We searched state- and nation-wide for 5 years, reviewing hundreds of programs & studies. We were committed to finding the most effective, scalable, & affordable programs to increase activity & improve nutrition. These programs needed to be able to prove with compelling evidence that they worked—and with a high enough ROI to become self-funding (per our SEAS Systems Change paradigm).

Two major, nationally significant, K-12 breakthroughs, developed in Arizona, provided clear evidence for this. These outstanding programs slashed the growth of child obesity and increase the % of fit K-12 students up to 4x—saving hundreds of dollars per child…and tens of thousands of dollars per adult later in life.

Partners for Healthy Promises

The Partners for Healthy Promises (PHP) project was led by Principal Investigator, University of Arizona Associate Research Scientist, Jennifer Reeves. The $1.8M federal-grant-funded PHP project ran for 3 years from 2012-2015, eventually reaching 20 K-12 Title 1 schools with total enrollment at the time of about 16,000 students, in the Sunnyside Unified School District (SUSD) in southern Tucson. SUSD has a very low income student body, with a Free and Reduced Lunch (FRL) population in the 63-94% range. Student body demographic data were approximately 90% Hispanic, 5% Native-American, 3% White, and 2% African-American.


Yet the percentage of students with cardiovascular aerobic fitness in the “Healthy Fitness Zone” (HFZ) increased 4x from the baseline in 2012 to 2015, improving from 18% to 78% of all students. There was also >6x increase in % of students with healthier nutrition habits, with 11%  73% consuming recommended fruit & vegetable servings. BMI also decreased: with % of students with Healthy Fitness Zone BMI (height/weight ratio) increasing by 12.5% from 48% to 54% of students. (HFZ = at level of fitness needed for good lifelong health.) The % students with 60 minutes/day of physical activity increased from 21% to 39%.

Healthy Fitness Zone standards are based on nationally validated FitnessGram® standards. FitnessGram is the successor to the Presidential Youth Fitness Test. Outcomes were measured by objective aerobic capacity (PACER), BMI, & muscular strength & endurance metrics, as well as CDC-validated YRBSS physical activity & nutrition questions.

Additional details including detailed physical activity, fitness, BMI & other data, are in the Grant Performance Report submitted to the US Department of Education in fulfillment of the federal Carol M. White Physical Education Program “PEP Grant” requirements (Reeves, 2016: ED 524B; PR/Award #Q215F120160).

The PHP Principal Investigator, Jen Reeves, subsequently worked with Keri Schoeff, a leader of Arizona Health & Physical Education and the Physical Education/Physical Activity Coordinator at the Arizona Department of Education, to develop Presidential Youth Fitness Program (PYFP) training, which was adopted by the CDC. They also developed follow-on programs, Empower Youth Fitness and Empower Youth Health, to continue implementing key components of PHP.

Listen to what teachers and students have to say about physical education at their schools using PHP-related approaches, and review the report on Partners for Healthy Promises.

Plan – Develop – Assess Model

The Plan-Develop-Assess model is based on “80/20” best practices from the Partners for Healthy Promises (PHP) project:

The P-D-A model utilizes a hybrid “local control with central support” approach. Schools are responsible for the key planning, development, & assessment tasks and implementation, but with significant guidance, development and remote & field support by regional and state P-D-A staff.

Schools must meet agreed requirements to participate. To participate in the full P-D-A program, they must have a qualified PE teacher with enough instruction time, typically at least 30 minutes of physical education weekly.

Keeping costs as low as possible, the core P-D-A program does not add staff to the school, but instead maximizes the impact of existing school staff and volunteers to improve student and staff health at the school.

Each school must develop a quality school wellness policy plan, typically using CDC’s School Health Index (SHI), with leaders from throughout the school working together. The PE teacher or another school wellness champion will often catalyze and lead this.

The wellness champion must also work with parents & the broader community to create a School Health Advisory Council (SHAC). The school will typically incorporate existing community partnerships and add new ones over time in its wellness policy plan.

Per the grant performance report, Sunnyside USD schools benefiting from the PEP Grant had a certified physical education (PE) teacher teaching an average of 30 minutes/week, with significant field support by the UofA project team. Community partnerships and peer-student leadership were a key part of the project.

With the PE teacher provided by the school district, P-D-A costs are expected to decline to about $10/student/year at a scale of 100,000 students in the program statewide. Also, additional funds were provided during Partners for Healthy Promises for the nutrition program, in order to encourage higher consumption of fruit & vegetables. Additional fruit & vegetable availability could be necessary at some schools.

Northern Arizona Healthcare’s Fit Kids

Please click here for more information on another evidence-based program with rapid payback, Fit Kids of Northern Arizona, which was sponsored by Northern Arizona Healthcare at close to $1 million annually.

Please see Payback/ROI for more details on payback and return on investment.

Please see our latest slide deck for more details.