Whole-school Physical Activity Research Articles

Ripples in the Water: Physical Education Teacher Education Program Influence on Graduates’ Perceptions of Expanded Physical Activity Programming

Physical educators are often asked to promote whole-school physical activity programming beyond their scheduled class times. Previous research has supported that training in expanded roles would be beneficial during university-based physical education teacher education (PETE) training. In this qualitative study, 13 graduates from a single PETE program that has integrated expanded physical activity into programming shared information about their current programming as physical education teachers in K–12 schools. Campus visits and one-on-one interviews were included. Some practices and values learned during participants’ PETE training were evident in graduates’ current practices. Aligning with previous studies of professional socialization of physical educators, the resulting themes concluded that (a) strategies and resources gained during PETE training were valued and still used and (b) other ripples of influence, such as administrators and other teachers at their current placement, influenced programming. PETE programming with whole-school physical activity can lead to expanded teaching practices in schools.

S1-2 Findings from the children and adolescent working group project on whole systems approaches to whole school physical activity promotion across Europe

Abstract This talk will focus on a working group project investigating the research, policy and practice needs related to co-developing a whole-school system approach to physical activity (PA). The World Health Organization (2018) calls for all countries to implement a whole-system approach and positions school as an opportune site for increasing PA opportunities for children. Yet, current research reveals that most whole-school approaches fail to create impactful and sustainable changes. Consistent limitations include a focus on short-term initiatives that fail to address the many ingredients required to promote systems change through addressing organisational structure and culture within and beyond school settings. While contemporary guidance provides an in-depth understanding of “what” factors to address within the school, the system still lacks an understanding of “how” to address each factor required to create impactful and sustainable change. It is essential that the implementation of the different ingredients that form the school system are co-developed with multi-stakeholders from within and beyond the school environment. Project description To establish the research, policy and practice needs related to co-developing a whole-school systems approach to PA, this project includes three stages. First, we drew on an extensive European network to identify and categorise stakeholders involved in influencing and/or operationalising whole-school PA across the region. Second, we will conduct a needs analysis to systematically identify training needs. We will conduct six focus groups across Europe to gain diverse stakeholders perspectives on the required training needs aligned to capabilities, opportunities, and motivation (COM-B). Finally, we will be using the aforementioned insights to create a policy briefing on whole-school systems-based PA training needs. We will conduct two virtual stakeholder events to consult on the findings and gather further insights, offering contextual different within and between countries. Conclusion The policy briefing will provide recommendations for working across national contexts relating to school-based PA, providing guidance for policymakers and practitioners. We anticipate these insights will promote the development of bottom-up and top-down approaches to create ‘systems’ change within the school context. Funding This project is supported by the WHO European Office for Prevention and Control of Noncommunicable Diseases.

S1-1 Whole systems approaches to the promotion of school-based physical activity

Abstract Physical inactivity increases the risk of physical and mental ill-health and lower academic performance during childhood and is therefore a key public health priority. Whole-school approaches (WSA) are recommended as part of a system-wide approach to tackling physical inactivity. WSAs focus on aligning school policies, environments, school stakeholders and opportunities for physical activity within and beyond the school day. Yet, review-level evidence deems current WSAs ineffective due to: a lack of understanding of what constitutes a whole-school physical activity approach, programmes not considering schools as complex adaptive systems, limited multi-stakeholder input in programme design and poor use of implementation theory within programme design and delivery. Therefore, initiatives fail to overcome the systemic barriers affecting the adoption and development of new school practices. As a result, schools fail to adapt unique, context-specific policies to address environmental and stakeholder needs and are insufficient to improve children’s physical activity. This symposium will present applied research relevant to the practice of whole systems approaches to whole school physical activity promotion in different European country contexts. In doing so, relevant work which addresses the interrelationships within and across levels of influence of the system will be presented, with the implications for practice, research and policy in the context of future challenges in this area, discussed.

Classroom Teachers’ Perceived Barriers to Implementing Comprehensive School Physical Activity Programs (TPB- CSPAP): Instrument Development

ABSTRACT Although physical education teachers generally act as the physical activity champion and promote adherence to whole-school physical activity programs, classroom teachers manage the majority of students’ access to movement throughout the school day. Purpose: To support the adoption of a whole-school physical activity program, this study developed an instrument that identifies barriers perceived by classroom teachers related to adopting this type of program in their school. Method: A four-step process provided the conceptual framework for this instrument development (literature review, expert review, quantitative evaluation, and validation). The final validation phase (N = 520 teachers) included two individual analyses to separately evaluate respondents from elementary (K-5) and secondary levels (6-12). Each group was randomly split to run exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the models. Results: CFA results support models with adequate fit to the data for barriers for elementary, e.g., (SRMR = 0.0726; Bentler CFI = 0.92.79) and secondary (SRMR = 0.0813; Bentler CFI = 0.9374) teachers for whole-school programming. Conclusion: This instrument can be used by school personnel and researchers to understand perceived barriers for classroom teachers to implement a whole-school physical activity program in their context and then follow up to remove or reduce the barriers.

Initial insights into the impact and implementation of Creating Active Schools in Bradford, UK

BackgroundFew whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active Schools (CAS) programme was co-designed and is underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Consolidated Framework for Implementation Research (CFIR). The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay’s et al.’s (2019) implementation evaluation roadmap.MethodsFocus groups and interviews were conducted with school staff (n = 30, schools = 25), CAS Champions (n = 9), and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al’s implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising.ResultsIdentified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided “safe spaces” for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff’s self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools.ConclusionsThis study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders’ perceived self-efficacy. The combination of McKay’s evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity.

Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity.

National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School's (CAS) programme on organisational changes to physical activity provision. In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change. >70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour. This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.

Considerations for Individual-Level Versus Whole-School Physical Activity Interventions: Stakeholder Perspectives.

Strategies to address declining physical activity levels among children and adolescents have focused on ‘individual-level’ approaches which often fail to demonstrate impact. Recent attention has been on an alternative ‘whole-school’ approach to increasing physical activity that involves promoting physical activity throughout all aspects of the school environment. There is, however, a lack of evidence on how whole-school physical activity approaches could be implemented in the UK. This qualitative study explored perspectives of key stakeholders on potential reasons for the lack of impact of individual-level school-based interventions on children’s physical activity, and key considerations for adopting a whole-school approach. Nineteen semi-structured interviews were conducted with a range of stakeholders involved in the implementation of physical activity programmes in UK schools. Data were analysed using an inductive approach. Respondents suggested that individual-level school-based interventions to increase physical activity often failed to consult end users in the design and were typically implemented in environments unsupportive of long-term change. They subsequently outlined specific barriers and key facilitators for the adoption and implementation of whole-school approaches in UK settings and recommended a shift in research foci towards building an evidence base around educational outcomes and whole-school implementation insights.

Ten Years of 'Flying the Flag': An Overview and Retrospective Consideration of the Active School Flag Physical Activity Initiative for Children-Design, Development & Evaluation.

Whole-school physical activity (PA) promotion programmes are recommended to increase youth PA. Evaluation of programmes is essential to ensure practice is guided by evidence. This paper evaluates the Active School Flag (ASF), a whole-school PA promotion programme in Ireland, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ASF was evaluated across three levels—(1) administration, (2) application, (3) outcomes—using a mixed-methods case study design. Existing data sources were reviewed, the programme coordinator was interviewed, and a pilot study was conducted to investigate impact on 3rd and 5th class students (3 schools, n = 126 students, age range 8–12 years). In-school Moderate to Vigorous Physical Activity (MVPA; by accelerometery), motivation for PA (BREQ), PA self-efficacy (PASES), school affect and peer social support (Kidscreen27) were measured pre-programme (0 months), post-programme (8 months), and at retention (12 months). Teacher perceptions of classroom behaviour (CBAST) were also measured pre- and post-programme. ASF has been successful in engaging 46% of primary schools nationally. Students’ in-school moderate–vigorous PA increased in all pilot-study schools from pre-programme to retention (η2 = 0.68–0.84). ASF programme design facilitates implementation fidelity, adoption and maintenance through buy in from schools and government stakeholders. ASF presents as an effective PA promotion programme in the short-to-medium term for primary schools. This RE-AIM evaluation provides evidence of ASF effectiveness, alongside valuable findings that could support programme improvement, and inform future similar programmes.

Protocol for a mixed methods process evaluation of a hybrid implementation-effectiveness trial of a scaled-up whole-school physical activity program for adolescents: Physical Activity 4 Everyone (PA4E1)

BackgroundPhysical Activity 4 Everyone (PA4E1) is a physical activity program for secondary schools located in low-socioeconomic areas. Over a 24-month period, schools in the program arm of a cluster randomised controlled trial (n = up to 38 schools) will receive a multi-component implementation support strategy to embed the seven school physical activity practices of the PA4E1 program. This article describes the process evaluation of the PA4E1 hybrid implementation-effectiveness trial. The process evaluation aims to describe the fidelity and reach of the implementation support strategies using quantitative data; and to describe the acceptability, appropriateness and feasibility of the implementation support strategies and physical activity practices to school stakeholders using mixed methods.MethodsQuantitative and qualitative data will be collected from participants (Physical Education teachers, in-School Champions, students) in the program arm. Data collection will involve semi-structured interviews, focus groups, a fidelity monitoring log, a fidelity checklist, surveys, and routinely collected administrative and website data. Quantitative data will be analysed descriptively and qualitative data will be analysed thematically within and across data sets. Triangulation between data sources will be used to synthesise findings regarding the implementation and potential mechanisms of impact of PA4E1 on school physical activity practice adoption, with respect to context.DiscussionResults of the process evaluation will facilitate the interpretation of the findings of the trial outcomes. It will comprehensively describe what was actually implemented and identify the potential contribution of the various components of the implementation support strategy to the school physical activity practice adoption outcomes. Findings will inform future improvement and scale-up of PA4E1 and approaches to implementing secondary school-based physical activity programs more broadly.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12617000681358 registered 12 May 2017.

Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework

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.

School Environment and its Effects on Physical Activity

School is an environment where children and adolescents spend most of their time during the day. The environment is characterized by a sedentary culture necessary for academic learning. In this article, I present research evidence showing the effects of four physical activity opportunities in this environment: school athletics, recess, classroom physical activity breaks, and physical education. Based on an analysis of research evidence on the four opportunities, I propose that the efforts to promote the opportunities should be coordinated into a concerted action to integrate a physical activity-friendly culture in the sedentary environment. Using an example of China's whole-school physical activity promotion strategy, I identify four areas for us to continue to work on: legislature-based policies, physical education as core content, creation and maintenance of physical activity traditions in schools, and integration of physical activity-friendly culture into the sedentary school environment.

Action Schools! BC: A whole-school physical activity model to increase children's physical activity

Action Schools! BC: A whole-school physical activity model to increase children's physical activity

Flying the ‘Active School Flag’: physical activity promotion through self-evaluation in primary schools in Ireland

Primary schools are key sites where children can be active, advance their knowledge and understanding of how to participate in physical activity (PA) and develop an appreciation of its importance in their lives. This study explored the role of schools in promoting PA asking: how do primary schools approach the promotion of whole-school PA? Data submitted by 21 schools as part of a self-evaluation PA initiative were included in a secondary analysis using an inductive thematic approach. Schools’ approaches to PA promotion were more structured and inclusive, illustrating what schools valued and what they viewed as feasible within their contexts and resources. Self-evaluation and self-improvement processes can contribute to the promotion of whole-school PA in primary schools. While changes to school practices that better reflect educational policy on PA promotion are encouraging, the long-term impact of the self-evaluation process merits further investigation.

The impact of Action Schools! BC on the health of Aboriginal children and youth living in rural and remote communities in British Columbia

Objectives: The aim of the study was to determine the short-term impact of a 7-month whole-school physical activity and healthy eating intervention (Action Schools! BC) over the 2007–2008 school year for children and youth in 3 remote First Nations villages in northwestern British Columbia.Study design: A pre-experimental pre/post design was conducted with 148 children and youth (77 males, 71 females; age 12.5±2.2 yrs).Methods: We evaluated changes in obesity (body mass index [wt/ht2] and waist circumference z-scores: zBMI and zWC), aerobic fitness (20-m shuttle run), physical activity (PA; physical activity questionnaire and accelerometry), healthy eating (dietary recall) and cardiovascular risk (CV risk).Results: zBMI remained unchanged while zWC increased from 0.46±1.07 to 0.57±1.04 (p<0.05). No change was detected in PA or CV risk but aerobic fitness increased by 22% (25.4±15.8 to 30.9±20.0 laps; p<0.01). There was an increase in the variety of vegetables consumed (1.10±1.18 to 1.45±1.24; p<0.05) but otherwise no dietary changes were detected.Conclusions: While no changes were seen in PA or overall CV risk, zWC increased, zBMI remained stable and aerobic fitness improved during a 7-month intervention.1Published ‘ahead-of-print’ 2 December 2011 (at www.ijch.fi) in accordance with previous publisher's routines.

School Programs to Increase Physical Activity

JOPERD • Volume 78 No. 5 • May/June 2007 N umerous reports have identifi ed substantial health benefi ts from regular participation in physical activity during childhood, and schools have been identifi ed as the primary agencies responsible for promoting the adoption of active lifestyles in children. Healthy People 2010 (U.S. Department of Health and Human Services, 2000), Guidelines for School and Community Programs: Promoting Lifelong Physical Activity (Centers for Disease Control and Prevention, 1997), and public health leaders (e.g., McKenzie, Sallis, Kolody, & Faucette, 1997) all advocate for schools and teachers taking a major role in promoting physical activity. A quality physical education program is at the heart of any plan to promote lifelong participation in enjoyable physical activity. In physical education, students are provided opportunities to engage in a range of developmentally appropriate movement activities and are taught basic skills that make participation more enjoyable. Competent physical education teachers play a critical role in giving students the knowledge to make good activity choices and helping them develop the skills and confi dence needed to adopt healthy lifestyles. Nevertheless, while most schools require some physical education, it has become clear that the instructional time allotted is insuffi cient to provide children with the recommended minimum levels of physical activity. The National Association for Sport and Physical Education (NASPE, 2004) has suggested that elementary school-age children should accumulate more than 60 minutes of age-appropriate physical activity each day, and physical education classes alone cannot provide opportunities for children to achieve that recommendation. For this reason, schools are beginning to increase children’s activity levels by incorporating a whole-school approach that involves interdisciplinary collaboration among all school personnel. Regular classroom teachers, for example, can promote daily exercise and help children understand the importance of making regular physical activity a lifelong habit. In addition, children can be provided with take-home activities for families to share. This article introduces several whole-school programs that have been designed to promote increased physical activity and healthy lifestyle choices for elementary school children. Recognizing that physical education specialists alone cannot address the physical activity needs of children, researchers at Louisiana State University (LSU) conducted a series of studies designed to develop successful strategies for partnering with elementary schools to implement a whole-school intervention program. This article describes several of these investigations and how they helped to identify both the benefi ts and the challenges associated with implementing physical activity across the curriculum. The success of a whole-school physical activity program depends on teachers and principals who recognize the potential health benefi ts of integrating physical activity into the total school experience and accept such a program on a wide-scale School Programs to Increase Physical Activity