ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Education and Promotion
This article is part of the Research TopicLife Skills in School Health Promotion: Challenges and SolutionsView all 8 articles
Policy Dosing in School Physical Education and Adolescent Fitness: A Threshold-Type Association in a Two-Wave Panel Study from Kunming, China
Provisionally accepted- Kunming City College, Kunming, China
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Background: The minimal effective "dosage" of school physical education (PE) and its nonlinear relation 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 in Kunming, China, from a single public middle school, yielding 2,673 student-occasion records: the same 891 students measured at three time points (Grade 7 baseline, then 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 (τ̂), compared restricted cubic splines versus linear models, and conducted robustness checks (alternative weights, 10-fold delete-group jackknife, placebo threshold, negative-control outcome). Outcomes were sex-by-grade z-scores; component-specific Ns vary slightly due to test-day absence/invalid measures. Results: EPDI showed a threshold-like association with fitness; τ̂≈66, with diagnostic breakpoints mostly 60–75 across outcomes. For every 10 EPDI units, composite PFI showed a pre-threshold slope −0.074 (95% CI −0.116 to −0.032), slope change +0.274 (0.151 to 0.397), and post-threshold slope +0.201 (0.110 to 0.291). Component effects were stronger and directionally consistent: vital capacity +0.588 (0.501–0.675), 50-m sprint (higher z=slower) −0.207 (−0.272 to −0.143); standing long jump and sit-and-reach showed moderate gains; BMI was negligible. Girls benefited at lower EPDI levels, whereas boys and Grade-8 students gained more after the breakpoint. For the composite PFI, evidence of non-linearity was modest; signals were stronger at the component level. 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 window and should be replicated across schools/districts with maturation and socioeconomic markers. Associations are interpreted as non-causal.
Keywords: school physical education policy, physical fitness (PFI), Dose–response, threshold, nonlinear modeling, adolescents
Received: 16 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 wang, feng, zhang, wei and bi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Degui wang, deguiwang@outlook.com
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