Abstract
BackgroundFew children meet physical activity (PA) recommendations, and are therefore at increased risk for overweight/obesity and adverse health outcomes. To increase children’s opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. The purpose of this study was to understand the processes underlying adoption and diffusion of Canadian DPA policies, and to review evidence regarding their implementation and impact.MethodsWe adopted a multiple case history methodology in which we traced the chronological trajectory of DPA policies among Canadian provinces by compiling timelines detailing key historical events that preceded policy adoption. Publicly available documents posted on the internet were reviewed to characterize adopter innovativeness, describe the content of their DPA policies, and explore the context surrounding policy adoption. Diffusion of Innovations theory provided a conceptual framework for the analyses. A systematic literature search identified studies that had investigated adoption, diffusion, implementation or impact of Canadian DPA policies.ResultsFive of Canada’s 13 provinces and territories (38.5%) have DPA policies. Although the underlying objectives of the policies are similar, there are clear differences among them and in their various policy trajectories. Adoption and diffusion of DPA policies were structured by the characteristics and capacities of adopters, the nature of their policies, and contextual factors. Limited data suggests implementation of DPA policies was moderate but inconsistent and that Canadian DPA policies have had little to no impact on school-aged children’s PA levels or BMI.ConclusionsThis study detailed the history and current status of Canadian DPA policies, highlighting the conditional nature of policy adoption and diffusion, and describing policy and adopter characteristics and political contexts that shaped policy trajectories. An understanding of the conditions associated with successful policy adoption and diffusion can help identify receptive contexts in which to pioneer novel legislative initiatives to increase PA among children. By reviewing evidence regarding policy implementation and impact, this study can also inform amendments to existing, and development of future PA policies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1669-6) contains supplementary material, which is available to authorized users.
Highlights
Few children meet physical activity (PA) recommendations, and are at increased risk for overweight/obesity and adverse health outcomes
Schools are suited for PA interventions because children already spend a substantial amount of time there, they have existing PA-related infrastructure, and they require most students to engage in some amount of PA through Physical Education (PE) courses
To complete the policy cycle, we performed a systematic review of studies that have evaluated adoption, diffusion, implementation or impact of school-based Canadian daily PA (DPA) policies
Summary
Few children meet physical activity (PA) recommendations, and are at increased risk for overweight/obesity and adverse health outcomes. To increase children’s opportunities for PA, several Canadian provinces have adopted school-based daily PA (DPA) policies. It is not clear why some jurisdictions have adopted DPA policies, and others have not, nor whether these policies have been implemented and have achieved their intended outcomes. Children who engage in 60 minutes of moderate-tovigorous physical activity (MVPA) daily are less likely to be overweight/obese and to exhibit risk factors for chronic disease [1]. For this reason, Health Canada [2,3] and other national governments [4] recommend that children accumulate at least 60 minutes of MVPA daily. School-based PE classes as currently offered may not provide children and youth with sufficient PA opportunities
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