An Evaluation of the University of Illinois Extension Get Up & Move ! Program

Get Up & Move! is a program created by University of Illinois Extension to address childhood obesity. It provides ready-to-use materials for youth leaders to promote healthy lifestyles through physical fitness and healthy eating. The impact of the program on participants’ physical activity was evaluated to see whether involvement produces an increase in physical activity to the USDA recommended 60 minutes per day. It was found that a significant increase in minutes of physical activity occurred in participants from an average of 51.88 minutes per day to an average of 58.84 minutes per day.


Introduction
The prevalence of obesity in children has been rapidly increasing in the last two decades, reaching epidemic proportions (National Center for Health Statistics, 1999-2002).There are many reasons cited as the causes of obesity in children.Genetic conditions such as Prader-Willi, Bardet-Biedl, and Cohen syndromes can also be associated with obesity, however these and endocrine conditions contribute only a small amount to the rising rates of obesity.(Greaser & Whyte, 2004;Philippas & Lo, 2005).It is speculated in children and adolescents that because the rate of childhood obesity has increased so quickly in recent years, changes in behavior of children are most likely a major cause of childhood obesity (Greaser & Whyte, 2004).The two main risk factors associated with overweight and obesity in children are poor eating habits and decreased physical activity (Nicklas & Johnson, 2004).
Children's lack of physical activity contributes significantly to the increased prevalence of obesity.In a study done by Trost, Kerr, Ward, and Pate in 2001, it was determined that obese children exhibited significantly lower daily amounts of moderate and vigorous physical activity (2001).Participation in sedentary behaviors, especially television viewing, video game playing, and computer usage, has been associated with increased risk of obesity in childhood (McMurray et al., 2000).
The Get Up & Move! program is part of an initiative created by University of Illinois Extension to address childhood obesity.The program was created as an optional educational programming activity for Illinois 4-H clubs.Program delivery through 4-H club meetings was chosen because of the following: • 4-H clubs usually meet monthly and are required to meet at least six times per year.

Program Design
Each Get Up & Move! series includes information for leaders and/or volunteers to teach youth simple principles during a 10-15 minute educational segment on a nutrition or fitness topic.This is a 15-20 minute physical activity related to the topic.While nutrition and fitness topics change each month, they build upon each other during the year.
The objectives of the Get Up & Move! program are as follows: • provide 4-H clubs/groups with ready-to-use materials • promote healthy lifestyles through physical fitness and healthy eating • provide youth leaders the opportunity to teach and model behavior with their peers • provide fun, easy-to-use activities for club programs • increase the number of minutes spent in physical activity for participants to average at least 60 minutes each day • encourage healthy snacks at club/group meetings.

Lesson topics of the Get Up & Move! program include:
• MyPyramid • healthy snacking • building healthy bones • protein and muscle • whole grains and fiber • nutrition facts labels • aerobic activity • outdoor exercising safety

• sports nutrition
Families and communities are so important in fostering healthy habits, thus, a new component was added to the third series of Get Up & Move!Each month, additional physical and social activities are suggested in the forms of family activities and community activities.In all series, roll call suggestions related to the month's topic are offered and nutritious snack recipes are provided for use as a club snack.Members are informed about different 4-H project ideas and opportunities that involve that month's topic.4-H youth are also provided with a monthly calendar where he or she can record physical activity (in minutes) each day, with space for weekly and monthly totals.Club members are encouraged to bring these monthly totals to club meetings, where the club leader will record the totals on the club's monthly total poster.

Methods
In order to evaluate the Get Up & Move! program and its impact on the involvement in physical activity of its participants, data was collected from children ages eight to eighteen from 4-H clubs in Illinois.This project was approved by the Institutional Review Board at the University of Illinois at Urbana-Champaign.Clubs were self-selected by their club leaders, and clubs were enrolled in one of three installments of the Get Up & Move!Program.Incentives for study enrollment were offered to club leaders in the form of activity equipment.The time frame for the study was twelve months.
Minutes of daily physical activity were self-reported by each club member onto a monthly calendar.Club leaders collected the calendars from club members and totaled each member's minutes of physical activity each month.Also collected from club leaders was a data sheet that indicated which components of the Get Up & Move! program the club utilized each month of the study.Data was analyzed using the SPSS program (SPSS, 2005).

Results
Data was collected from 104 children from ten 4-H clubs in Illinois for a period of twelve months, although not all clubs collected data for all of the months of the study.The mean minutes of physical activity for all participants in the first month of the program was 1556.69 minutes (51.89 minutes per day).In the last month of the program, the mean minutes of physical activity for all participants was 1765.26 minutes (58.84 minutes per day).This increase of 208.57minutes was statistically significant at the .05level (sig=.022),and participants became significantly closer to the USDA recommended goal of 60 minutes of physical activity per day (U.S.Department of Health and Human Services & U.S. Department of Agriculture, 2005).Further, the females in the sample (n=69) showed an increase in minutes of physical activity from first month to last month, and this difference was significant at the .05level.(sig=.035).Males in the sample (n=35) showed an increase in minutes of physical activity from first month to last month of participation; however this was not a significant increase at the .05level (sig=.401).
When participants were divided by club, eight of the ten 4-H clubs showed an increase in mean minutes of physical activity from the first month of participation to the last month of participation, and two of these clubs showed a significant increase (sig=.041,.025).Two clubs showed a decrease in mean minutes of physical activity, with one of these clubs showing a significant decrease (sig=.007).There seemed to be no significant relationship between the number of months using the Get Up & Move! program and change in physical activity minutes over time.
Feedback from parents indicated that families attempted to get more physical activity after their children became involved in Get Up & Move!Parents reported an increase in physical activities done together with their children and less time spend participating in sedentary activities such as watching television.

Limitations
From the results of this study, participation in the Get Up & Move! program results in an increase in the amount of physical activity over time.However, since this study consisted of a small sample size (n=104) from only ten 4-H clubs from the state of Illinois who were participating in the Get Up & Move! program, the results may not be generalizable to all groups using this program.
It is not required for any 4-H club to enroll in the Get Up & Move! program.The clubs enrolled in Get Up & Move! study may be more interested and concerned with combating childhood obesity than those not enrolled in the program.Since the clubs involved in this study were selfselected from the clubs enrolled in Get Up & Move! the results showing an increase in physical activity may be falsely elevated.
Clubs who enrolled in the research study were offered an incentive in the form of an activity kit containing equipment for the program's activities.Perhaps clubs in an area of lower income or with a lower budget may be more inclined to participate because they need the incentive more than other clubs might.This would cause a difference in the clubs that participate compared to those who do not.
With the method of data collection utilized, other biases are introduced.The minutes of physical activity are derived by a self-report method from children aged eight to eighteen.This can introduce sources of error because subjects may inflate their data for many reasons, such as wanting to seem more active than they actually are.Parents of the children are encouraged to supervise this activity to ensure accuracy, but there is no way for the research team to enforce this.Therefore, there may be incorrect reporting of data.

Program Strengths
The success of the Get Up & Move! program in increasing participant's physical activity can be attributed to many factors.The nature of the program itself gives club leaders ready-to-use materials and scripts for lessons and activities, which minimizes the preparation leaders must do and allows for consistent dissemination of information to all groups.This ease of administration increases the likelihood that leaders will use the program with their clubs.Members participating in Get Up & Move! are also accountable for their physical activity levels in that they are encouraged to report physical activities they have done or tried at each club meeting.
The activities presented in Get Up & Move! were chosen to appeal to a wide range of ages, as 4-H clubs are comprised of members aged eight to eighteen.Many of the activities can be modified to be less or more challenging to accommodate groups with older or younger members.Activities were also chosen that do not require much equipment or special accommodations so that they are applicable to a variety of settings and spaces.Most activities can be held indoors or outdoors, eliminating the reliance on weather.Individual and group activities were included that can be modified for different-sized clubs.Informal interviews with school physical education teachers, coaches, and children were conducted to assess the feasibility and appeal of activities for club meetings.
The Get Up & Move! program also provides ideas to leaders, club members, and members' families about how to incorporate more physical activity into their lives.Feedback from parents shows that families attempted to get more physical activity after their children became involved in the program.In this respect, the sustainability of the program is promising, as behavior changes much be incorporated into one's life to be effective on a long-term basis.

Conclusion
This program can be readily implemented by other groups wishing to increase the physical activity levels of children.Based on the results of this study, children who participate in Get Up & Move! will show an increase in their levels of physical activity.In turn, these children will lead more healthy and active lifestyles, combating the increasing prevalence of overweight and obesity in this age group.The Get Up & Move! program materials are available at http://www.4-h.uiuc.edu/opps/move/index.html