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The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion!

ABSTRACT: Comprehensive school physical activity programs (CSPAPs) have been endorsed as a promising strategy to increase youth physical activity (PA) in school settings. A CSPAP is a five-component approach, which includes opportunities before, during, and after school for PA. Extensive resources are available to public health practitioners and school officials regarding what should be implemented, but little guidance and few resources are available regarding how to effectively implement a CSPAP. Implementation science provides a number of conceptual frameworks that can guide implementation of a CSPAP, but few published studies have employed an implementation science framework to a CSPAP. Therefore, we developed Be a Champion! (BAC), which represents a synthesis of implementation science strategies, modified for application to CSPAPs implementation in schools while allowing for local tailoring of the approach. This article describes BAC while providing examples from the implementation of a CSPAP in three rural elementary schools.

SUBMITTER: Moore JB

PROVIDER: S-EPMC5760502 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion!

Moore Justin B JB Carson Russell L RL Webster Collin A CA Singletary Camelia R CR Castelli Darla M DM Pate Russell R RR Beets Michael W MW Beighle Aaron A

Frontiers in public health 20180105

Comprehensive school physical activity programs (CSPAPs) have been endorsed as a promising strategy to increase youth physical activity (PA) in school settings. A CSPAP is a five-component approach, which includes opportunities before, during, and after school for PA. Extensive resources are available to public health practitioners and school officials regarding <i>what</i> should be implemented, but little guidance and few resources are available regarding <i>how</i> to effectively implement a ...[more]

PMID: 29354631

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Project description:BACKGROUND:Increasing children's physical activity (PA) at school is critical to obesity prevention and health promotion. Implementing novel, low-cost PA programs offers potential to contribute to children's in-school PA, particularly in resource-constrained schools. This evaluation describes implementation fidelity, reach, and dose of two PA programs in the Fueling Learning through Exercise (FLEX) Study. METHODS:Thirteen diverse, low-income Massachusetts elementary schools were recruited and randomized to the 100 Mile Club walking/running program (n?=?7) or CHALK/Just Move classroom activity break PA program (n?=?6). Intervention programs were delivered across two school years. Surveys with program champions/teachers and children, in-session measurement of children's PA by accelerometry (Actigraph GT3X) in a subset of schools, and key informant interviews were used to collect information on implementation, including fidelity, dose, reach, and sustainability, and to calculate an implementation score. RESULTS:Six CHALK/Just Move schools implemented the program in both years. Two schools randomized to 100 Mile Club did not implement at all, and only three schools implemented both years. Implementing schools had similar implementation scores (range?=?0-3; 100 Mile Club?=?2.0 vs. CHALK/Just Move?=?1.9) but fidelity to core and enhanced elements differed between programs. In 100 Mile Club schools, dose of program delivered was greater than in CHALK/Just Move schools (34.9 vs. 19.7?min per week). Dose of PA received per session was also greater in 100 Mile Club schools (n?=?55, 2 schools) compared with CHALK/Just Move schools (n?=?160, 2 schools) (13.6?min vs. 2.7?min per session). A slightly higher proportion of eligible children participated in CHALK/Just Move compared to 100 Mile Club (54.0% vs. 31.2%). Both programs were well received by champions/teachers and students. CONCLUSIONS:Program implementation varied across programs and schools, and erosion in delivery was seen over the two years. However, among implementing schools, additional PA was delivered and received, and the programs were generally well-received. Although school resource issues remain barriers to implemention, this evaluation demonstrates that low-cost programs may enhance PA opportunities. Future research should evaluate how multiple programs can be implemented to increase children's PA at school. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT02810834 . Registered May 11, 2015.

Project description:BackgroundIn British Columbia Canada, a Daily Physical Activity (DPA) policy was mandated that requires elementary school teachers to provide students with opportunities to achieve 30 min of physical activity during the school day. However, the implementation of school-based physical activity policies is influenced by many factors. A theoretical examination of the factors that impede and enhance teachers' implementation of physical activity policies is necessary in order to develop strategies to improve policy practice and achieve desired outcomes. This study used the Theoretical Domains Framework (TDF) to understand teachers' barriers and facilitators to the implementation of the DPA policy in one school district. Additionally, barriers and facilitators were examined and compared according to how the teacher implemented the DPA policy during the instructional school day.MethodsInterviews were conducted with thirteen teachers and transcribed verbatim. One researcher performed barrier and facilitator extraction, with double extraction occurring across a third of the interview transcripts by a second researcher. A deductive and inductive analytical approach in a two-stage process was employed whereby barriers and facilitators were deductively coded using TDF domains (content analysis) and analyzed for sub-themes within each domain. Two researchers performed coding.ResultsA total of 832 items were extracted from the interview transcripts. Some items were coded into multiple TDF domains, resulting in a total of 1422 observations. The most commonly coded TDF domains accounting for 75% of the total were Environmental context and resources (ECR; n = 250), Beliefs about consequences (n = 225), Social influences (n = 193), Knowledge (n = 100), and Intentions (n = 88). Teachers who implemented DPA during instructional time differed from those who relied on non-instructional time in relation to Goals, Behavioural regulation, Social/professional role and identity, Beliefs about Consequences. Forty-one qualitative sub-themes were identified across the fourteen domains and exemplary quotes were highlighted.ConclusionsTeachers identified barriers and facilitators relating to all TDF domains, with ECR, Beliefs about consequences, Social influences, Knowledge and Intentions being the most often discussed influencers of DPA policy implementation. Use of the TDF to understand the implementation factors can assist with the systematic development of future interventions to improve implementation.

Project description:ObjectivePhysical education, physical activity and sports provision are important factors in whole school health promotion, however, a standardised evaluation framework to evaluate the contribution of these components is lacking. A framework that accounts for the distinct structures and associated factors, that impact upon provision would facilitate a more coherent evaluation.MethodsA concept mapping methodology, involving the generation of factors relevant to school physical education, physical activity and sports provision and their subsequent thematic and numeric rating and sorting was utilised. Concept mapping effectively gathers, integrates, and visually and numerically represents the composite thinking of a group of relevant and expert stakeholders around a complex social phenomenon. Following a review of the extant literature and synthesis among 20 expert stakeholders, a list of 95 factor statements relevant to school physical education, physical activity and sports provision were developed.ResultsEach factor statement was rated and sorted by 197 multi-disciplinary participants. An eight-cluster framework that demonstrated good validity (stress value: 0.266), was derived from the data based on: 1. Partnerships and Pupil Centered Physical Education; 2. Physical Activity and Sports; 3. School Demographics; 4. Equipment, Facilities and Budget; 5. Extra Costs; 6. Curriculum and Policy; 7. School Management and 8. Timetable. Statements within the cluster on school management received the highest mean importance and modifiability ratings while statements within the cluster on school demographics received the lowest mean importance and modifiability ratings.ConclusionsEight overarching structures which account for school physical education, physical activity and sports provision have been identified. Within each of these, structures and overall factors of greatest importance and modifiability have been illuminated. Findings stemming from this rigorous methodology, provide the foundation for the development of a national provision evaluation index to inform both school-level and national policy and actions. It is recommended the current methodology is replicated in other nations to gain corresponding insights.

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The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion!

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The Application of an Implementation Science Framework to Comprehensive School Physical Activity Programs: Be a Champion!

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