Comprehensive school health: teachers' perceptions and implementation of classroom physical activity breaks in US schools.

Global health statistics suggest that youth health is deteriorating. In response, international and national health organizations have called for school settings to adopt comprehensive school health approaches that provide youth with ample opportunities, such as physical activity across the school day, to improve their health behaviors and instill lifelong healthy habits. This study used the social­ecological model, which considers the interactions between an individual, their community, and the physical, social and political environments, to frame the exploration of how teachers and principals perceive and utilize physical activity breaks in elementary schools. Findings indicate that to foster school health, a comprehensive approach that supports teachers and their interactions while providing resources and policies is needed. Adoption of classroom physical activity breaks begins with teacher knowledge which fosters teacher interaction where best practices are built. Structural supports, including access to resources and the presence of policy, are also critical to sustained implementation because they can reinforce and support teachers' individual and shared use of health-based learning practices across the school day.