BACKGROUND: Most US children and adolescents do not meet recommended daily physical activity (PA) guidelines. Determinants of PA are complex; however, access to opportunities precedes actual PA engagement. Schools are well positioned to support student PA through the provision of physical education (PE) and before, during, and after school PA opportunities through comprehensive (ie, expanded) school PA programming. Monitoring access to school PE and PA opportunities is an essential function of public health. However, there are limited comprehensive data across K-12 settings. Therefore, the purpose of this study was to evaluate students' access to PE and expanded recreation time before, during, and after school PA opportunities in K-12 schools across 25 US states. METHODS: The US Physical Education and Physical Activity Policy questionnaire was completed by 4845 K-12 PE teachers across 25 states, representing diverse geographical regions, with responses standardized across varying academic calendars. Descriptive statistics were used to illustrate access to PE and PA opportunities. RESULTS: Access to PE and PA varied, with elementary schools generally providing more opportunities than middle and high schools. There was an overall misalignment with national PE and recess recommendations. Limited before and after school PA opportunities were also reported. DISCUSSION: The relative dearth of access to PE and expanded PA opportunities currently available to students in relation to national guidelines shows a need for states to prioritize expanding access to PE and recreational PA to reduce disparities. To ensure more equitable student access, collaborative efforts among educators, policymakers, and stakeholders are essential.
