Barriers and facilitators to the adoption of physical activity policies in elementary schools from the perspective of principals: An application of the consolidated framework for implementation research–A cross-sectional study

Abstract

BackgroundStudies have shown that policies to promote physical activity in schools can have a positive impact on children's physical activity behavior. However, a large research gap exists as to what determinants may influence the adoption of such policies. Applying the Consolidated Framework for Implementation Research (CFIR), we investigated barriers and facilitators to the adoption of physical activity policies in elementary schools in Baden-Wuerttemberg, Germany, from the perspective of school principals.MethodsA cross-sectional study was conducted between May and June 2021. School principals from elementary and special needs schools (n = 2,838) were invited to participate in the study. The online questionnaire used was developed based on the CFIR and included questions on school characteristics and constructs of the CFIR domains inner setting, characteristics of individuals, and process. Logistic regression analyses were performed to examine associations between policy adoption and school characteristics as well as CFIR determinants.ResultsIn total, 121 schools (4%) participated in the survey, of which 49 (40.5%) reported having adopted a policy to promote physical activity. Positive associations with policy adoption were found for general willingness among teaching staff [odds ratio (OR): 5.37, 95% confidence interval (CI): 1.92–15.05], available resources (OR: 2.15, 95% CI: 1.18–3.91), access to knowledge and information (OR: 2.11, 95% CI: 1.09–4.09), and stakeholder engagement (OR: 3.47, 95% CI: 1.24–9.75).ConclusionsThis study provides a first insight into potential barriers and facilitators at the organizational level of schools that may be relevant to the adoption of physical activity policies, from the perspective of school principals. However, due to a low response rate, the results must be interpreted with caution. A strength of this study includes theoretical foundation through the use of the CFIR. The CFIR could be well-adapted to the school setting and provided valuable support for developing the questionnaire and interpreting the study results.

Barriers and facilitators to physical activity and further digital exercise intervention among inactive British adolescents in secondary schools: a qualitative study with physical education teachers

“…While previous studies have identified PA preferences and barriers ( 17–19 ) among adolescents in schools, there is a lack of evidence on the habits and behaviors of inactive adolescents, particularly from the perspective of PE teachers. Although other school staff including headteachers/principals ( 20 ) have an impact, PE teachers are the gatekeepers for delivering interventions in schools and have a better understanding of the complex range of needs, attitudes, and preferences of inactive adolescents since they work with them every week.…”

Good practice recommendations on implementation evaluation for policies targeting diet, physical activity, and sedentary behaviour

“…Between 2019 and 2022, seven reviews and three case studies were conducted to identify key requirements of policy implementation evaluation (see Supplementary Table ). Our experiences and findings of this research are summarized in case reports, including their objectives, methods, findings & lessons learned: case report 1: scoping reviews on implementation processes of sugar-sweetened beverage taxation and public physical activity policies [ 20 , 21 ] case report 2: a qualitative study on implementation determinants of the EU School Fruit and Vegetables Scheme [under review] case report 3: a meta-review on social, economic, political, and geographical context determinants for policies promoting a healthy diet and physical activity [ 22 ] case report 4: a systematic review of frameworks for implementation of policies promoting a healthy diet and physical activity [ 23 ] case report 5: a systematic review on acceptability of policies targeting dietary behaviours and physical activity [ 24 ] case report 6: meta-review of implementation determinants for policies promoting a healthy diet and physical activity [ 25 ] case report 7: a systematic review on implementation determinants of direct fruit and vegetables provision interventions in kindergartens and schools [ 26 ] case report 8: a quantitative cross-sectional study on determinants for the adoption of physical activity policies in elementary schools [ 27 ] case report 9: participatory stakeholder studies on implementation determinants following the Theory of Change approach [ 28 ] …”

“…case report 8: a quantitative cross-sectional study on determinants for the adoption of physical activity policies in elementary schools [ 27 ]…”

Solid Waste Management Relative to Implementation of Policies and Programs Towards Safe and Healthy Environment

“…Moreover, the adoption of recycling practices in schools is influenced by various factors, and understanding stakeholders' perspectives, particularly principals, is crucial for policy implementation. The Consolidated Framework for Implementation Research (CFIR) is a valuable tool for interpreting study results and developing effective strategies in school settings, as highlighted by Wendt et al (2023). Studies have shown that education plays a crucial role in shaping individuals' awareness of waste management practices.…”