Background: To have population-level impact, physical activity (PA) interventions must be effectively implemented and sustained under real-world conditions. Adequate Fundamental Movement Skills (FMS) is integral to children being able to actively participate in play, games, and sports. Yet, few FMS interventions have been implemented at scale, nor sustained in routine practice, and thus it is important to understand the influences on sustained implementation. The study’s aim was to use Collective Intelligence (CI)—an applied systems science approach—with stakeholder groups to understand barriers to the implementation of FMS interventions, interdependencies between these barriers, and options to overcome the system of barriers identified. Methods: Three CI sessions were conducted with three separate groups of experienced FMS intervention researchers/practitioners (N = 22) in the United Kingdom and Ireland. Participants generated and ranked barriers they perceive most critical in implementing FMS interventions. Each group developed a structural model describing how highly ranked barriers are interrelated in a system. Participants then conducted action mapping to solve the problem based on the logical relations between barriers reflected in the model. Results: The top ranked barriers (of 76) are those related to policy, physical education curriculum, and stakeholders’ knowledge and appreciation. As reflected in the structural model, these barriers have influences over stakeholders’ efficacy in delivering and evaluating interventions. According to this logical structure, 38 solutions were created as a roadmap to inform policy, practice, and research. Collectively, solutions suggest that efforts in implementation and sustainability need to be coordinated (i.e., building interrelationship with multiple stakeholders), and a policy or local infrastructure that supports these efforts is needed. Conclusions: The current study is the first to describe the complexity of barriers to implementing and sustaining FMS interventions and provide a roadmap of actions that help navigate through the complexity. By directing attention to the ecological context of FMS intervention research and participation, the study provides researchers, policy makers, and practitioners with a framework of critical components and players that need to be considered when designing and operationalising future projects in more systemic and relational terms.

The present study aimed to examine cross-cultural differences in fundamental movement skills (FMS) proficiency levels in children aged 9–10 years old in England and China, using a process-oriented FMS measurement. Four FMS (run, jump, throw, catch) were measured using the Test of Gross Motor Development-2 (TGMD-2). The sample consisted of 272 (58.3% boys, 41.7% girls) Chinese children and 273 (48.7% boys, 51.3% girls) English children. ANCOVA analysis for the raw FMS scores showed significant sex by country interaction ( P = .022, partial η² = .01). Chinese children scored higher than English children on total FMS, locomotor, and object control skill subsets. Additional Chi-squared analyses revealed significant differences regarding mastery levels of skills, with a higher proportion of Chinese children being classified as having advanced skill proficiency across three of four selected FMS (i.e. run, throw, and catch). The substantial cross-cultural differences found may be related to aspects such as Physical Education (PE) provision and process, educational policy, and other physical activity opportunities (e.g. extracurricular organised sports). Our findings require further examination of the contextual influences, in order to understand the optimal strategies that promote children's FMS development through PE, youth sports, or physical activity promotion.

To have population-level impact, interventions must be effectively implemented and sustained under real-world conditions. Few Fundamental Movement Skill (FMS) interventions are implemented at scale, and even fewer are sustained in a way that allows for ongoing evaluation. There has been increasing recognition of applying systems thinking to investigate the multitude of influences on interventions. To improve research-practice translations, investigations need to incorporate synthesised perspective and collective input from intervention stakeholders. This study trials Collective Intelligence (CI) – an applied systems science approach – to understand barriers to the adoption, implementation and institutionalisation of effective FMS interventions for children and adolescents. A total of 58 barriers were generated and organised into 13 barrier categories. Participants voted to select 10 critical barriers and generated a structural map among the barriers to guide future action mapping. Barriers related to Government and Institutional factors and Curricular Conflicts were structured as fundamental drivers of the system of barriers. By presenting this application example, we aim to underline the considerations and alleviate barriers to conducting much needed implementation and sustainability studies in FMS interventions. CI also adds to the “tool box” to understand the complexity and functioning of public health interventions, such as those targeting physical activity behaviours.

The concept of physical literacy (PL) has witnessed enormous popularity in recent years and has undergone substantial theoretical evolvement during the last 2 decades. However, the research field pertaining to PL has not yet initiated discussions around the challenges of climate change and the alignment with conceptualizations of planetary health. Therefore, we argue that the consideration of an “ecological domain” for individual physical activity, in the form of ecological awareness, would further evolve the concept. We illustrate how to potentially integrate adjustments within the most frequent PL definitions of the field (eg, those in Australia, Canada, England, Ireland, the United States, or by the International Physical Literacy Association) without questioning the entire integrity of these elaborate conceptualizations. An ecological domain of PL would not only interact with the postulated physical, cognitive, psychological/affective, and social domains of PL but also have important implications for the (re)design of interventions and practices in physical activity contexts. We call the scientific community, both on national and international scales, to intensify the discussions and initiate a research agenda involving an “ecological domain” of PL.

Managing blood glucose levels and adhering to exercise is challenging for older adults with obesity and type 2 diabetes mellitus (T2DM). Digital voice assistants (DVAs) utilising conversation-based interactions and natural language may overcome barriers to accessing home-based lifestyle programs, but end-user perspectives are essential for implementation. This analysis investigated end-user perspectives on implementation outcomes of a DVA-delivered lifestyle program nested within a randomised controlled trial of 50 older adults (aged 50–75 years) with obesity and T2DM (DVA n = 25; control n = 25). Following trial completion, 10 DVA participants (mean ± SD age 67 ± 4 years) completed semi-structured interviews guided by the Practical Planning for Implementations and Scale-up guide and Proctor’s implementation outcome taxonomy. Over half (60%) were willing to pay for the DVA-delivered program, indicating perceived value. DVA audiovisual and conversation-based modalities enhanced engagement and acceptability. Most end-users found the DVA program feasible as a modality for delivering lifestyle programs, but suggested greater personalisation to bolster sustainability. Overall, the intervention was identified as acceptable and appropriate, suggesting digitally delivered programs may be feasible and sustainable for long-term use. Findings should be interpreted cautiously, given the small sample size and short intervention period. Nevertheless, end-users’ suggestions could inform the implementation of digital health interventions into healthcare systems.