Background: Globally, many children fail to meet the World Health Organization’s physical activity and sedentary behaviour guidelines. Schools are an ideal setting to intervene, yet despite many interventions in this setting, success when delivered under real-world conditions or at scale is limited. This systematic review aims to i) identify which implementation models are used in school-based physical activity effectiveness, dissemination, and/or implementation trials, and ii) identify factors associated with the adoption, implementation and sustainability of school-based physical activity interventions in real-world settings.Methods: The review followed PRISMA guidelines and included a systematic search of seven databases from January 1st, 2000 to July 31st, 2018: MEDLINE, EMBASE, CINAHL, SPORTDiscus, PsycINFO, CENTRAL, and ERIC. A forward citation search of included studies using Google Scholar was performed on the 21st of January 2019 including articles published until the end of 2018. Study inclusion criteria: (i) a primary outcome to increase physical activity and/or decrease sedentary behaviour among school-aged children and/or adolescents; (ii) intervention delivery within school settings, (iii) use of implementation models to plan or interpret study results; and (iv) interventions delivered under real-world conditions. Exclusion criteria: (i) efficacy trials; (ii) studies applying or testing school-based physical activity policies, and; (iii) studies targeting special schools or pre-school and/or kindergarten aged children.Results: 27 papers comprising 17 unique interventions were included. Fourteen implementation models (e.g., RE-AIM, Rogers’ Diffusion of Innovations, Precede Proceed model), were applied across 27 papers. Implementation models were mostly used to interpret results (n = 9), for planning evaluation and interpreting results (n = 8), for planning evaluation (n = 6), for intervention design (n = 4), or for a combination of designing the intervention and interpreting results (n = 3). We identified 269 factors related to barriers (n = 93) and facilitators (n = 176) for the adoption (n = 7 studies), implementation (n = 14 studies) and sustainability (n = 7 studies) of interventions.Conclusions: Implementation model use was predominately centered on the interpretation of results and analyses, with few examples of use across all study phases as a planning tool and to understand results. This lack of implementation models applied may explain the limited success of interventions when delivered under real-world conditions or at scale.Trial registration: PROSPERO (CRD42018099836).

Promoting physical activity has become a priority because of its role in preventing childhood obesity and chronic disease. Ecological approaches that recognise the interaction between individuals and the settings in which they spend their time are currently at the forefront of public health action. Schools have been identified as a key setting for health promotion. An overview of the literature addressed the promotion of physical activity in schools and showed that school-based strategies (elementary or high school) that utilised classroom-based education only did not increase physical activity levels; one notable exception was screen time interventions. Although evidence is sparse, active school models and environmental strategies (interventions that change policy and practice) appear to promote physical activity in elementary schools effectively. There is also strong evidence to support multicomponent models in high schools, particularly models that incorporate a family and community component. An emerging trend is to involve youth in the development and implementation of interventions. In the context of childhood obesity and sedentary lifestyles, modest increases in physical activity levels in school-based trials are important. School initiatives must be supported and reinforced in other community settings. Health professionals play a key role as champions in the community, based on their influence and credibility. Health professionals can lend support to school-based efforts by asking about and emphasising the importance of physical activity with patients, encouraging family-based activities, supporting local schools to adopt an “active school” approach and advocating for support to sustain evidence-based and promising physical activity models within schools.

Due to physiological and cognitive changes that occur with aging, accurate physical activity (PA) measurement in older adults represents a unique challenge. The primary purpose of this study was to systematically review measures of PA and their use and appropriateness with older adults. A secondary aim was to determine the level of agreement between PA measures in older adults.

Our aim was to examine the relationship between motor skill proficiency and perceptions of competence of children in their first year of school. We also explored gender-based differences.

Public policies targeting the school setting are increasingly being used toaddress childhood obesity; however, their effectiveness depends on theirimplementation. This study explores the factors which impeded or facilitatedthe implementation of publicly mandated school-based physical activity andnutrition guidelines in the province of British Columbia (BC), Canada. Semi-structured interviews were conducted with 50 school informants (17principals - 33 teacher/school informants) to examine the factors associatedwith the implementation of the mandated Daily Physical Activity (DPA) andFood and Beverage Sales in Schools (FBSS) guidelines. Coding used aconstructivist grounded theory approach. The first five transcripts andevery fifth transcript thereafter were coded by two independent coders withdiscrepancies reconciled by a third coder. Data was coded and analysed inthe NVivo 9 software. Concept maps were developed and current theoreticalperspectives were integrated in the later stages of analysis. The Diffusion of Innovations Model provided an organizing framework topresent emergent themes. With the exception of triability (not relevant inthe context of mandated guidelines/policies), the key attributes of theDiffusion of Innovations Model (relative advantage, compatibility,complexity, and observability) provided a robust framework for understandingthemes associated with implementation of mandated guidelines. Specifically,implementation of the DPA and FBSS guidelines was facilitated by perceptionsthat they: were relatively advantageous compared to status quo; werecompatible with school mandates and teaching philosophies; had observablepositive impacts and impeded when perceived as complex to understand andimplement. In addition, a number of contextual factors includingavailability of resources facilitated implementation. The enactment of mandated policies/guidelines for schools is considered anessential step in improving physical activity and healthy eating. However,policy makers need to: monitor whether schools are able to implement theguidelines, support schools struggling with implementation, and document theimpact of the guidelines on students’ behaviors. To facilitate theimplementation of mandated guidelines/policies, the Diffusion of InnovationsModel provides an organizational framework for planning interventions.Changing the school environment is a process which cannot be undertakensolely by passive means as we know that such approaches have not resulted inadequate implementation.