Abstract
BackgroundGiven the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation.MethodsA scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student’s physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains.ResultsThe search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers’ perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student’s PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains.ConclusionsWith the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future.RegistrationA protocol for this review was not registered.
Highlights
Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers
Of the 15 studies that met the inclusion criteria, 11 articles evaluated the Ontario DPA policy [19, 20, 38,39,40,41,42,43,44,45,46], and 2 articles were from both Alberta [47, 48] and British Columbia [18, 49]
With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA, and the impact on student’s physical activity levels is not well understood; this review revealed that DPA deliverers often report many barriers to DPA implementation, most of which relate to the environmental context and resources, beliefs about consequences, and social influences domains of the Theoretical Domains Framework (TDF)
Summary
Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. DPA policies aim to change and have an effect on students’ physical activity levels at school, within the context of elementary schools, the implementation of DPA policies require behavior change of the teacher to provide opportunities for children to be active, and the approaches they chose to provide these opportunities is left at their personal or school’s discretion. In this way, the DPA policies potentially affect two different, yet interrelated behaviors (the provision by teachers and the physical activity of students). If DPA policies are implemented as intended, teachers, principals, and/or administration will change their provision/implementation behaviors, and students will change their physical activity behaviors
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