Recommendations of IOM on Setting Standards for Youth Fitness Testing

Background/Purpose: A key need in youth fitness testing is to have standards to provide a way to provide youth (and parents) with feedback. Two evaluation frameworks have been often used in youth fitness evaluation: Norm-referenced (NR) and criterion-referenced (CR). Due to the limitations of NR evaluation, i.e., time dependence, population dependence, discouraging unfit children and favoring genetically talented or punishing disadvantaged children, CR evaluation is in general recommended for youth fitness evaluation. 

Method: Setting an appropriate standard, known as “cut-off score” sometimes, for a CR evaluation could be a challenge. For CR based health-related fitness evaluation, the “Health Outcome Centered” method, in which a cutoff score is associated with a health outcome classification, has been the predominant approach in setting CR standards. The FITNESSGRAM program has recently updated standards for both body composition and aerobic capacity using national representative data from the National Health and Nutrition Examination Survey (NHANES). The methodologies used in setting these standards will be summarized and related to other available methods and approaches. 

Analysis/Results: Potential approaches will be summarized to provide clarity on the various methods available for setting standards. Other assessments in the FITNESSGRAM battery (e.g., Curl-up and Pushup) have weaker associations with health so it has proven more difficult to set standards for these assessments. 

Conclusions: CR based “health outcome centered” method is the most popular and effective one for setting standards for health-related fitness tests, but specifics may vary depending on the known relationship between fitness and health outcome.