Implementation of school based physical activity interventions: A systematic review

Abstract Objective Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors tha...

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Bibliographic Details
Published in:Preventive medicine 2015-03, Vol.72, p.95-115
Main Authors: Naylor, Patti-Jean, Nettlefold, Lindsay, Race, Douglas, Hoy, Christa, Ashe, Maureen C, Wharf Higgins, Joan, McKay, Heather A
Format: Article
Language:English
Subjects:
Adolescent
Child
Diffusion of innovation
Exercise - physiology
Female
Health promotion
Health Promotion - methods
Humans
Implementation
Internal Medicine
Male
Outcome Assessment (Health Care)
Physical activity
School Health Services
Schools
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Summary:Abstract Objective Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors that influence implementation. Methods We searched 7 electronic databases (1995–2014) and included controlled studies of school-based PA programmes for healthy youth (6–18 y) measuring at least one physical health-related outcome. For objective 1, studies linked implementation level to student-level health outcome(s). For objective 2, studies reported factors associated with implementation. Results There was substantial variability in how health outcomes and implementation were assessed. Few studies linked implementation and health outcomes (n = 15 interventions). Most (11/15) reported a positive relationship between implementation and at least one health outcome. Implementation factors were reported in 29 interventions. Of 22 unique categories, time was the most prevalent influencing factor followed by resource availability/quality and supportive school climate. Conclusions Implementation evaluation supports scale-up of effective school-based PA interventions and thus population-level change. Our review serves as a call to action to 1) address the link between implementation and outcome within the school-based PA literature and 2) improve and standardize definitions and measurement of implementation.
ISSN:0091-7435
1096-0260
DOI:10.1016/j.ypmed.2014.12.034