A before-school physical activity initiative started by a group of moms is an effective path to helping kids lose weight, according to a study by researchers from Massachusetts General Hospital for Children and Harvard Medical School.
The K-8 BOKS program, which has spread to 2,700 schools in four countries and attracted sponsorship from sneaker giant Reebok, requires little from school districts by way of staff and equipment, relying on volunteer leaders and emphasizing simple, accessible activities.
Rachel Whooten, a postdoctoral fellow in pediatric endocrinology, worked on the study with Professor of Pediatrics Elsie Taveras, project manager Meghan Perkins, and analyst Monica Gerber. We asked Whooten about the findings.
GAZETTE: What’s the state of exercise in schools today? Are kids getting the recommended amount through gym class?
WHOOTEN: When kids are being active, most of it is happening in the schools. But the unfortunate thing is the time that kids are actually being active in schools is not enough.
The official recommendation is for 60 minutes a day of physical activity, and only about 50 percent of kids have physical education offered even weekly. There are opportunities for recess in some schools, but the majority of kids aren’t getting enough physical activity. A lot of that is due to an increasing emphasis on academics, and also the reality that it’s difficult to find the resources to support physical activity in schools.
GAZETTE: Your study examined an exercise program called Build Our Kids’ Success. Could you describe it?
WHOOTEN: It’s a program based on the idea of fitting physical activity in before school. It was started by a group of moms outside of Boston who realized, as they were waiting for the bus with their kids, the kids just naturally wanted to run around.
So the moms started a physical activity program for their kids and were able to turn that into a much broader movement, which is now BOKS. It has been catching on in schools throughout Massachusetts as well as throughout the country and internationally. Basically, kids come before school and are led by a group of volunteers — who can be parents, or teachers, or nurses, and who attend a short training and then have resources for a curriculum available online. Kids are active for about an hour.
GAZETTE: What did you do and what did you find?
WHOOTEN: Three communities outside Boston had independently decided to start the BOKS program and chose whether to do it two days a week or three days a week, based on the resources in their schools. We compared kids who were in the two-days-a-week program, the three-days-a-week program, and those who did not participate.
One key thing to know is that it was not a randomized controlled trial. In partnership with the schools, any kid who wanted to participate in the BOKS program was able to participate in the BOKS program. So there is potential that there are differences between the kids who chose to participate and those who chose to not participate. That’s a limitation of the research.
There was a pretty large sample size — we had about 700 kids from kindergarten to eighth grade who were participating in the study. The BOKS program occurs over 12 weeks, so we had baseline and 12-week follow-up measures of height and weight. All kids over 8 years of age completed surveys on social and emotional functioning. The surveys [measured] how engaged they are in the school, positive feelings, how much energy they have, how relationships with friends are going, and their life satisfaction.
We found a favorable change in the body mass index in kids participating in the program three days a week compared to those who weren’t participating at all. We also found different results between the two-days and three-days-a-week groups for social-emotional wellness outcomes. The two-days-a-week group had improvements in positive feelings and vitality/energy, while the three-days-a-week group had improvements in student engagement.