Stand Out in Class: restructuring the classroom environment to reduce sitting time - findings from a pilot cluster randomised controlled trial.

BACKGROUND: Excessive sedentary behaviour (sitting) is a risk factor for poor health in children and adults. Incorporating sit-stand desks in the classroom environment has been highlighted as a potential strategy to reduce children's sitting time. The primary aim of this study was to examine the feasibility of conducting a cluster randomised controlled trial (RCT) of a sit-stand desk intervention within primary school classrooms. METHODS: We conducted a two-armed pilot cluster RCT involving 8 primary schools in Bradford, United Kingdom. Schools were randomised on a 1:1 basis to the intervention or usual practice control arm. All children (aged 9-10 years) in participating classes were eligible to take part. Six sit-stand desks replaced three standard desks (sitting 6 children) in the intervention classrooms for 4.5-months. Teachers were encouraged to use a rotation system to ensure all pupils were exposed to the sit-stand desks for > 1 h/day on average. Trial feasibility outcomes (assessed using quantitative and qualitative measures) included school and participant recruitment and attrition, intervention and outcome measure completion rates, acceptability, and preliminary effectiveness of the intervention for reducing sitting time. A weighted linear regression model compared changes in weekday sitting time (assessed using the activPAL accelerometer) between trial arms. RESULTS: School and child recruitment rates were 33% (n = 8) and 75% (n = 176). At follow-up, retention rates were 100% for schools and 97% for children. Outcome measure completion rates ranged from 63 to 97%. A preliminary estimate of intervention effectiveness revealed a mean difference in change in sitting of - 30.6 min/day (95% CI: - 56.42 to - 4.84) in favour of the intervention group, after adjusting for baseline sitting and wear time. Qualitative measures revealed the intervention and evaluation procedures were acceptable to teachers and children, except for some problems with activPAL attachment. CONCLUSION: This study provides evidence of the acceptability and feasibility of a sit-stand desk intervention and evaluation methods. Preliminary evidence suggests the intervention showed potential in reducing children's weekday sitting but some adaptations to the desk rotation system are needed to maximize exposure. Lessons learnt from this trial will inform the planning of a definitive trial. TRIAL REGISTRATION: ISRCTN12915848 (registered: 09/11/16).

"I Just Like the Feeling of It, Outside Being Active": Pupils' Experiences of a School-Based Running Program, a Qualitative Study.

INTRODUCTION: School-based running programs that promote daily (or regular) walking/jogging/running are an emerging public health initiative. However, evaluation of these programs has predominantly used quantitative measures that limit understanding and explanations of contextual influences on pupil participation. Therefore, the aim of this study was to qualitatively explore pupils' experiences of participating in a primary-school-based running program (Marathon Kids) to provide relevant insights and inform program developments. METHODS: Nine semistructured focus groups were conducted with a purposeful sample of 50 pupils (26 girls and 24 boys) between 6 and 10 years of age from 5 primary schools in England. All schools had delivered the running program for 5-9 months during the 2015-16 academic year. Transcripts were analyzed using an inductive thematic approach. RESULTS: Pupils identified a range of organizational, interpersonal, and intrapersonal factors that they believed influenced their participation in the program. Six themes were identified as being important to pupils' experiences: Marathon Kids as an enabling program, pupils' autonomy to participate, peer influence on participation (e.g., development of social cohesion), teacher influence on delivery (e.g., fidelity of implementation), logistics and suitability of the school environment, and appropriateness of program resources. CONCLUSIONS: School-based running programs can offer an enjoyable physical activity experience for children; however, it is important to understand how current delivery approaches influence pupils' participation. Aspects that were believed to facilitate enjoyment included pupil autonomy to participate, perceived benefits of participation (including psychosocial outcomes), and a supportive school environment. Further research is required to identify the type and level of support required by schools to sustain pupil participation in running programs so that their perceived value is maintained.

A retrospective qualitative evaluation of barriers and facilitators to the implementation of a school-based running programme.

BACKGROUND: There is growing interest in school-based interventions which deliver opportunities for additional physical activity time outside of physical education (PE). A practical and cost-effective approach may be school running programmes. Consequently, many school-based running initiatives are currently being implemented in a grass-roots style movement across the UK. However, research on the implementation of physical activity programmes in schools is notably underdeveloped. Therefore, this qualitative study aimed to better understand the barriers and facilitators to the implementation of a running programme, Marathon Kids (MK), within primary schools in England. METHODS: Two sets of semi-structured interviews were conducted, the first with each of the three core members of staff responsible for MK, and the second with each of the MK school staff Champions from 20 primary schools. Also, nine focus groups were conducted with 55 pupils (6-10 years) from five of the schools; all were analysed using thematic analysis. RESULTS: Three themes were identified surrounding the barriers and facilitators to implementation: features of the programme (e.g. ethos and resources), school climate (e.g. culture; whole school engagement; PE and physical activity policies and goals; and physical environment) and programme implementation decisions (e.g. aspirations and planning and sustainability). CONCLUSION: Findings suggest that the barriers and facilitators to implementation are wide-ranging and include programme, organisational and system-level factors. Collectively pointing towards the need for a preparation period before implementation to understand schools' readiness to implement and context-specific factors, both regarding organisational capacity and programme specific capacity.

Physical Education: At the Centre of Physical Activity Promotion in Schools.

Whilst recognising and advocating for the role and importance of schools and whole school approaches to the promotion of physical activity in schools, this paper argues that physical education (PE) should be at the centre of and driving schools' efforts to promote physical activity. Various reasons are given for this, with these broadly centring on the unique goal, nature, and responsibilities of the subject with respect to promoting physically active lifestyles and health-related learning. Furthermore, there have been positive strides in recent years to support this endeavour and that serve to highlight, strengthen, and reinforce the focus and responsibility of PE in the promotion of physical activity. In light of these, it is suggested that it is a pivotal time for PE. Equally, it is accepted that PE faces some longstanding challenges that are hindering and raise questions concerning the subject's physical activity promotion efforts. Despite this, it is contended that these should not be unsurmountable, and more recent developments should also help the subject to realise its physical activity promoting potential moving forwards. In particular, the critical importance of high-quality PE that has young people at the core is highlighted. It is concluded that it is both time and timely for the PE profession to be bold, have confidence, and grasp these opportunities and ensure that high-quality PE is central to the explicit planning and co-ordination of meaningful, coherent, relevant, and sustainable physical activity opportunities for young people in schools.

"Instead of Being on a Screen You Can Be More Out There and Enjoy Your Life": Young People's Understandings of Physical Activity for Health.

BACKGROUND: Despite documented evidence of the benefits of leading a physically active life, it is reported that less than half of young people in Europe meet the physical activity recommendations. Schools, and in particular physical education (PE), are viewed to be at the forefront of addressing inactive lifestyles and educating young people about physical activity. Nonetheless, given advancements in technology, young people are increasingly exposed to physical activity information "beyond the school gates". Consequently, if PE teachers are to support young people to understand the information they receive surrounding physical activity online, then they need to be able to address any misconceptions about health they may have. METHODS: In this study, fourteen young people (7 boys and 7 girls) in year 9 (13-14 years old) from two secondary schools in England participated in a digitally-based activity and semi-structured interviews which aimed to explore their conceptions of physical activity for health. RESULTS: It was found that the young people had limited and narrow conceptions of what it means to be physically active. CONCLUSIONS: It was suggested the findings could be partly attributed to limitations in students' learning and experiences with respect to physical activity and health in the PE curriculum.

Adolescents' Experiences and Perspectives on Physical Activity and Friend Influences Over Time.

Purpose: Understanding friend influences on adolescents' PA, and how these change over time, is fundamental to developing interventions for promoting active lifestyles yet the latter in particular remains unexplored. This study explored the experiences and perspectives of physically active and inactive adolescents regarding the influence of their friends on their PA throughout childhood and adolescence. Methods: Following the completion of a questionnaire, 16 adolescents, 8 boys (4 physically inactive, 4 active) and 8 girls (4 inactive, 4 active), aged 17 ± 1.0 years, were selected from two schools. A qualitative design was adopted whereby each adolescent was interviewed individually. Using the constant comparative method, the interviews were inductively and thematically analyzed. Results: Four main themes were identified: I) PA journeys; II) Friends provide PA benefits); III) Friends matter in PA, but change; IV) Against all odds-rising above others. Compared to the inactive, active adolescents perceived that their friends were fundamental to them becoming and remaining active, specifically in terms of: offering support to internalize an active sense of belonging in different contexts when family support diminished; providing opportunities to be active at key transition points; and helping them to overcome peer victimization. Conclusion: This study confirms the important role of friends in adolescents' PA, and provides new evidence concerning the changing patterns and influence of friends from childhood to late adolescence. Recommendations are made relating to the role of friends in youth PA with a view to improving the effectiveness of approaches to promoting active lifestyles.

Stand Out in Class: Investigating the Potential Impact of a Sit-Stand Desk Intervention on Children's Sitting and Physical Activity during Class Time and after School.

Sedentary behaviour (sitting) is a risk factor for adverse health outcomes. The classroom environment has traditionally been associated with prolonged periods of sitting in children. The aim of this study was to examine the potential impact of an environmental intervention, the addition of sit-stand desks in the classroom, on school children's sitting and physical activity during class time and after school. The 'Stand Out in Class' pilot trial was a two-arm cluster randomised controlled trial conducted in eight primary schools with children from a mixed socioeconomic background. The 4.5 month environmental intervention modified the physical (six sit-stand desks replaced standard desks) and social (e.g., teachers' support) environment. All children wore activPAL and ActiGraph accelerometers for 7 days at baseline and follow-up. In total 176 children (mean age = 9.3 years) took part in the trial. At baseline, control and intervention groups spent more than 65% of class time sitting, this changed to 71.7% and 59.1% at follow-up, respectively (group effect p < 0.001). The proportion of class time spent standing and stepping, along with the proportion of time in light activity increased in the intervention group and decreased in the control group. There was no evidence of any compensatory effects from the intervention after school. Incorporating sit-stand desks to change the classroom environment at primary school appears to be an acceptable strategy for reducing children's sedentary behaviour and increasing light activity especially during class time. Trial registration: ISRCTN12915848 (registered: 09/11/16).

Prompting Pedagogical Change through Promoting Active Lifestyles Paradoxes.

This study explored approaches to promoting active lifestyles (PAL) in schools which aimed to inform and develop physical education (PE) trainees and teachers' health-related philosophies and pedagogies. Thirty-two secondary school PE trainees and teachers involved in a University-based Initial Teacher Education partnership in England participated in this study during the period 2015-2019. The participants were involved in professional development which included an introduction to research-informed PAL 'paradoxes' associated with promoting active lifestyles. Participants were asked to review their own health-related philosophies and practices in light of these paradoxes and were encouraged to use them to influence their own pedagogies as well as those of colleagues/peers. Participants found the PAL paradoxes interesting, surprising and perplexing; expressed a keen desire to address and solve them; and experienced the joys and challenges of influencing colleagues'/peers' health-related philosophies and pedagogies. The findings suggest that this innovative low-cost, flexible and accessible approach to pedagogical change has the potential to engage PE teachers, increase their effectiveness as promoters of physical activity, and to greatly enhance the subject's contribution to public health. This is significant, given calls for new pedagogical approaches and teachers' previously reported lack of engagement in professional development in this area.

An Evaluation of the Implementation of a UK School-Based Running Program.

The adoption of school-based running programs has rapidly increased over the last five years in the UK and globally. However, there is currently a lack of information on how these initiatives are implemented, and whether they are generalizable and/or sustainable. This study evaluated the implementation (including reach, fidelity, and dose) of a school-based running program over seven months to inform future delivery. This observational study used a mixed-method, single-group, before-and-after design strengthened by multiple interim measurements to evaluate the implementation of an optional school-based running program. Five state-funded primary schools in Leicestershire, UK, participated, with 17 teachers and 189 (81 boys (47.4%) and 90 girls (52.6%)) Year 5 pupils (aged 9-10 years) from eight classes. During the 2016/2017 academic year, data were collected via several measures (including interviews, focus groups, observations, questionnaires, and teacher implementation logs) at multiple levels (i.e., school and individual) and at multiple time points during implementation. Follow up qualitative data were also collected during 2017/2018. The school-based running program achieved good reach, with 100% of pupils opting to participate at some point during the academic year. All schools implemented the program with good fidelity, although the level of implementation varied between schools and over time. The average number of sessions held per week ranged from 0.94-3.89 with the average distance accumulated per pupil per week ranging from 0.02 to 2.91 kilometers and boys being more likely than girls to be classed as high-level participators. Despite an initial drop off in participation over time, all schools remained engaged in the program and continued to implement it until the end of the school year. Contextual features (e.g., staff capacity and resources) differed between schools and influenced the quality of implementation and the frequency of delivery. The school-based running program is simple, inexpensive, and versatile and can be implemented by schools with relative ease. However, schools are diverse settings, with unique challenges to ongoing delivery. Thus, planned adaptations, specific to each school's context, are likely necessary to sustain participation in the longer term and should be considered prior to implementation.

Marathon Kids UK: study design and protocol for a mixed methods evaluation of a school-based running programme.

INTRODUCTION: Schools are promising settings for physical activity promotion; however, they are complex and adaptive systems that can influence the quality of programme implementation. This paper presents an evaluation of a school-based running programme (Marathon Kids). The aims of this study are (1) to identify the processes by which schools implement the programme, (2) identify and explain the contextual factors affecting implementation and explications of effectiveness and (3) examine the relationship between the level of implementation and perceived outcomes. METHODS: Using a realist evaluation framework, a mixed method single-group before-and-after design, strengthened by multiple interim measurements, will be used. Year 5 (9-10 years old) pupils and their teachers will be recruited from six state-funded primary schools in Leicestershire, UK.Data will be collected once prior to implementation, at five discrete time points during implementation and twice following implementation. A weekly implementation log will also be used. At time point 1 (TP1) (September 2016), data on school environment, teacher and pupil characteristics will be collected. At TP1 and TP6 (July 2017), accelerometry, pupil self-reported physical activity and psychosocial data (eg, social support and intention to be active) will be collected. At TP2, TP3 and TP5 (January, March and June 2017), observations will be conducted. At TP2 and TP5, there will be teacher interviews and pupil focus groups. Follow-up teacher interviews will be conducted at TP7 and TP8 (October 2017 and March 2018) and pupil focus group at TP8. In addition, synthesised member checking will be conducted (June 2018) with a mixed sample of schools. ETHICS AND DISSEMINATION: Ethical approval for this study was obtained through Loughborough University Human Participants Ethics Subcommittee (R16-P032 & R16-P116). Findings will be disseminated via print, online media and dissemination events as well as practitioner and/or research journals.

Stand Out in Class: restructuring the classroom environment to reduce sedentary behaviour in 9-10-year-olds - study protocol for a pilot cluster randomised controlled trial.

BACKGROUND: Sedentary behaviour (sitting) is a highly prevalent negative health behaviour, with individuals of all ages exposed to environments that promote prolonged sitting. Excessive sedentary behaviour adversely affects health in children and adults. As sedentary behaviour tracks from childhood into adulthood, the reduction of sedentary time in young people is key for the prevention of chronic diseases that result from excessive sitting in later life. The sedentary school classroom represents an ideal setting for environmental change, through the provision of sit-stand desks. Whilst the use of sit-stand desks in classrooms demonstrates positive effects in some key outcomes, evidence is currently limited by small samples and/or short intervention durations, with few studies adopting randomised controlled trial (RCT) designs. This paper describes the protocol of a pilot cluster RCT of a sit-stand desk intervention in primary school classrooms. METHODS/DESIGN: A two-arm pilot cluster RCT will be conducted in eight primary schools (four intervention, four control) with at least 120 year 5 children (aged 9-10 years). Sit-stand desks will replace six standard desks in the intervention classrooms. Teachers will be encouraged to ensure all pupils are exposed to the sit-stand desks for at least 1 h/day on average using a rotation system. Schools assigned to the control arm will continue with their usual practice, no environmental changes will be made to their classrooms. Measurements will be taken at baseline, before randomisation, and at the end of the schools' academic year. In this study, the primary outcomes of interest will be school and participant recruitment and attrition, acceptability of the intervention, and acceptability and compliance to the proposed outcome measures (including activPAL-measured school-time and school-day sitting, accelerometer-measured physical activity, adiposity, blood pressure, cognitive function, academic progress, engagement, and behaviour) for inclusion in a definitive trial. A full process evaluation and an exploratory economic evaluation will also be conducted to further inform a definitive trial. DISCUSSION: The primary output of this study will be acceptability data to inform the development of a definitive cluster RCT designed to examine the efficacy of this intervention on health- and education-related outcomes in UK primary school children. TRIAL REGISTRATION: ISRCTN12915848 (retrospectively registered, date registered 9 November 2016).

Atividade física para saúde, covid-19 e mídias sociais: o quê, onde e por quê? / Actividad física para la salud, covid-19 y medios sociales: ¿qué, dónde y por qué? / Physical activity for health, covid-19 and social media: what, where and why?

Resumo Este estudo concentra-se no uso de mídias sociais por professores de Educação Física (EF) para o ensino de atividade física para saúde durante a pandemia de covid-19. Com base na pesquisa apreciativa e utilizando uma metodologia de teoria fundamentada em dados (Grounded Theory), a análise de duas entrevistas e uma tarefa digital permitem apresentar três principais temas: (1) Mídias Sociais como Ferramenta de Ensino; (2) Um Legado Digital Duradouro?, e; (3) Desigualdade do Aprendizado Remoto. Esses temas destacam a urgência em utilizar mídias sociais quando os espaços físicos da EF foram removidos, o reconhecimento de que o ensino poderia ser diferente no futuro e os desafios inerentes aos espaços digitais. Em conclusão: (1) defendemos a efetiva formação inicial e continuada de professores e no uso positivo de tecnologias digitais; (2) sugerimos que atividades on-line futuras incorporadas ao aprendizado, e; (3) exigir aos governos ações para nivelar as desigualdades tecnológicas.

Resumen Este estudio se centra en el uso de los medios sociales por parte de los profesores de Educación Física (EF) para enseñar actividad física para la salud durante la pandemia de covid-19. Con base en la investigación apreciativa y utilizando una metodología teórica fundamentada en datos (Grounded Theory), el análisis de dos entrevistas y una tarea digital permiten presentar tres temas principales: (1) Medios Sociales como Herramienta de Enseñanza, (2) ¿Un Legado Digital Duradero?, y (3) Desigualdad del Aprendizaje Remoto. Estos temas destacan la urgencia de utilizar medios sociales cuando los espacios físicos de la EF fueron suspendidos, el reconocimiento de que la enseñanza podría ser diferente en el futuro y los desafíos inherentes a los espacios digitales. En conclusión, (1) abogamos por la efectiva formación inicial y continua de profesores en el uso positivo de las tecnologías digitales, (2) sugerimos que actividades online futuras sean incorporadas al aprendizaje, y (3) demandar a los gobiernos acciones para nivelar las desigualdades tecnológicas.

Abstract This study focuses on Physical Education (PE) teachers' use of social media to teach physical activity for health during the covid-19 pandemic. Drawing on appreciative inquiry and utilising a grounded theory methodology, analysis of two interviews and a digital task allow us to present three main themes: (1) Social Media as a Teaching Tool, (2) A Lasting Digital Legacy?, and (3) Inequity of Remote Learning. These themes highlight the rush to utilise social media when the physical spaces of PE were removed, the recognition that teaching could be different in the future, and challenges inherent to digital spaces. In concluding we: (1) advocate for effective initial teacher education and ongoing professional development in the positive use of digital technologies, (2) suggest that future online activities incorporate learning, and (3) urge governments to do more in terms of levelling out technological inequalities.

Study design and protocol for a mixed methods evaluation of an intervention to reduce and break up sitting time in primary school classrooms in the UK: The CLASS PAL (Physically Active Learning) Programme.

INTRODUCTION: Children engage in a high volume of sitting in school, particularly in the classroom. A number of strategies, such as physically active lessons (termed movement integration (MI)), have been developed to integrate physical activity into this learning environment; however, no single approach is likely to meet the needs of all pupils and teachers. This protocol outlines an implementation study of a primary school-based MI intervention: CLASS PAL (Physically Active Learning) programme. This study aims to (A) determine the degree of implementation of CLASS PAL, (B) identify processes by which teachers and schools implement CLASS PAL and (C) investigate individual (pupil and teacher) level and school-level characteristics associated with implementation of CLASS PAL. METHODS AND ANALYSIS: The intervention will provide teachers with a professional development workshop and a bespoke teaching resources website. The study will use a single group before-and-after design, strengthened by multiple interim measurements. Six state-funded primary schools will be recruited within Leicestershire, UK.Evaluation data will be collected prior to implementation and at four discrete time points during implementation: At measurement 0 (October 2016), school, teacher and pupil characteristics will be collected. At measurements 0 and 3 (June-July 2017), accelerometry, cognitive functioning, self-reported sitting and classroom engagement data will be collected. At measurements 1(December 2016-March 2017) and 3 , teacher interviews (also at measurement 4; September-October 2017) and pupil focus groups will be conducted, and at measurements 1 and 2 (April-May 2017), classroom observations. Implementation will be captured through website analytics and ongoing teacher completed logs. ETHICS AND DISSEMINATION: Ethical approval was obtained through the Loughborough University Human Participants Ethics Sub-Committee (Reference number: R16-P115). Findings will be disseminated via practitioner and/or research journals and to relevant regional and national stakeholders through print and online media and dissemination event(s).

More than 10 years after "the horse is dead . . .": surely it must be time to "Dismount"?!

This article represents a response to an editorial piece written in Pediatric Exercise Science over 10 years ago by Thomas Rowland in which he debated fitness testing and asked whether the "horse" of fitness testing in schools was dead. Here, the authors revisit the debate and consider the progress that has been made with regard to fitness testing in schools in recent years. On the basis of findings from the literature and some of their research, the authors suggest that accepting the fact that the horse is dead would not be a bad thing. Their advice is certainly to pull tightly on the reigns, slow the horse down, and not allow fitness testing to dominate schools' efforts to promote physical activity.