A cluster randomised controlled trial of an intervention to increase the implementation of school physical activity policies and guidelines: study protocol for the physically active children in education (PACE) study

Abstract

Background In an attempt to improve children’s physical activity levels governments have introduced policies specifying the minimum time schools are to schedule physical activity each week. Despite this, the majority of schools in many jurisdictions fail to implement these policies. This study will assess the effectiveness of a multi-component implementation strategy on increasing the minutes of planned physical activity scheduled by primary school teachers each week. Methods A cluster randomised controlled trial will be conducted in 62 primary schools in the Hunter New England region of New South Wales, Australia. Schools will be randomly allocated to receive either a multi-component implementation strategy that includes; obtaining executive support, training in-school champions, provision of tools and resources, implementation prompts, reminders and feedback; or usual practice. The study will employ an effectiveness-implementation hybrid design, assessing both policy implementation and individual (student) behavioural outcomes. The primary trial outcome of mean minutes of physical activity scheduled by classroom teachers across the school week will be measured via teacher log-book at baseline and approximately 12 and 18 months post baseline. A nested evaluation of the impact of policy implementation on child physical activity will be undertaken of students in Grades 2 and 3. Analyses will be performed using an intention to treat framework. Linear mixed effects regression models will be used to assess intervention effects on the primary outcome at both follow-up periods. Discussion This study will be the one of the first well powered randomised trials internationally to examine the impact of an implementation strategy for a physical activity policy in primary schools and will address a fundamental research translation gap. Given the dearth of research, the findings will be important in informing future implementation efforts in this setting. Trial registration ANZCTR ACTRN12617001265369 version 1 registered 1st September 2017.

Associations between in-school-hours physical activity and child health-related quality of life: A cross-sectional study in a sample of Australian primary school children

“…A cross-sectional analysis was employed using baseline data collected from the PACE cluster randomised controlled trial, conducted by Nathan et al (2019) , between October 2017 and December 2018. The study was undertaken with children in Grades 2 and 3, aged between 7 and 9 years, from 62 primary schools in the HNE region of New South Wales (NSW), Australia.…”

“…All government and Catholic schools in the study region were considered. Schools were ineligible to participate if they were currently participating in another PA intervention, had both primary and secondary children, or catered exclusively for children requiring specialist care ( Nathan et al, 2019 ). School principals were provided with a study information package and asked to provide written informed consent.…”

A Systematic Review of School Health Policy Measurement Tools: Implementation Determinants and Outcomes

“…The nding that readiness for implementation as a general construct was most measured re ects prior research stressing the importance of assessing readiness and organizational capacity for implementation (22,(68)(69)(70)(71)(72)(73). Within this broader construct, non-training resources was the most common determinant assessed; provision of nancial resources and personnel support have been cited as supportive factors for policy and innovation implementation in school research (9,74,75). Following this, leadership for implementation was very prevalent in the measures, which again re ects extant knowledge that new innovations require a leader to succeed (61,76,77).…”

A pilot randomised controlled trial of a web-based implementation intervention to increase child intake of fruit and vegetables within childcare centres

“…Upon notification of group allocation, the HPO will ask centres to identify and prepare a staff member from the centre who will dedicate themselves to supporting, marketing and driving implementation of the intervention [ 49 , 51 ].…”