ArticleFrontiers in public health2025
Policy dosing in school physical education and adolescent fitness: a threshold-type association in a two-wave panel study from Kunming, China.
Article in Frontiers in public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The minimal effective "dosage" of school physical education (PE) and its nonlinear relationship to adolescent fitness are not well defined. We developed a policy-based Education Policy Dosing Index (EPDI, 0-100) from four exam-oriented domains-compulsory test intensity, elective test diversity, scoring/enforcement strictness, and competition & incentive provision-aligned with Yunnan's 2019 education-exam reform and the junior-middle-school PE examination scheme. Multiple weighting checks (equal, ±20%, PCA/entropy) were used to confirm its formative nature. Methods: We analyzed a two-wave school panel from a single public middle school in Kunming, China, yielding 2,673 student-occasion records, comprising the same 891 students measured at three time points (Grade 7 baseline, followed by two follow-ups in Grades 8-9; 2021-2023). Segmented regressions with two-way fixed effects (per 10 EPDI; reference threshold = 60) used CR2 inference. We profiled the breakpoint ( Results: EPDI showed a threshold-like association with fitness; Conclusion: An EPDI around 60 is a practical, exam-aligned planning benchmark, with diminishing marginal returns beyond the breakpoint and equity-relevant heterogeneity by sex and grade. Segmented and spline models outperformed linear models for most outcomes, and findings were robust across weighting/sensitivity checks. Estimates reflect one school over a short time period and should be replicated across schools/districts, accounting for maturation and socioeconomic markers. Associations are interpreted as non-causal.
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