Effects of Four-Day School Weeks on Physical Education Exposure and Childhood Obesity

in Journal of Physical Activity and Health

Background: Use of 4-day school weeks (FDSWs) as a cost-saving strategy has increased substantially as many US school districts face funding declines. However, the impacts of FDSWs on physical activity exposure and related outcomes are unknown. This study examined physical education (PE) exposure and childhood obesity prevalence in 4- versus 5-day Oregon schools; the authors hypothesized lower PE exposure and higher obesity in FDSW schools, given reduced school environment exposure. Methods: The authors utilized existing data from Oregon to compare 4- versus 5-day models: t tests compared mean school-level factors (PE exposure, time in school, enrollment, and demographics) and complex samples weighted t tests compared mean child-level obesity data for a state representative sample of first to third graders (N = 4625). Results: Enrollment, time in school, and student–teacher ratio were significantly lower in FDSW schools. FDSW schools provided significantly more PE, both in minutes (120 vs 101 min/wk in 4- vs 5-d schools, P < .01) and relative to total time in school (6.9% vs 5.0%, P < .0001). Obesity prevalence did not differ significantly between school models. Conclusion: Greater PE exposure in FDSW schools was observed, and it remains unknown whether differences in PE exposure contributed to obesity prevalence in this sample of students. Efforts to better understand how FDSWs impact physical activity, obesity risk, and related factors are needed.

Schools are critical venues to support child health and well-being.13 School-based physical activity is one mechanism that may influence these outcomes, but substantial declines in education funding in the United States have forced many school districts to consider cost-cutting measures that may impact physical activity exposure and related outcomes.4 For example, many schools are seeing substantial cuts to physical education (PE) programs (ie, removing the PE specialist position) to account for budget shortfalls.57 Four-day school weeks (FDSWs) have been increasingly adopted as a cost-saving measure that eliminates 1 day per week while lengthening the 4 remaining school days. During the 2018–2019 school year, more than 1500 schools in 24 states reported operating FDSWs.8 Across the United States, the majority (90%) of FDSWs are operated by school districts in rural areas where significant disparities in obesity and other health outcomes have been documented.9

FDSWs may produce minimal cost savings (0.4%–5.4%)10 that are comparable to those of other cost-savings approaches, such as increasing class size11 or year-round schooling.12 Findings relating to effects of many cost-savings approaches, including FDSWs, show predominately detrimental impacts on student achievement.8 However, FDSWs may have negative repercussions on other child and family outcomes that are not likely to occur as a result of the other cost-saving measures. For example, a study in Colorado found an increase in juvenile crime after switching to a FDSW,13 perhaps due to an increase in unstructured time, whereas another study suggested FDSWs are associated with decreased maternal labor participation,14 which could impact household finances. Schools also provide daily meals and exposure to physical activity, which reduce risks for food insecurity and obesity and promote socioemotional well-being and academic success.1518 Policies like FDSWs that reduce exposure to this critical setting, therefore, may have negative implications for children and families and may exacerbate existing health and achievement disparities for rural children.

Mounting evidence suggests that children gain weight more rapidly over the summer19; other studies have shown declines in healthy behaviors (eg, sleep, physical activity) during nonschool versus school time.2023 It has been hypothesized that the loss of access to the structured school environment that occurs over the summer promotes obesogenic behaviors,24 but no data exist on whether repeated exposure to 3 consecutive days away from school during the school year via FDSWs has similar effects. Children accumulate at least 70% of their daily moderate to vigorous physical activity during the school day, the majority of which comes during PE.25,26 As such, PE exposure may contribute significantly to overall activity levels and consequent health outcomes for children.

This study aimed to compare PE exposure and child obesity along with other school-level factors (eg, enrollment, instructional minutes, demographics) between 4- and 5-day schools in Oregon, which is among the states with the most FDSW districts.8 We hypothesized that obesity would be higher and PE exposure would be lower in 4- compared with 5-day schools, given the reduced exposure to the school environment.

Methods

Design

We linked our previously created FDSW database to existing data sets on school-level factors and child-level obesity to examine differences in these factors between 4- and 5-day schools in Oregon. To create the FDSW database, we utilized Oregon Department of Education data on days in session, supplemented with school district website review and e-mail/phone correspondence to confirm present and historical school schedules and to determine school day start and end times to calculate time in school. With this information, we created a unique longitudinal FDSW database (1999–2019). As this database was initially prepared to examine cost savings associated with this model, 1999 was chosen to correspond to the year that extensive school financial data were available nationally. Data for schools that adopted an FDSW as of 1999 (29.8% of the state total) were still included in the database for this date range.

School-Level Variables

We linked this FDSW database with school-level National Center for Education Statistics data, including total enrollment, student-teacher ratios, student demographics, free- and reduced-lunch (FRL) eligibility, and urbanicity. Historical data on actual minutes of PE offered by each school were obtained from the Oregon Department of Education. Both of these school-level data sets included data for all Oregon schools across 2 time points: the 2011–2012 (n = 1296 schools) and 2017–2018 (n = 1243 schools) school years.

Child-Level Obesity

Our FDSW database was linked to the Smile and Healthy Growth Survey. This ongoing survey is conducted every 5 years and reports on obesity prevalence of a state-representative sample of Oregon first to third graders (n = 4625 in the 2012 survey). Oregon Health Authority (OHA) conducted the linkage between our FDSW database and their survey to preserve the anonymity of participant schools and provided an indicator of FDSW status based on the number of school days in session for each observation. For the 2012 Smile and Healthy Growth Survey, height and weight were collected by trained study personnel and converted to body mass index (BMI) percentiles and z scores using age- and sex-specific criteria.27 The 2012 Smile and Healthy Growth Survey contains a proportion of FDSW schools that approximates the state proportion (note: the 2017 data have not yet been released). Schools were eligible to participate if at least 15 children attended third grade during the previous year. Eligible schools were stratified by Oregon Public Health Division planning regions and, then, ordered by rates of FRL eligibility. From this ordered list, a probability sample of 82 schools was selected. Due to the confidential nature of the survey, the length of time each school had employed a FDSW is not definitively known. However, our comprehensive FDSW database indicates ∼90% of schools had been utilizing an FDSW for ≥3 years in 2012. Given the random sampling strategy employed by OHA to conduct the Smile and Healthy Growth Survey, it seems likely that most schools would have been utilizing this schedule for several years before BMI data were collected.

The total analytic sample included 76 schools (8 FDSW schools) after accounting for missing data corresponding to (1) session days needed to ascertain FDSW status (1 school) and (2) FRL status (5 schools). Sample weights were used to produce population estimates based on selection probabilities. In this representative sample of Oregon first to third grade children, 68% were classified as normal weight, 15% as overweight, 15% as obese, and 2% as underweight, with significantly higher obesity rates for children who were older, low income, or Hispanic.28

Analysis

For this study, 2011–2012 and 2017–2018 school-level data were used: 2011–2012 aligns with the most currently available Smile and Healthy Growth Survey, and 2017–2018 represents the most currently available school-level data. For school-level data, we conducted t tests to compare mean demographic and time in school factors across 4- and 5-day schools; we also conducted these comparisons restricting the sample to only rural schools. For the obesity data, we conducted sample weighted t tests clustered at the school-level to compare mean BMI z scores and percentiles across 4- and 5-day schools. To examine heterogeneous impacts across vulnerable populations, we interacted the type of school schedule with an indicator for whether children were FRL eligible. Analyses were conducted using R (version 3.2.2; R Foundation for Statistical Computing, Vienna, Austria) and STATA (version 15; StataCorp LLC, College Station, TX, USA) with significance set at P < .05.

Results

School-Level Variables

All school-level variables by school schedule (4- vs 5-d wk) are shown in Table 1. FDSW use increased in Oregon from 8.8% of schools in 2011–2012 to 12.2% in 2017–2018. Compared with 5-day schools, a significantly higher proportion of FDSW schools were in rural areas (P < .0001 at both time points). Enrollment and time in school were significantly lower in 4- compared with 5-day schools at both time points (P < .0001) and remained significantly lower when only rural schools were considered. The student–teacher ratio was also significantly lower at both time points in 4- compared with 5-day schools overall and in rural schools only, perhaps due to the lower enrollments. FDSW schools had a significantly greater proportion of white students across all schools and in rural schools only. Significantly more children were FRL eligible in 4- compared with 5-day schools, although this difference was not present when only rural schools were compared.

Table 1

School-Level Variables Compared Between 4- and 5-Day Schools for All Oregon Schools in 2011–2012 (n = 1296) and 2017–2018 (n = 1243) and Rural Oregon Schools Only in 2011–2012 (n = 387) and 2017–2018 (n = 338)

All schools, 2011–2012All schools, 2017–2018
VariableFour-day schools (n = 105)Five-day schools (n = 1191)P valueFour-day schools (n = 135)Five-day schools (n = 1108)P value
Enrollment166 (112)450 (371)<.0001223 (338)488 (377)<.0001
Student–teacher ratio14.4 (4.6)20.8 (7.4)<.000115.7 (5.5)19.8 (5.7)<.0001
%Female48%48%.348%48%.2
%White84%68%<.000180%65%<.0001
%FRL54%50%.259%53%<.01
Time in school, min/wk1808 (67)1952 (102)<.00011799 (72)1951 (97)<.0001
Time in PE, min/wk110.4 (64.2)84.8 (64.9)<.001120.2 (63.2)101.4 (62.2)<.01
PE/time in school6.2%4.3%<.00016.9%5.0%<.0001
%Rural73%25%<.000174%20%<.0001
Rural schools only, 2011–2012Rural schools only, 2017–2018
VariableFour-day schools (n = 81)Five-day schools (n = 306)P valueFour-day schools (n = 100)Five-day schools (n = 238)P value
Enrollment139 (101)285 (286)<.0001194 (381)270 (203).02
Student–teacher ratio13.5 (4.8)19.5 (7.1)<.000115.0 (5.9)18.1 (5.7)<.0001
%Female48%48%.948%47%.6
%White87%76%<.000184%76%<.001
%FRL eligible50%50%.858%54%.2
Time in school, min/wk1808 (114)1986 (104)<.00011806 (70)2006 (97)<.0001
Time in PE, min/wk113.5 (62.0)90.7 (65.9).02116.6 (58.2)116.3 (62.3).9
PE/time in school6.5%4.6%<.00016.9%5.6%<.01

Abbreviations: FRL, free- and reduced-lunch eligibility (National School Lunch Program); PE, physical education.

Physical Education

At both time points, FDSW schools spent a significantly greater amount of time administering PE both as an absolute measure (120 vs 101 min/wk in 4- vs 5-d schools in 2017–2018, P < .01) and relative to total time in school (6.9% vs 5.0% in 4- vs 5-d schools in 2017–2018, P < .0001). When only rural schools were included, the PE/time in school ratio remained significantly increased in 4- versus 5-day schools at both time points (P < .01).

Obesity

No significant differences in obesity prevalence were observed between children attending 4- versus 5-day schools (BMI z scores of 0.536 vs 0.548 for 4- vs 5-d schools, respectively; Table 2). BMI z scores were significantly higher for FRL-eligible children compared with noneligible children in 5-day schools (P < .001) and were significantly higher for noneligible children in 4-day schools compared with noneligible children in 5-day schools (P = .024).

Table 2

Child-Level Obesity Compared Between 4- and 5-Day Schools and by FRL Status

VariableFour-day schools (n = 334)Five-day schools (n = 4291)P value
BMI z score0.536 (0.052)0.548 (0.030).85
BMI percentile65.8 (1.6)64.9 (0.7).62
 FRL = yesFRL = noFRL = yesFRL = no 
BMI z scorea0.459 (0.103)0.601 (0.082)0.720 (0.028)0.344 (0.033) 
BMI percentileb64.2 (2.6)67.2 (2.7)69.3 (0.6)59.8 (0.8) 

Abbreviations: BMI, body mass index; FLR, free- and reduced-lunch eligibility (National School Lunch Program).

aInteraction terms were significant for FRL = yes versus FRL = no in 5-day schools only (P < .0001) and for FRL = no versus FRL = no in 4- versus 5-day schools (P = .024). bInteraction terms were significant for FRL = yes versus FRL = no in 5-day schools only (P < .0001) and for FRL = no versus FRL = no in 4- versus 5-day schools (P = .052).

Discussion

Our finding of higher PE exposure in FDSW schools compared with traditional 5-day school models was surprising, given the lower amount of time in school offered in FDSW schools. Moreover, our hypothesis that obesity would be higher in FDSW schools was not supported. Of note, FDSW schools are predominately located in rural areas where rates of poverty, household food insecurity, and obesity are known to be higher compared with urban areas.9,29 For this reason, our school-level analyses compared all 4- versus 5-day schools and, then, in rural areas only to account for this important factor.

In a previous study of 6 rural Oregon elementary schools, we reported moderate to vigorous physical activity at school was associated with lower BMI and that children accumulated less than one-third of the daily recommendation for moderate to vigorous activity during the school day.30 The highest proportion of moderate to vigorous activity occurred during PE; other studies have shown PE to be a major contributor to moderate to vigorous activity during school, along with recess.3133 Moreover, rural families in this study experiencing food insecurity reported low readiness to provide their children with physical activity outside of the school setting34; this finding suggests an underlying resource deficit may impact the ability of families to participate in extracurricular physical activity programs, perhaps due to costs related to transportation or registration fees. As such, school day PE and physical activity are critical for children from low-income families living in rural areas. Beck et al20 demonstrated that children spend significantly more time in sedentary behavior outside of school compared with in school, suggesting that repeated exposure to 3 consecutive nonschool days with the FDSW model could impact child BMI trajectory overtime.

We report high levels of obesity (15%) and overweight (15%) for this state representative sample of early elementary students. National Health and Nutrition Examination Survey (NHANES) data suggest slightly higher obesity rates of 18.4% among children 6–11 years nationally, although a larger age range was included.35 Moreover, 58% of Oregon children in FDSW schools were FRL eligible in 2017–2018, meaning a majority of children in FDSW schools saw a 20% reduction in National School Lunch Program-provided meals relative to eligible children in 5-day schools. It is unknown how a reduction in school meal service via FDSW would impact child diet or household food security as families may need to allocate household budgets to pay for food on the fifth day (ie, the nonschool weekday). The FDSW model also may require parents to seek childcare or reduce their work commitments on the fifth day,14 creating even greater financial strain for families.

Several factors may explain the lack of a significant difference in obesity between FDSW and non-FDSW schools reported here. First, the effects of FDSWs on obesity may not emerge until later childhood after longer exposure to this school schedule. In addition, the lack of difference may be related to the notable differences in school-level factors across 4- and 5-day schools (ie, enrollment, student–teacher ratio, rural locale) and to other variables not included in this analysis, particularly as we were not able to restrict the obesity analysis to rural schools only due to restrictions on use of the survey data. Finally, the higher PE exposure observed may not be leading to higher amounts of physical activity. However, no longitudinal data exist on obesity, physical activity, or other health behaviors related to use of FDSWs to test this hypothesis.

Limitations

Restrictions on Smile and Healthy Growth data set use prohibited us from (1) linking the child-level obesity data to any school-level variables or (2) restricting the data set in other ways (eg, rural or FDSW districts only) to test the sensitivity of the obesity results to different control groups. Therefore, we were unable to determine whether minutes of PE are related to obesity, specifically whether higher amounts of PE offset any potential risk associated with reductions in school exposure. Moreover, the length of exposure to the FDSW model also is unknown. Finally, many other factors related to obesity risk, including diet and other physical activity exposures, were not examined here. However, this study was strengthened by the use of the only state-representative obesity data for Oregon elementary-age children.

Significance

Use of FDSWs has expanded rapidly in the United States over the last 20 years despite very little evidence regarding impacts of this model on child health. We demonstrated significant differences in school-level variables between 4- and 5-day schools in Oregon, including higher PE exposure in FDSW schools, but did not observe differences in childhood obesity between school models. Of note, Oregon legislators recently amended the rules of a 2017 law that guides PE requirements to include a 20% reduction in PE minutes required for FDSW schools (79th Oregon Legislative Assembly. Senate Bill 4, Salem, OR; 2017). Our study provides a baseline against which to assess the impacts of this recent rule change.

Our previous pilot data suggest potential cost savings are the primary motivation for the majority of US districts that switch to FDSWs.8 To date, there have been 2 metrics predominantly used to weigh the impacts of adopting an FDSW: cost effectiveness and academic achievement. As more schools face increasing financial strain, data from this study on potential health impacts associated with FDSW will inform use of this model compared with other cost-saving strategies, such as increasing class size. Future research examining longitudinal impacts of exposure to this model on more comprehensive outcomes, including obesity, diet, total physical activity, sleep, student academic performance, household routines, food security, community supports, and other critical factors is needed.

Acknowledgments

The authors gratefully acknowledge John Putz, Kelly Hansen, and other members of the Public Health Division, Maternal and Child Health of the OHA for their partnership. The authors declare there are no conflicts of interest. This research received no specific grant from any funding agency.

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Tomayko is with the Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA. Gunter and Schuna are with the Kinesiology Program, School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA. Thompson is with the Economics Program, School of Public Policy, College of Liberal Arts, Oregon State University, Corvallis, OR, USA.

Tomayko (emilytomayko@montana.edu) is corresponding author.
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