Cross-posted from the President's Council of Fitness, Sports and Nutrition blog.

By: Karin Allor Pfeiffer, PhD, FACSM, Associate Professor in the Department of Kinesiology and faculty in the Center for Physical Activity and Health at Michigan State University, Member of the PCFSN Science Board, and Subcommittee Member of the Physical Activity Guidelines Midcourse Report

In 2008, the U.S. Department of Health and Human Services (HHS) released the first-ever Physical Activity Guidelines (PAG), which describes the amount and types of physical activity Americans need for overall health and well-being.

To mark the fifth anniversary of the PAG, the President's Council on Fitness, Sports and Nutrition (PCFSN) convened a subcommittee of experts to conduct a midterm review of effective interventions that promote physical activity opportunities for youth ages 3-17.

After reviewing the relevant science, the subcommittee developed a report - Physical Activity Guidelines Midcourse Report: Strategies to Increase Physical Activity Among Youth - that focused on five key settings that provide opportunities for youth to be active for 60 minutes or more a day where they live, learn, and play.

School: Make quality physical activity a part of the school day in a variety of ways. Overall, findings supported school-based interventions as having the most evidence to increase physical activity among youth. With the average school day lasting 6-7 hours, it is not surprising that enhanced PE classes, classroom activity breaks, recess, and before and after school activities have played a large role in advancing childhood health. Active transporation, which includes walking or biking to and from school, also provides a great opportunity for kids to get their daily physical activity.

Preschool and Childcare: Start healthy habits for life with active play in preschool. Preschool and childcare centers showed excellent results in starting healthy habits for youth. Increasing time children spend outside and providing portable play equipment on playgrounds were especially effective. The findings also demonstrated that training staff in the delivery of structured physical activity sessions is a productive way to get youth active at an early age.

Community: Build the physical environments of cities, towns and neighborhoods to encourage physical activity. Community settings were found to be promising in impacting physical activity at the population level. Changes to the built environment, such as altering the mix of residential and retail space to be more walker-friendly can encourage more physical activity and shape the sociocultural environment of a community.

Family and Home: Be physically active with your kids and help them develop active lifestyles at a young age. Research shows that children develop physical activity behaviors, attitudes and values in the home, but there is not yet enough evidence to make firm recommendations in this area.

Primary Care: Physical activity is critical for overall health. Talk to your patients about the importance of being active every day. Health care providers remain critical to monitoring children's health, but more research should be conducted to determine specific recommendations on enhancing physical activity.

Parents and caregivers, childcare providers, teachers, healthcare professionaks and policymakers have an opportunity to work together to ensure that children are able to achieve 60 minutes or more of physical activity each day. By providing support at home, integrating physical activity into the school day and building smarter communities, we can enable youth to adopt healthier, more active lifestyles.

To download the Physical Activity Guidelines Midcourse Report: Strategies to Increase Physical Activity Among Youth and infographic, visit www.health.gov/paguidelines.

On January 24, 2013, the Office for Civil Rights (OCR) issued a Dear Colleague Letter clarifying school's obligations under the Rehabilitation Act of 1973 to provide extracurricular athletic opportunities for students with disabilites. The guidance creates a clear roadmap for how schools can integrate students with disabilities into mainstream athletic programs and create adapted programs for students with disabilities.

"OCR's guidance is a landmark moment for individuals with disabilities, as it sends a loud message to educational institutions that students with disabilities must be provided opportunities for physical activity and sports equal to those afforded to students without disabilities," said Terri Lakowski, policy chair of the Inclusive Fitness Coalition (IFC) and nationally recognized sports policy advocate.

You may have seen this announcement in the media or through your organization, but what does it all mean and how will this impact extracurricular athletics?

The road towards victory for student athletes with disabilities was relentless. The letter released by the OCR came after ten years of advocacy to level the playing field in school-based athletic programs. The release of the Dear Colleague letter is merely further guidance on what should already be happening for students with disabilities, based on section 504 of the Rehabilitation Act of 1973. The purpose is to clarify school's responsibilities under the law; it does not provide any additional legislation. Similar to Title IX, which paved the way for women to have equal opportunities in sports, the updated guidance will hopefully provide a similar effect for student athletes with disabilities.

Above: Wheelchair athelete Tatyana McFadden, front, races in her first high school track meet alongside able-bodied runners, April 2006 in Rockville, MD. Photo courtesy of (Chris Gardner/AP)

Why are these guidelines important? The benefits of providing ALL students with opportunities for exercise and sports participation goes beyond justice and individual opportunity. There is a major epidemic of obesity among our youth and even more so among youth with disabilities.

"Inclusion in athletics is how children learn from each other, build social skills and optimize their growth and development. The OCR guidance is a clear indication that athletics is an extremely important part of our educational system and that youth and young adults with disabilities must be afforded the same opportunities as their non-disabled peers," said James Rimmer, Ph.D., who co-chairs the IFC and directs the National Center on Health, Physical Activity and Disability. "This should be part of a national strategy to lower obesity rates, which are disproportionately higher among youth with disabilities compared to their non-disabled peers." By providing equal access in extracurricular activities for students with disabilities, maybe we can begin to break down the common barriers to physical activity, and create a new culture of inclusion in our schools and communities.

To ensure equal opportunity does not mean a fundamental alteration to the program, but simply providing a reasonable modification to allow the student athletes with a disability to participate alongside their peers. The Dear Colleague Letter document outlines what constitutes a reasonable modification. One example is to provide a visual cue at the start of high school track races, simultaneously wtih the starter pistol sound, to be inclusive of students with hearing impairments. Another example of a reasonable modification is to allow an individual born with only one hand to be allowed to finish a swim race with a "onehand touch" as opposed to the "two-hand touch" finish rule for certain strokes. As you can see, inclusion can be a reality in all aspects of physical activity. The message is simple: Prevent Obesity, Be Inclusive.

The IFC, led by the Lakeshore Foundation in partnership with the American College of Sports Medicine, comprises over 200 organizations representing a cross-section of disability rights, sports, health/fitness, and civil rights communities. Recognizing the barriers that continue to limit opportunities for physical activity for individuals with disabilities in the school setting, the IFC works to expand opportunities for physical activity, exercise and athletics for individuals with disabilities. For more information, please visit www.incfit.org and www.lakeshore.org.

We know childhood and adolescence is a period when regular physical activity is critical for healthy growth and development, but today America's youth are less active than ever before.

This Friday, the Office of Disease Prevention and Health Promotion (ODPHP) and the President's Council on Fitness, Sports, & Nutrition (PCFSN) will release the Physical Activity Guidelines for Americans Midcourse Report: Strategies to Increase Physical Activity Among Youth at the Partnership for a Healthier America Summit in Washington, D.C.

Friday, March 8, 2013 9:45 - 11:00 AM EST

Burnham Room | Grand Hyatt Hotel | Washington, DC

The Physical Activity Guidelines for Americans (PAG) Midcourse Report comes five years after the U.S. Department of Health and Human Services (HHS) published the first-ever PAG in 2008, describing the types and amounts of physical activity Americans ages 6 years and older need for overall health.

The PAG Midcourse Report builds on the Guidelines by highlighting intervention strategies for increasing physical activity in youth ages 3 to 17 years, identified in the current literature using a review-of-reviews approach.

The report provides implementation and research recommendations for leaders within five key settings that provide opportunities for youth to be active for 60 minutes or more each day:

• School
• Preschool and childcare
• Community
• Family and home
• Primary health care

Download the PAG Midcourse Report and other materials at www.health.gov/PAGuidelines/Midcourse.

What are you doing in your home, school, organization or community to help kids be more active? We invite you to share your experiences and ideas.