Abstract

BackgroundUK and global policies recommend whole-school approaches to improve childrens’ inadequate physical activity (PA) levels. Yet, recent meta-analyses establish current interventions as ineffective due to suboptimal implementation rates and poor sustainability. To create effective interventions, which recognise schools as complex adaptive sub-systems, multi-stakeholder input is necessary. Further, to ensure ‘systems’ change, a framework is required that identifies all components of a whole-school PA approach. The study’s aim was to co-develop a whole-school PA framework using the double diamond design approach (DDDA).MethodologyFifty stakeholders engaged in a six-phase DDDA workshop undertaking tasks within same stakeholder (n = 9; UK researchers, public health specialists, active schools coordinators, headteachers, teachers, active partner schools specialists, national organisations, Sport England local delivery pilot representatives and international researchers) and mixed (n = 6) stakeholder groupings. Six draft frameworks were created before stakeholders voted for one ‘initial’ framework. Next, stakeholders reviewed the ‘initial’ framework, proposing modifications. Following the workshop, stakeholders voted on eight modifications using an online questionnaire.ResultsFollowing voting, the Creating Active Schools Framework (CAS) was designed. At the centre, ethos and practice drive school policy and vision, creating the physical and social environments in which five key stakeholder groups operate to deliver PA through seven opportunities both within and beyond school. At the top of the model, initial and in-service teacher training foster teachers’ capability, opportunity and motivation (COM-B) to deliver whole-school PA. National policy and organisations drive top-down initiatives that support or hinder whole-school PA.SummaryTo the authors’ knowledge, this is the first time practitioners, policymakers and researchers have co-designed a whole-school PA framework from initial conception. The novelty of CAS resides in identifying the multitude of interconnecting components of a whole-school adaptive sub-system; exposing the complexity required to create systems change. The framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. To enact such change, CAS presents a potential paradigm shift, providing a map and method to guide future co-production by multiple experts of PA initiatives ‘with’ schools, while abandoning outdated traditional approaches of implementing interventions ‘on’ schools.

Highlights

  • United Kingdom (UK) and global policies recommend whole-school approaches to improve childrens’ inadequate physical activity (PA) levels

  • The aim of the current study was to co-develop a whole-school physical activity framework with multiple stakeholders, using the diamond design approach (DDDA)

  • While little is currently known about the inter-relationship between the different elements - and Creating Active Schools Framework (CAS) does not identify those with the greatest effect - it is the first framework to establish whole-school ethos and practice at the heart of whole-school physical activity provision

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Summary

Introduction

UK and global policies recommend whole-school approaches to improve childrens’ inadequate physical activity (PA) levels. 50% of children do not meet the internationally recognised target of 60 min of moderate-to-vigorous physical activity (MVPA) per day [1, 2]. This figure rises to 80% in higher-income countries [2] and persists into adolescence [3]. Given these figures, it is not surprising that the latest global physical activity report card states “children’s physical activity poses a serious level of concern” [4]. Within the UK, the government provide ring-fenced funding to support primary schools (children aged 5 to 11) to provide a minimum of 30-min of physical activity per day for all pupils [9, 10]

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