physical education ranged from one time per week for 25 min, at the elementary
level, up to 400 min per week with daily, blocked scheduled physical education
on the secondary level. Eighty-two percent of the schools reported the
administration of some form of student fitness assessment prior to this
investigation. Schools represented 48 states.</p></sec><sec id="S10"><label>3.2.</label><title>Data sources</title><p id="P14">The primary instruments used in this study included site visits and
interviews. Artifacts, including the PYFP funding application and the Fitness
Education Index, were also collected.</p><sec id="S11"><label>3.2.1.</label><title>Site visit instrument</title><p id="P15">A subsample of schools (N = 7) were selected for site visits to
observe and identify student, teacher, and school-level barriers and
facilitators of PYFP implementation. <italic toggle="yes">The CDC Program Evaluation Site
Visit Checklist</italic> was used to assess program impact,
innovativeness, feasibility of implementation and adoption, and
generalizability (<xref rid="R7" ref-type="bibr">Centers for Disease Control
&#x00026; Prevention, Program Performance &#x00026; Evaluation Office,
2017</xref>; <xref rid="R4" ref-type="bibr">Castelli, Cance et al.,
2014</xref>; <xref rid="R5" ref-type="bibr">Castelli, Carson et al.,
2014</xref>). Additionally, on-site interviews were conducted with
physical educators, administrators, and stakeholders to gain expansive
details regarding a school's history of involvement with PYFP as well as
personal experiences with its implementation. Artifacts specific to site
visits (i.e., lesson plans, student and parent handouts, pictures of
bulletin boards and facilities, etc.) were gathered, and SOPARC was used to
systematically observe and record the intensity and duration of
students&#x02019; physical activity (<xref rid="R18" ref-type="bibr">McKenzie, Cohen, Sehgal, Williamson, &#x00026; Golinelli, 2006</xref>). All
data were recorded, transcribed, and member checked and then reduced through
coding and compared with phone interview data.</p></sec><sec id="S12"><label>3.2.2.</label><title>Phone interviews</title><p id="P16">Semi-structured interviews were administered via the phone to gain
expansive details regarding a school's history of involvement with PYFP as
well as personal experiences with its implementation. An interview guide was
developed collaboratively across the research team to include questions that
provided further insight into processes of organizational change (inputs,
transformation, and outputs). Each interview lasted 20&#x02013;30 min and
consisted of 10 semi-structured questions such as &#x0201c;What facilitated
the implementation of the PYFP program in your school&#x0201d;
(transformation). All data were recorded, transcribed, and member checked
and then reduced through coding and compared with site visit data.</p></sec><sec id="S13"><label>3.2.3.</label><title>Artifacts</title><p id="P17">Two formal artifacts were intentionally collected and utilized to
conceptualize key inputs related to PYFP implementation, but additional
artifacts were also included and coded if offered by a teacher. The
<bold><italic toggle="yes">PYF Funding Application</italic></bold> was collected
from all participating schools. This online survey provided information on
institutionalized contextual factors including, school demographics,
physical education and fitness assessment practices, and opportunities for
physical education specific PD. Participating teachers also completed the
<bold><italic toggle="yes">Fitness Education Index</italic></bold>. This online
survey required teachers to self-assess their degree of implementation
(full, partial, under development, not in place) of specified criteria
(e.g., Teachers use student FitnessGram<sup>&#x000ae;</sup> scores to develop
lessons targeting student needs).</p></sec><sec id="S14"><label>3.2.4.</label><title>Data reduction &#x00026; analysis procedures</title><p id="P18">The study was conducted in two phases, as a means of appropriately
capturing rich contextual data in alignment with the sequencing of
programming delivery. First, the participant application and the Fitness
Education Index were collected online, followed by an interview and site
visit data. In phase one of the study, the research team focused on the
analysis of the school program and teacher demographic data obtained from
the PYFP funding applications. Through this review process, the research
team was able to determine &#x0201c;unmalleable&#x0201d; inputs (i.e., school
type, enrollment, teacher years of service, familiarity with PE assessment,
and past participation in PD). Participating teachers were also asked to
complete the Fitness Education Index to self-assess their current capacity
to implement the PYFP based on necessary inputs (i.e., access to facilities,
provision of resources, allocations for PA and PE minutes, administrative
support). Participant Fitness Education Index results and their
corresponding demographic and program data were used to assess the school's
readiness to implement the PYFP fully. This step involved identifying
behavioral outcomes by classifying school programs as full-, partial-, and
non-implementing. Broadly the classifications suggested that a
<italic toggle="yes">full-implementer</italic> completed their PD, administered the
FitnessGram<sup>&#x000ae;</sup> to all students in all grades (as
developmentally appropriate), and utilized awards to recognize student
fitness. A <italic toggle="yes">partial implementer</italic> was able to fulfill some of
the program requirements (i.e., PD) but was still working toward completion
of other elements (i.e., FitnessGram<sup>&#x000ae;</sup> assessments of
students). Generally a <italic toggle="yes">non-implementer</italic> was inhibited by a
contextual barrier (i.e., issues with the technology, a change in physical
education teachers at the school) and therefore failed to carry out all of
the steps involved in the implementation process.</p><p id="P19">In the third and final phase, the reduced and categorized artifacts
were used to select a subgroup of participants for site visits and
interviews. Twenty teachers participated in semi-structured formal
interviews used to gain further understanding of the role of PD, support,
and student recognition. Thirteen teachers completed phone interviews. The
remaining seven were selected for one-day site visits based on their school
classification of full, partial, or non-implementing. When visiting the
seven schools, all teachers at that site, even though they had not
previously been identified through the Fitness Education Index, typically
were involved in the one-day data collection. Interviews were transcribed
verbatim and coded. Patterns were placed on a matrix that included all data
to identify emergent themes (<xref rid="R21" ref-type="bibr">Webb &#x00026;
Glesne, 1992</xref>).</p><p id="P20">All data were stored in a password protected database and
deidentified by one delegated research assistant to ensure the integrity of
the data was maintained. To establish trustworthiness among these data
weekly research team debriefs, member checking (transcribed interviews were
provided to participants to confirm accuracy), and data audits were
conducted. Data sources were triangulated with coded patterns emerging as
themes (<xref rid="R21" ref-type="bibr">Webb &#x00026; Glesne, 1992</xref>).</p></sec></sec></sec><sec id="S15"><label>4.</label><title>Results</title><p id="P21">Results gathered from the baseline application, coupled with the Fitness
Education Index results were used to identify key contextual variables related to a
school&#x02019;s readiness to adopt and implement the PYFP. Specifically, the
baseline application data indicated that of the 353 selected schools, forty-four
percent (n = 156) of the participating schools had at least one policy in place at
the district level. Further, 64% (n = 226) of schools noted that there was a stated
requirement for the number of minutes of physical education, yet from those schools,
72% self-reported that they do not meet recommended guidelines for the number of
minutes of physical education each week (i.e., elementary = 135; secondary = 225).
Through the Fitness Education Index, teachers indicated that across influential
inputs, standards-based physical education curriculum (n =68 %), adequate facilities
(n = 59 % ), and assessment of the physical education standards (n = 57 %) were
commonly reported practices. The least occurring inputs were nutrition education (n
= 9%), classroom physical activity (n = 23 %), and family access to physical
activity facilities (n = 22 %). Despite the school-level awareness and written
intention to abide by policies about physical education (64%) and fitness education
(48%), adherence to these guidelines was a challenge. Informed by the results of the
merged inputs artifacts, transformational factors of PD, administrative support, and
student recognition emerged as essential action items or influencers of a
school&#x02019;s readiness to adopt and implement the PYFP. These results structured
and informed interview and site visit inquiries.</p><p id="P22">Phone interviews and site visits findings converged into three overarching
themes of (a) leveling of the playing field with academics, (b) strategically
overcoming barriers, and (c) recruiting teacher fitness champions. Through these
themes (as described in detail to follow), a more thorough understanding of pivotal
antecedents emerged (<xref rid="T1" ref-type="table">Table 1</xref>).</p><sec id="S16"><label>4.1.</label><title>Leveling of the playing field with academics</title><p id="P23">Teachers learn through the virtual PD and via the PYFP website that
student recognition is an essential piece to encouraging lifelong fitness among
students. Teacher interviews with fully implementing teachers brought to light
an unexpected finding. The use of the PYFP awards for student recognition
extended beyond the influence of individual student awareness to collectively
shape the perceptions of the school. As explained by teachers, including the
PYFP recognition component for student performance brought unexpected notoriety
and acceptance of physical education throughout the school.</p><p id="P24">One teacher said, &#x0201c;Our kids have an awards day at the end of the
year, and they and the teachers dress nice. Their parents show up. The teachers
get to stand up and call up their students to receive the awards&#x0201d;
(Teacher 12, site visit). This was the first time the subject matter of physical
education was acknowledged at the academic awards ceremony. Another teacher
commented about how she used the fitness assessment as an incentive and as a way
for students to set goals, &#x0201c;Of course the awards helped. They liked
getting those certificates. It gave them something to work for. They set goals.
So, that is how we trained in class, by the components we were taught in the
FitnessGram<sup>&#x000ae;</sup> training [virtual courses].&#x0201d; She added
later in the day, &#x0201c;Oh, it was so cool. The awards were on the web for
everyone to see. Just like the academic awards.&#x0201d; For the first time,
student performance within physical education was publicly acknowledged.
Finally, when another teacher was asked how they disseminate their PYFP awards,
they explained that they are given out in an assembly with all other academic
awards. One teacher commented that by giving awards for all scholastic
accomplishments, they intentionally set out to &#x0201c;show the balance and
equity in physical education awards to things like the math awards and most
improved student awards&#x0201d; and went on to state, &#x0201c;We try and put it
(PYFP) on an equal plane with other things we recognize kids for&#x0201d;
(Teacher 16, site visit).</p></sec><sec id="S17"><label>4.2.</label><title>Strategically overcoming barriers</title><p id="P25">As a component of the virtual PD, the Fitness Education Index prompted
teachers to reflect on their current pedagogical strategies as well as the
resources they utilized in conjunction with those strategies. Through this
reflection, it was identified that teachers increased their self-awareness of
best practices and therefore, it helped teachers identify ways to enhance their
current pedagogy by adopting those practices. Further, based on this newly
acquired knowledge, teachers set forth as advocates for resources (e.g.,
assistance with the imputation of student data) necessary to providing quality
fitness assessment and education in their schools. One identified barrier was
the lack of physical education, activity, and fitness.</p><p id="P26">The resources, such as Physical Best books and student awards were made
available through this funding opportunity. As stated in the Fitness Education
Index by one teacher, &#x0201c;Our district has no funding for PE PD, yet all of
our PE staff can participate in this training.&#x0201d; Further, teachers
reported that the virtual courses were &#x0201c;relevant PD for physical
education teachers&#x0201d; (Teacher 2, interview) and courses were
&#x0201c;user-friendly. I could go back and review and was able to start and
stop. Because my incorrect answers were shown, I was able to learn from
them&#x0201d; (Teacher 3, virtual course evaluations). Another teacher commented,
&#x0201c;I really liked them (the courses) because they got really into depth and
detail regarding the FitnessGram<sup>&#x000ae;</sup> testing&#x02026; I actually
learned more things within the courses&#x02026;I actually had clarification (on
assessment), and I really enjoyed the feedback at the end of the courses&#x0201d;
(Teacher 15, site visit). The virtual training and Physical Best resources
empowered teachers to request team time or release time from teaching
responsibilities so all of the physical education teachers could work together
to input data from the administration of the FitnessGram<sup>&#x000ae;</sup>
assessments, print FitnessGram<sup>&#x000ae;</sup> reports, or plan recognition
ceremonies.</p><p id="P27">Additionally, PD increased teacher buy-in through unfreezing the status
quo. As stated by one teacher in regards to the outcomes of receiving PD,
&#x0201c;I feel very comfortable delivering the PYFP content after all the
training from PYFP and the training I have gotten from my district&#x02026;it has
prepared me for testing the students&#x02026;and now as a department we all help
one another&#x02026;now if we see a fellow teacher not doing something correctly
we talk to them about it&#x02026;we want them on board so that we are all
conducting the assessments consistently&#x0201d; (Teacher 18, site visit). As
indicated by this teacher, PYFP and the PD it provided gave teachers the
efficacy to deliver quality fitness education within their own classroom, and
also ensure that their team of fellow PE teachers offer the same. One educator
noted another way in which PYFP facilitated change in the status quo, explaining
that the PD not only helped them discover the depth of their role, but it also
brought credibility school-wide. &#x0201c;We are not gym teachers, we are
physical educators, so there are elements of physical fitness, elements of
nutrition and health, there&#x02019;s an element of the team and an individual
sport, and they all fit together&#x02026;now I can tell a math teacher that
physical education is just as important&#x02026;this (PYFP) is about physical
education and how it is important&#x0201d; (Teacher 13, site visit).</p></sec><sec id="S18"><label>4.3.</label><title>Recruiting teacher fitness champions</title><p id="P28">All twenty teachers interviewed suggested they were willing and ready to
serve as champions to advocate for physical activity opportunities, more
physical education, and achievement of the fitness standards as a means of
minimizing health risk. One teacher stated that PYFP &#x0201c;gives me validity,
it is why we are here. We love team sports; we love the activity, but really our
purpose is this (PYFP).... it sets it up; tha&#x00165;s why i&#x00165;s (PYFP)
awesome&#x0201d; (Teacher 7, interview). As this teacher noted, the PYFP gave
teachers the opportunity to become fitness experts equipped with knowledge about
how to enhance curriculum beyond sports by incorporating fitness content and
assessment into daily lessons (Teacher 19, site visit).</p><p id="P29">Teachers were eager to recruit peers not only from physical education
but other disciplines to become involved. &#x0201c;The key is other specialist
teachers,&#x0201d; commented Teacher 6, during an interview, thus confirming that
art, music, and special education teachers may be most aware of the need for
physical activity in schools. Because physical education, art, music, theater,
and dance are often block scheduled in the same class period, which rotates
every 4&#x02013;6 weeks, if needed, additional time for physical education could
be secured by rearranging the schedule. One teacher explained that it&#x02019;s
about negotiations among specials teachers. &#x0201c;Specials will clump together
to help each other&#x02026;kids get pulled out all the time, sometimes (during
assessments) especially this week we (PE) will ask them (the kids) to go tell
the (music) teacher that we&#x02019;ll have you go first, and then we'll send you
to band&#x02026;so they miss a little music but its ok, because we negotiate so
its ok&#x0201d; (Teacher 16, site visit).</p><p id="P30">Classroom generalist teachers can also serve as facilitators of the
PYFP. Teacher 5 stated, &#x0201c;all teachers need this kind of PD, not just PE
teachers.&#x0201d; Utilizing general classroom teachers and other school
specialists as resources is a strategic way to develop a health-related fitness
culture that begins with physical education but then supported and strengthened
by the whole school community.</p></sec></sec><sec id="S19"><label>5.</label><title>Conclusions</title><p id="P31">In summary, this study facilitated investigation into the efficacy of the
PYFP as a source of organizational change. The process evaluation team first
identified key contextual variables through artifact analysis that are essential to
the adoption and implementation of the PYFP. Guided by the process of inquiry, the
process evaluation team then identified emergent themes that provided a broader
understanding of how these variables facilitated and/or hindered the PYFP
adoption.</p><p id="P32">As recommended by the IOM, school-based PD is a feasible way to help
teachers integrate fitness testing and recognition into the curriculum (<xref rid="R14" ref-type="bibr">Institute of Medicine of the National Academies,
2012</xref>). In this present study, data indicated content-based PD matters,
and without it, schools are not primed to initiate programmatic and organizational
change. As one teacher highlighted, the PYFP virtual PD is ideal because it provides
teachers who lack funding resources an opportunity to enhance their knowledge about
fitness - it was not just another unfunded mandate. Further, because the content is
provided in an online format, there is an opportunity for teachers to note personal
progress, revisit the material, and gain knowledge at their pace. In the current
economic climate where school and district funding is minimal, virtual PD may be a
prime opportunity to provide teachers with continual access to the educational
resources they need.</p><p id="P33">It is important to note that only schools identified as full and partial
implementers were able to provide evidence that they used the knowledge obtained
from the virtual PD to enhance communications with parents and to increase parental
involvement and interest in the topic. There were only two confirmed instances where
teachers used the results of the fitness assessment to modify their lessons, change
the physical education curriculum, or restructure their physical education schedule.
Teacher 10, site visit interview, &#x0201c;It [the PYFP] caused me to change this
year. Three days per week, I do physical education content, and one day per week I
do health and physical activity that goes along with the coordinated school health
[as part of a Comprehensive School Physical Activity Program]. On the fifth day in
the classroom, I have incorporated a [health-related] fitness day.&#x0201d; Based on
this awareness, further consideration for ways to provide support for teachers as
they translate content knowledge gained online into practice may be warranted.</p><p id="P34">As stated, physical education teachers are committed to being physical
fitness leaders. Yet to create cultural change at the school level, further support
among administration, faculty, and community is needed (<xref rid="R22" ref-type="bibr">Weber, 1964</xref>). Teachers identified as full and partial
implementers shared a common component of a supportive administration. Support from
administration translated into the allocation of resources and more importantly, the
shared value that fitness education as an essential component of a thriving
curriculum. Conversely, non-implementers identified the lack of administrative
support, including crucial resources and time to engage in PD opportunities. These
results parallel the idea that without a shared mission and vision, a school cannot
overcome barriers that get in the way of instituting change. In addition to support
on an individual basis, the collective perception of support throughout a school is
vital to the change process. One future direction for the PYFP might include
training for school administrators and decision-makers.</p><p id="P35">Finally, data interpretation and follow-up analysis did not reveal that
student recognition directly contributed to school-level change, despite the
teachers highlighting its importance in creating a healthy school climate. Physical
education teachers noted a shift in school climate after the dissemination of the
PYFP awards. Specifically, they observed how recognition ignited a newfound
appreciation and awareness among classroom teachers, parents, and students of the
role physical education has in the school community. Although participants in the
current study are provided student recognition, certificates are available online at
a minimal cost. Therefore, the inclusion of fitness-based awards may be a viable and
cost-effective way for all schools regardless of financial limitations to make small
strides towards creating a school culture that values physical activity and
fitness.</p><sec id="S20"><label>5.1.</label><title>Lessons learned</title><p id="P36">This study provided insight into the efficacy of PYFP implementation
uncovering the vital role of school and teacher readiness to unfreeze the status
quo as it relates to transformation and moving toward a shared culture of
health. Without school and teacher level readiness to promote and recognize
student fitness, organizational change within schools cannot occur. This may
present far reaching implications given the introduction of accountability
standards in Canada and the UK in 1997 as well as nationally driven school
reform initiatives as of 2001 such as the <italic toggle="yes">No Child Left Behind and Race
to the Top</italic> that have placed school leaders, administrators and
teachers under pressure to significantly improve student academic achivement
(<xref rid="R10" ref-type="bibr">Darby, 2008</xref>). Given that these
initiatives have prioritized core curriculum, reform efforts have given little
consideration for how we maximize physical and health education, despite the
known importance of health regarding a student&#x02019;s readiness to learn
(<xref rid="R2" ref-type="bibr">Basch, 2011</xref>). Taken collectively, the
lesson we can take from the findings presented in this study coupled with the
known challenges of academically driven reform initiatives, is that we may need
to reconceptualize what effective school reform looks like, and as we do so, we
need to include teachers in the process so that they are active players in the
transformation. This is especially relevant for physical educators as reform
efforts to date have lacked consideration for physical education. Physical
educators must be willing to advocate for their inclusion in the process,
navigating their way among the existing tensions between core and specials
content, and perhaps the only way to facilitate this is by evaluating factors
related to quality programming.</p><p id="P37">Another important lesson learned from the current study is that
evaluation has the capacity to shed light on the disparate funding within the
school setting. Our findings support literature suggesting a lack of funding
globally for physical education (<xref rid="R12" ref-type="bibr">Hardman,
2008</xref>) despite its potential to create a more holistic school culture
(<xref rid="R20" ref-type="bibr">Storey et al., 2016</xref>). However, we
also learned that programs such as PYFP are a feasible and cost-effective way
for schools to invest in physical education programming, providing virtual PD
and curriculum resources for teachers as well as student recognition through
awards. This small investment in physical education may reap high rewards given
that the PYFP holds the potential to deliver quality programming that is not
only accepted in the gym but also across the larger school community (<xref rid="R16" ref-type="bibr">Lawson, 2005</xref>).</p><p id="P38">Perhaps the greatest lesson learned from the current study is that
evaluation should not be siloed. The work of the current study evaluated the
capcity of PYFP to prompt organizational change utilizing qualitative methods to
understand the contextual factors influencing PYFP implementation and its impact
on the school culture. In doing so, we learned that evaluation approaches must
be comprehensive. That is, it is not enough to evaluate one aspect of school
curriculum or culture. Future evaluations need to explore the synergy between
all inputs and consider how their interactions may prompt organizational change
in schools. This is important because comprehensive evaluation approaches may
provide a better understanding of how programming beyond core content such as
physical education contributes to overall student performance. In an era where
reform initaitives are academically driven, evidencing the intersections between
core and specials curriculum may facilitate a reprioritization of physical
education and programs such as the PYFP.</p></sec><sec id="S21"><label>5.2.</label><title>Significance</title><p id="P39">By definition evaluation typically seeks to &#x0201c;form an idea of the
amount, number, or value of&#x0201d; (<xref rid="R23" ref-type="bibr">Webster,
1999</xref>). That is, evaluation typically seeks to quantitatively measure
stregnths and weaknesses of a given phenomenon. That stated, perhaps one of the
most significant strengths of this study is that we sought to go beyond
surveillance and quantification of program adoption and implementation. Instead,
we prioritized the teacher voice seeking to better understand through the
school-based experiences how the PYFP was being implemented and what that meant
to physical educators, students and the larger school community.</p><p id="P40">Our investigation into the antecedents of organizational change also
shed light on current practice and the triumphs and trials related to refocusing
physical education and other programs to be more health-related within the
school context. As determined by these findings, there were some valuable
outcomes from the provision of PD and other resources (i.e., student awards,
FitnessGram<sup>&#x000ae;</sup>). The affect of student recognition was
far-reaching. Expectedly, some schools continue to struggle to change as a lack
of technological and administrative support inhibited progress. Additionally, we
are still working to identify those things that must be considered before
administering a school-based fitness assessment, so that it will foster desired
outcomes among the school community. Furthermore, the PYFP resources and one
academic year were not enough to overcome local and state barriers. Perhaps in
the second year of the implementation process, the present supports will evolve
and facilitate more considerable change, thereby evidencing the full potential
of the PYFP.</p><p id="P41">Identification of the antecedents of organizational change should permit
educators and scholars alike to target schools and teachers who exhibit the
highest readiness for a structural and personal modification that focus on
student health as a valued learning outcome.</p></sec></sec></body><back><ack id="S22"><title>Acknowledgements</title><p id="P42">This research and the larger program evaluation could not have occurred
without the participating sponsors and program partners of Human Kinetics, The
Cooper Institute, SHAPE America (formerly called the American Alliance for Health,
Physical Education, Recreation, and Dance; AAHPERD), the UT Austin student
researchers, and the school representatives who facilitated data collection and the
implementation of the Presidential Youth Fitness Program. The research team would
also like to thank all of the teachers and school administrators who agreed to share
their educational experiences with us.</p><sec id="S23"><title>Funding source</title><p id="P43">This work was supported by a grant from the General Mills Foundation,
which was facilitated by the Centers for Disease Control and Prevention and
health specialist Seraphine Pitt Barnes, PhD, MPH, CHES in the Division of
Population Research.</p></sec></ack><fn-group><fn fn-type="COI-statement" id="FN2"><p id="P49">Declaration of Competing Interest</p><p id="P50">The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence the
work reported in this paper.</p></fn></fn-group><bio id="d64e427"><p id="P44"><bold>Jeanne M. Barcelona</bold> is an assistant professor at Wayne State
University. Dr. Barcelona's research evaluates the efficacy of comprehensive school
health approaches.</p></bio><bio id="d64e431"><p id="P45"><bold>Darla M. Castelli</bold> is a professor at The University of Texas at
Austin. She has spent her career researching the relationship between fitness and
cognitive performance in youth.</p></bio><bio id="d64e435"><p id="P46"><bold>Jessica Duncan Cance</bold> holds dual positions serving as a
professor at The University of Texas at Austin and as a Research Public Health
Analyst at RTI International.</p></bio><bio id="d64e439"><p id="P47"><bold>Seraphine Pitt Barnes</bold> is a General Health Scientist at the
Centers for Disease Control and Prevention where she examine school health policy
and practice.</p></bio><bio id="d64e443"><p id="P48"><bold>Sarah Lee</bold> is a team lead at the Centers for Disease Control and
Prevention researching outcomes of comprehensive school physical activity
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Mifflin</publisher-name>.</mixed-citation></ref></ref-list></back><floats-group><fig position="float" id="F1"><label>Fig. 1.</label><caption><p id="P51">Systems Model of Organizational Development. Note: <xref rid="R17" ref-type="bibr">Lewin (1947)</xref> Stage Model of Organizational
Change.</p></caption><graphic xlink:href="nihms-1923525-f0001" position="float"/></fig><fig position="float" id="F2"><label>Fig. 2.</label><caption><p id="P52">PYFP Evaluation Logic Model.</p></caption><graphic xlink:href="nihms-1923525-f0002" position="float"/></fig><table-wrap position="float" id="T1"><label>Table 1</label><caption><p id="P53">Antecedents to Organizational Change.</p></caption><table frame="hsides" rules="groups"><colgroup span="1"><col align="left" valign="middle" span="1"/><col align="left" valign="middle" span="1"/><col align="left" valign="middle" span="1"/></colgroup><thead><tr><th align="left" valign="top" rowspan="1" colspan="1">Unfreezing</th><th align="left" valign="top" rowspan="1" colspan="1">Changing</th><th align="left" valign="top" rowspan="1" colspan="1">Refreezing</th></tr></thead><tbody><tr><td align="left" valign="top" rowspan="1" colspan="1">Professional Development</td><td align="left" valign="top" rowspan="1" colspan="1">Use of Awards and Recognition</td><td align="left" valign="top" rowspan="1" colspan="1">Utilization of FITNESSGRAM<sup>&#x000ae;</sup>
data to drive curriculum change</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">District Level Policy for Fitness and PA</td><td align="left" valign="top" rowspan="1" colspan="1">Self-awareness of current pedagogical
practices</td><td align="left" valign="top" rowspan="1" colspan="1">Obtaining Teacher Fitness Champions</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Allocation for PA &#x00026; PE minutes</td><td align="left" valign="top" rowspan="1" colspan="1">Self-reflection on movement toward best
pedagogical practice</td><td align="left" valign="top" rowspan="1" colspan="1">Engagement of School Community</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Adherence to PA &#x00026; PE minutes</td><td align="left" valign="top" rowspan="1" colspan="1">Utilizing Resources</td><td align="left" valign="top" rowspan="1" colspan="1">Student obtainment of Healthy Fitness
Zone</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Standards-based PE curriculum</td><td align="left" valign="top" rowspan="1" colspan="1">Scheduling common planning time</td><td align="left" valign="top" rowspan="1" colspan="1"/></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Facilities</td><td align="left" valign="top" rowspan="1" colspan="1">FITNESSGRAM<sup>&#x000ae;</sup> Assessment</td><td align="left" valign="top" rowspan="1" colspan="1"/></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Assessment of PE Standards</td><td align="left" valign="top" rowspan="1" colspan="1">FITNESSGRAM<sup>&#x000ae;</sup> Reporting</td><td align="left" valign="top" rowspan="1" colspan="1"/></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Nutrition Education</td><td align="left" valign="top" rowspan="1" colspan="1">Adding Nutrition Education &#x00026; PA
Tracking</td><td align="left" valign="top" rowspan="1" colspan="1">Continued use of physical activity tracking
within the curriculum</td></tr><tr><td align="left" valign="top" rowspan="1" colspan="1">Classroom Physical Activity Family Access to
Facilities</td><td align="left" valign="top" rowspan="1" colspan="1"/><td align="left" valign="top" rowspan="1" colspan="1"/></tr></tbody></table></table-wrap></floats-group></article>