Project description: Despite the proven effectiveness of school-based programs on improving physical activity (PA) and nutrition in children, sustaining delivery is a significant challenge. Developing strategies to support program sustainment requires an understanding of the multilevel determinants of program sustainability. As such, this study aimed to: (i) Evaluate the prevalence of the sustained delivery of PA and nutrition programs in schools. (ii) Identify differences in program delivery duration between nutrition and PA programs. (iii) Identify the top reported determinants of program sustainment. (iiii) Assess the determinants associated with program delivery duration. A cross sectional study was undertaken with 201 Australian primary schools currently implementing physical activity and nutrition programs. Factors perceived to be influential to program sustainment were assessed using a 28-item measure of sustainability determinants developed by the research team. This reflected five domains of the Integrated Sustainability Framework. A 5-point Likert scale was used and domain scores were calculated for each school by averaging item responses. Linear mixed regressions were conducted to evaluate associations between measure domains and length of program delivery.

Impact: Preliminary data from 201 primary schools across eight Australian states and territories found that on average programs were sustained for 7.4 years. The lowest scoring measure item was related to the existence of a governing body policy or guideline related to the program (mean = 3.50 [SD 1.08]). Conversely, the health benefits of the program (mean = 4.44 [SD 0.75]), was the highest scoring item. Ongoing analysis aims to uncover associations between measure domains and program delivery length. The results improve our understanding of what determinants are associated with sustained delivery of physical activity and nutrition programs in schools and where support can be targeted.

Learning: We will share important learnings regarding the development of pragmatic measures to assess the determinants of sustainability.

Project description: The scoping review aims to describe the scope of monitoring system literature and identify key features of monitoring systems for public health programs and policies in community settings. The scoping review will search academic databases and grey literature for all recommendations relating to monitoring programs and policies in community settings. Framework synthesis will be used to analyse the results. This project is due for publication in Q2 of 2024. Impact: Monitoring systems involve the regular tracking of essential information related to a program or policy to assess the progress of implementation and sustainability, offering early indicators of successes and challenges. Evidence indicating successful implementation or sustainment provides a foundation that can be used to advocate for continued support. Evidence indicating unsuccessful implementation or sustainment can trigger an investigation into adapting and optimising the program or policy and lobbying for further resources. Consequently, monitoring systems facilitate a continuous feedback loop for addressing program slippage to adapt implementation and sustainment strategies to optimally fit the changing contexts of schools and government, such as teacher turnover. It is essential that future school-based physical activity initiatives use monitoring systems so resources are not wasted due to inadequate program and policy implementation and sustainability. Learning: As an alternative to explicit physical activity outcomes, I will present the full results of our study on monitoring systems, with a focus on monitoring system features that apply to physical activity and school programs and policies. Understanding recommended features of monitoring systems would be the first step towards generating guidance about how best to implement and sustain school physical activity initiatives. This review can be utilised as guidance for developing a system to monitor the implementation and sustainability of future school-based physical activity initiatives.

This study explores whether the socioeconomic region of England primary schools has an impact upon the CAS Profiling Tool Policy, Environments, Stakeholders, and Opportunities (PESO) scores. The CAS Profiling Tool is a self-evaluation form that schools fill out when joining CAS. The intention is to determine a school’s specific areas of need related to whole-school physical activity. The form is multiple-choice, and answers are scaled in relation to one another. Upon completion of the profiling tool, schools are given individual category scores and an overall PESO score. Researchers examined these individual subcategory/category/overall PESO scores in relation to IDACI Rank and OFSTED rank as measures of socioeconomic status (SAS). As of March 2024, the analysis is still underway. So far, the data seems to suggest large variability and weak correlations between SAS and PESO scores. This finding could suggest whole-school physical activity outcomes are not necessarily bound to the SAS. There are ways to work creatively around socioeconomic barriers.

Since 2010, Finland has been building a concept called Finnish Schools on the Move (FSM), which is a national action programme supporting educational institutions to develop a more physically active operating culture. The Self-Evaluation Survey for Physical Activity (PA) Promotion in School is a tool developed in 2015 for FSM to support schools in implementing their own unique action plans and to monitor the progress of PA promotion at the levels of schools, municipalities, and the nation. A self-evaluation survey for students was developed in 2021 to increase and strengthen student participation. The online survey for schools, available on the programme’s website, has altogether 36 statements. Teams in schools evaluate each statement using a scale of 0-4 (0=not at all, 4= fully realised). The online survey for students, also available on the programme’s website, has six statements related to adolescents’ participation in PA during the school day and 14 statements related to students’ opinions and experiences on operations increasing PA in school. By the end of year 2023, datasets consisted of over 5,000 self-evaluations concerning the physically active operating culture in schools and over 4,000 student responses. The self-evaluation produces up-to-date information on the PA promotion progress in schools for PA promotors, coordinators, and decision-makers. For schools, it provides a diverse tool that increases schools’ awareness of the state of their physically active operating culture and inspires discussions among staff to find areas for development. To increase PA especially in lower secondary schools, students could be given more opportunities to take part in planning and implementing different kinds of activities. The self-evaluation survey for students is one way to gather students’ opinions and strengthen their participation in the development of actions increasing PA during the school day.

Background. The school day and setting represents an important part of children's lives. Understanding intra- and inter-individual differences in physical activity, and the potential drivers of these differences, may support the development of improved strategies to ensure that as many children as possible have appropriate levels of in-school physical activity. The aim of this study was to examine variability in pupils’ physical activity between English primary schools within the same academic year. Methods. School physical activity data from a wearable technology company was obtained for the 2021/22 academic school year. Additional information was obtained using UK Government information about schools, including area indices of multiple deprivation scores, and estimated playground area using Google Earth. All analysis was performed using R Studio. Descriptive statistics were performed, and data visualization used to explore patterns in the data, before using multilevel models to explore the associations between children’s in-school physical activity and school variables, with pupils nested within schools, adjusted for individual characteristics. Results. The final dataset included 17,043 pupils across 165 primary schools. Children engaged in an average of 6244 steps per day within school hours and 27 minutes of moderate to vigorous physical activity (MVPA), with 34% achieving 30-minute targets. There were large variations and inequalities seen between schools, ranging from 4253 to 8356 steps/day or 16.4-39.1 minutes of MVPA/day. On average, children at schools with higher levels of deprivation engaged in lower levels of physical activity, and the physical activity level of school staff was positively associated with pupils’ physical activity. Other school-level data, such as playground space and Ofsted ratings, not explain much between-school variance. Conclusions. There is considerable heterogeneity in physical activity in a large sample of English primary schools. Factors such as playground size did not explain between-school differences, and thus in-school physical activity is more likely to be related to school policies and practices.