Acceptability, appropriateness, and feasibility of Rural School Support Strategies for behavioral interventions: a mixed methods evaluation over two years of a hybrid type 3 implementation-effectiveness trial.

BACKGROUND: Positive Behavioral Interventions and Supports (PBIS) is a framework for implementing evidence-based interventions for preventing behavioral issues and improving climate in schools. The implementation of school-wide PBIS with fidelity is complex, requiring leadership commitment, teaming, and coordination of systems for tracking behaviors and consequences. Putting these components in place while ensuring alignment with the values and needs of the school community can be difficult for schools with fewer resources, such as rural schools. Implementation supports are needed, including strategies such as technical assistance, but it is unclear whether lower-cost modalities such as virtual support are acceptable, appropriate, and feasible and whether perceptions vary throughout the implementation process. METHODS: A type 3 hybrid implementation-effectiveness trial is taking place in 40 Idaho schools, testing a bundle of implementation supports selected to meet the needs of schools in rural areas. Supports include technical assistance from an implementation support practitioner (ISP), didactic trainings, virtual learning sessions, and an online resource portal. Surveys and interviews in the first 2 years of implementation (fall 2019 to spring 2021) explored outcomes of acceptability, appropriateness, and feasibility regarding the implementation supports among more than 150 school stakeholders. RESULTS: Evaluations showed high acceptability and appropriateness of the PBIS concepts and training. The 20 schools receiving additional implementation support rated the technical assistance and support from the project's ISPs as the most acceptable and appropriate resource. Reasons for acceptability were the relationship built with the ISP, the ISP's expertise, and being a "neutral party." Although in-person support from the ISP was preferred, remote support was acceptable and increased feasibility of attendance. Virtual learning sessions were acceptable for learning and collaboration, particularly in the second year of implementation, once ISPs had developed closer relationships with school teams. CONCLUSIONS: School staff found training, technical assistance, and virtual learning sessions to be acceptable and appropriate. Virtual formats of training and technical assistance decreased in acceptability but increased feasibility of attendance. In-person support was preferred during initial implementation, and virtual support was more acceptable thereafter. TRIAL REGISTRATION: This trial was prospectively registered on ClinicalTrials.gov ( NCT03736395 ), on November 9, 2018.

Individual and Contextual Factors Associated with Classroom Teachers' Intentions to Implement Classroom Physical Activity.

Classroom-based physical activity (CPA) is an evidence-based practice that improves student physical activity outcomes, but national data suggest implementation is insufficient in US classrooms. The purpose of this study was to examine individual and contextual factors associated with elementary school teachers' intentions to implement CPA. We collected input survey data from 181 classroom teachers (10 schools; 98.4% participation among eligible teachers) across three separate cohorts to examine associations between individual and contextual constructs and future CPA implementation intentions. Data were analyzed using multilevel logistic regression. Individual-level characteristics of perceived autonomy for using CPA, perceived relative advantage/compatibility of CPA, and general openness to educational innovations were positively associated with intentions to implement CPA (p < 0.05). Teacher perceptions of contextual factors such as administrator support for CPA were also associated with implementation intentions. This study adds to prior evidence about the importance of theoretically determined constructs for understanding behavioral intentions among front-line implementers such as classroom teachers. Additional research is needed to evaluate interventions designed to change malleable factors, including teachers' perceptions, as well as changing school environments so that teachers perceive more autonomy to use CPA and have the training and resources that build skills for implementation.

Physical activity and academic achievement: an analysis of potential student- and school-level moderators.

BACKGROUND: Many children do not engage in sufficient physical activity, and schools provide a unique venue for children to reach their recommended 60 daily minutes of moderate-to-vigorous physical activity (MVPA). Prior research examining effects of MVPA on academic achievement is inconclusive, and few studies have investigated potential moderators of this relationship. This study examined whether student-level characteristics (gender, race/ethnicity, free/reduced-price lunch status) and school-level characteristics (proportion of students qualifying for free/reduced-price lunch, physical activity environment and opportunities) moderate the relationship between MVPA and academic achievement. METHODS: In a large, diverse metropolitan public school district in Georgia, 4,936 students in Grade 4 were recruited from 40 elementary schools. Students wore accelerometers to measure school-day MVPA for a total of 15 days across three semesters (fall 2018, spring 2019, fall 2019). Academic achievement data, including course marks (grades) for math, reading, spelling, and standardized test scores in writing, math, reading, and Lexile (reading assessment), were collected at baseline (Grade 3, ages 8-9) and at follow-up in Grade 4 (ages 9-10). Standardized test scores were not measured in Grade 5 (ages 10-11) due to COVID-19-related disruptions. Multilevel modeling assessed whether student-level and/or school-level characteristics were moderators in the cross-sectional and longitudinal MVPA-academic achievement relationship. RESULTS: Cross sectional analyses indicated that the MVPA and AA relationship was moderated only by student Hispanic ethnicity for Grade 4 fall spelling marks (ß = -0.159 p < 0.001). The relationship for Grade 4 fall spelling marks was also moderated by school physical activity opportunities (ß = -0.128 (p < 0.001). Longitudinally, there was no significant moderation of the MVPA-academic achievement. A relationship by student gender, free/reduced-price lunch status, race/ethnicity; nor for school-level factors including proportion of students qualifying for free/reduced-price lunch, physical activity environment, and physical activity opportunities. CONCLUSIONS: Overall, our results did not suggest that student- or school-level characteristics moderate the MVPA-academic achievement relationship. While statistically significant results were observed for certain outcomes, practical differences were negligible. In this population, school-based MVPA does not appear to differently affect academic performance based on student gender, race/ethnicity, free/reduced-price lunch, nor school characteristics. TRIAL REGISTRATION: This study was registered with the National Institutes of Health (NIH) ClinicalTrials.gov system, with ID NCT03765047 . Registered 05 December 2018-Retrospectively registered.

Study protocol for a cluster-randomized trial of a bundle of implementation support strategies to improve the fidelity of implementation of schoolwide Positive Behavioral Interventions and Supports in rural schools.

Background: Improving the implementation of evidence-based interventions is important for population-level impacts. Positive Behavioral Interventions and Supports (PBIS) is effective for improving school climate and students' behavioral outcomes, but rural schools often lag behind urban and suburban schools in implementing such initiatives. Methods/Design: This paper describes a Type 3 hybrid implementation-effectiveness trial of Rural School Support Strategies (RS3), a bundle of implementation support strategies selected to improve implementation outcomes in rural schools. In this two-arm parallel group trial, 40 rural public schools are randomized to receive: 1) a series of trainings about PBIS; or 2) an enhanced condition with training plus RS3. The trial was planned for two years, but due to the pandemic has been extended another year. RS3 draws from the Interactive Systems Framework, with a university-based team (support system) that works with a team at each school (school-based delivery system), increasing engagement through strategies such as: providing technical assistance, facilitating school team functioning, and educating implementers. The primary organizational-level outcome is fidelity of implementation, with additional implementation outcomes of feasibility, acceptability, appropriateness, and cost. Staff-level outcomes include perceived climate and self-reported adoption of PBIS core components. Student-level outcomes include disciplinary referrals, academic achievement, and perceived climate. Mediators being evaluated include organizational readiness, school team functioning, and psychological safety. Discussion: The study tests implementation strategies, with strengths including a theory-based design, mixed methods data collection, and consideration of mediational mechanisms. Results will yield knowledge about how to improve implementation of universal prevention initiatives in rural schools.

The longitudinal association between objectively-measured school-day physical activity and academic achievement in US elementary school students.

BACKGROUND: It is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement. METHODS: In a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics. RESULTS: Cross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had ß = --0.066, ß = --0.063, ß = --0.066, and ß = --0.058 associations (p <  0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had ß = --0.206 and ß = --0.283 (p <  0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were - 1.666, - 1.638, and - 1.993 points lower respectively (p <  0.001). CONCLUSION: The cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA - which would constitute an approximately 300% increase from current levels - results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress. TRIAL REGISTRATION: ClinicalTrials.gov , NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03765047.

Prevalence of Evidence-Based School Meal Practices and Associations with Reported Food Waste across a National Sample of U.S. Elementary Schools.

Providing meals at school is an important part of the hunger safety net for children in the United States and worldwide; however, many children do not receive school meals even when they qualify for federally-subsidized free or reduced-priced meals. This study investigates the prevalence of several evidence-based practices that have previously been shown to increase the reach and impact of school meals. A survey was sent to a national sample of US elementary schools, with items examining practices regarding school breakfast, school lunch, recess, the promotion of meals, nutrition standards, and food waste, during the 2019-20 school year. Almost all schools that offered lunch also offered breakfast. More than 50% used a breakfast service strategy other than cafeteria service, such as grab-and-go breakfast meals. Providing at least 30 min for lunch periods and providing recess before lunch were reported by less than half of schools. About 50% of schools reported using only one or fewer meal promotional strategies (such as taste tests) throughout the school year. Use of more promotional strategies was associated with less reported food waste in a multivariable regression model accounting for school demographic characteristics. Findings show that some evidence-based practices for school meals are being implemented, but many recommendations are not being widely adopted.

Implementation of Physical Activity in US Elementary Schools: The Role of Administrative Support, Financial Resources, and Champions.

The intentional integration of physical activity in elementary school classrooms-including brief instructional breaks for activity, or integration into lessons-can benefit children's physical activity and education outcomes. Teachers are key implementation agents, but despite physical activity in the classroom being an evidence-informed practice, many teachers do not regularly implement it. The aim of this study was to obtain updated nationally representative prevalence estimates in United States public elementary schools, regarding four key outcomes: (1) school adoption of physically active lessons (PA lessons); (2) school adoption of physical-activity breaks (PA breaks); (3) penetration in the classroom, defined as ≥50% of teachers using PA breaks; and (4) dose, defined as an average of at least 50 min per week of PA breaks. We examined variations in outcomes by school demographic characteristics, and by three factors hypothesized to be implementation facilitators (administrative support, financial resources, and presence of a wellness champion at the school). In the 2019-20 school year, surveys were distributed to a nationally representative sample of 1010 public elementary schools in the US; responses were obtained from 559 (55.3%). The weighted prevalence of schools reporting adoption of PA lessons was 77.9% (95% CI = 73.9% to 81.9%), and adoption of PA breaks was nearly universal at 91.2% (95% CI = 88.4% to 94.1%). Few demographic differences emerged, although adoption of PA lessons was less prevalent at higher-poverty schools (73.9%) and medium-poverty schools (77.0%) as compared to schools with lower poverty levels (87.1%; p < 0.01). Across all four outcomes, associations emerged with facilitators in multivariable logistic regression models. The prevalence of adoption of PA lessons, adoption of PA breaks, and dose of PA breaks were all significantly higher at schools where administrative encouragement occurred more frequently. Financial support was associated with implementation outcomes, including adoption of PA lessons, and penetration and dose of PA breaks. Presence of a champion was associated with higher prevalence of reporting adoption of PA lessons. School leaders can play a crucial role in supporting teachers' implementation of PA breaks and lessons in the classroom, through providing financial resources, encouragement, and supporting champions. Effective school-leadership practices have the potential to positively impact students at a large-scale population level by supporting implementation of PA lessons and breaks.

Elementary Schools' Response to Student Wellness Needs during the COVID-19 Shutdown: A Qualitative Exploration Using the R = MC2 Readiness Heuristic.

During spring of 2020, the COVID-19 pandemic and accompanying public health advisories forced K-12 schools throughout the United States to suspend in-person instruction. School personnel rapidly transitioned to remote provision of academic instruction and wellness services such as school meals and counseling services. The aim of this study was to investigate how schools responded to the transition to remote supports, including assessment of what readiness characteristics schools leveraged or developed to facilitate those transitions. Semi-structured interviews informed by school wellness implementation literature were conducted in the spring of 2020. Personnel (n = 50) from 39 urban and rural elementary schools nationwide participated. The readiness = motivation capacity2 (R = MC2) heuristic, developed by Scaccia and colleagues, guided coding to determine themes related to schools' readiness to support student wellness in innovative ways during the pandemic closure. Two distinct code sets emerged, defined according to the R = MC2 heuristic (1) Innovations: roles that schools took on during the pandemic response, and (2) Readiness: factors influencing schools' motivation and capacity to carry out those roles. Schools demonstrated unprecedented capacity and motivation to provide crucial wellness support to students and families early in the COVID-19 pandemic. These efforts can inform future resource allocation and new strategies to implement school wellness practices when schools resume normal operations.

A systematic review of existing observational tools to measure the food and physical activity environment in schools.

Objective measures of schools' wellness-promoting environments are commonly used in obesity prevention studies; however, the extent to which findings from these measures translate to policy and practice is unknown. This systematic review describes the comprehensiveness and usability (practicality, quality, and applicability) of existing objective measures to assess schools' food and physical activity environments. A structured keyword search and standard protocol in electronic databases yielded 30 publications reporting on 23 measures that were deemed eligible to include in this review. Findings provide details to guide researchers and practitioners in selecting the best tool for use in policy and program evaluations.

Comprehensive Policies to Support Comprehensive Practices: Physical Activity in Elementary Schools.

BACKGROUND: Schools are a setting in which students learn about the importance of lifelong physical activity (PA). Best practice guidelines indicate that schools should provide students with adequate physical education (PE) minutes and opportunities to engage in PA throughout the school day. METHODS: Data from the nationally representative School Nutrition and Meal Cost Study in 2014-2015 were utilized to assess PA practices (including PE) at 412 public elementary schools. These data were linked to state- and district-level policy data from the National Wellness Policy Study to examine the relationships between state law and school district policies and school practices. RESULTS: Just over half of the schools were in a state with a policy regarding PE minutes. The comprehensiveness and strength of PA policies were higher at the district level than the state level, but were still low overall. Comprehensiveness of PA policies at the state level, but not at the district level, was related to schools within those states that provide more PA practices. CONCLUSIONS: Existence of PE and PA policies at the state level appears to be an important predictor of school PA practices. Having more comprehensive policies at the state level may be an important facilitator of school implementation of comprehensive PA practices.

An evaluation of the coverage of theoretically based implementation factors in disseminated classroom physical activity programs.

Classroom-based physical activity (CBPA) is increasingly recommended as a method to support children's physical activity, health, and academic performance. Many adoption-ready programs exist to aid in the implementation of CBPA in schools; yet, implementation rates remain low. The purpose of this study was to evaluate the extent to which resources provided by adoption-ready CBPA programs addressed theory-based implementation contextual factors to support implementation. Existing CBPA programs (N = 37) were identified through Internet searches and all materials (e.g., implementation guides) provided by each program were coded for their inclusion of 51 implementation factors based on the Consolidated Framework for Implementation Research (CFIR). Analyses were conducted to compare inclusion of implementation factors across CFIR Domains and by three program groupings: free (yes/no), research evidence (yes/no), and targeted to teacher only (vs. school). Programs covered a mean of 25.9 per cent (SD = 18.7 per cent) of the 14 Inner Setting implementation factors, 34.2 per cent (SD = 18.0 per cent) of the 6 Characteristics of Individuals implementation factors, and 34.8 per cent (SD = 24.3 per cent) of the 8 Process implementation factors. Programs with research evidence covered more implementation factors than programs without research evidence (43.7 vs. 25.9 per cent; p < .05). Although numerous adoption-ready CBPA programs are available and have many strengths, their inclusion of theory-based factors that support or inhibit implementation is generally low. Consideration of such factors, including organizational climate and teacher-level behavior change, is likely critical to supporting ongoing school-wide implementation of CBPA. Research is needed to develop and test effective strategies for addressing these factors to support more widespread CBPA implementation.

Development of the Fitness Education Index: A Scale of Organizational Level Capacity.

Purpose: Fitness education is essential for children's health, but determining the effectiveness of instruction related to health-related fitness is difficult. The present study developed and confirmed the validity of a 20-item scale, adapted from the School Health Index (Centers for Diseases Control and Prevention [CDC], 2014), to evaluate the success of fitness education portion of the Presidential Youth Fitness Program (PYFP) across a sample of 785 teachers. Method: The initial subset (n = 373) represented 353 schools and was used for conducting an exploratory factor analysis. The second subset (n = 412) representing 404 schools, was used to conduct the confirmatory factor analysis. Teachers self-assessed their perceived degree of implementation of fitness education (full, partial, under development, not in place) within their school (i.e., teachers helped students set fitness goals). Results: An initial exploratory factor analysis revealed that the Fitness Education Index questions clustered into six factors. A subsequent confirmatory factor analysis conducted using Mplus concluded the six-factor solution was a good fit (CFI = 0.90, TLI = 0.88, RMSEA = 0.08, SRMR = 0.06). Conclusion: This scale is a valid measure of a school's readiness to initiate and track progress toward the full implementation of fitness education.

The Academic, Behavioral, and Health Influence of Summer Child Nutrition Programs: A Narrative Review and Proposed Research and Policy Agenda.

Since 1975, the US Department of Agriculture has sponsored the Summer Food Service Program as a nationwide strategy for providing nutritious meals to children and youth (aged 18 years or younger) in low-income communities during the summer months. Many programs are sponsored by community organizations as well as school districts that may offer the program through the Summer Food Service Program or a seamless waiver, allowing them to extend school meals programs into the summer. These summer nutrition programs are designed to decrease food insecurity and improve health outcomes among at-risk populations. However, the characteristics of these programs, including the types of participants reached, and the programs' influence on outcomes such as academics, behavior, and physical and mental health, have not been summarized. The aims of this narrative review are to present existing knowledge about the characteristics of summer nutrition programs and their influence on students, to identify knowledge gaps, and to identify future research needs. An extensive search identified eight peer-reviewed articles and 10 reports, briefs, or other documents reporting research on the Summer Food Service Program. A variety of additional literature was reviewed to provide relevant information about summer nutrition programs. The review revealed a dearth of research regarding current Summer Food Service Program implementation. Summer nutrition programs alleviated food insecurity among at-risk populations; however, little research was found about the influence of summer programs on students' dietary intake or weight outcomes. More rigorous and mixed-methods studies examining the characteristics and influence of summer nutrition programs are needed.

Prevalence and Types of School-Based Out-of-School Time Programs at Elementary Schools and Implications for Student Nutrition and Physical Activity.

BACKGROUND: Out-of-school time (OST) programs are an important setting for supporting student health and academic achievement. This study describes the prevalence and characteristics of school-based OST programs, which can inform efforts to promote healthy behaviors in this setting. METHODS: A nationally representative sample of public elementary schools (N = 640) completed surveys in 2013-2014. Administrators reported on OST programs and policies at their school. Multivariable logistic regression models estimated the prevalence of school-based OST programs, adjusting for school characteristics. Among schools with OST programs (N = 475), chi-square tests identified school characteristics associated with having an OST policy about physical activity or nutrition. RESULTS: Three fourths of elementary schools (75.6%) had a full- or partial-year school-based OST program, with 30.8% having both. Full- and partial-year programs were significantly less prevalent in rural and township areas versus urban settings. Only 27.5% of schools with OST programs reported having physical activity and/or nutrition policies. CONCLUSIONS: Most US elementary schools have an on-site OST program, but disparities in access exist, and most lack policies or awareness of existing policies regarding physical activity and nutrition. To maximize OST programs' potential benefits, strategies are needed to increase access to programs and physical activity and/or nutrition policy adoption.

Barriers to Shared Use of Indoor and Outdoor Facilities at US Elementary Schools.

BACKGROUND: School policies and practices, such as the sharing of school facilities with the surrounding community, support physical activity among students and community members, but are often underutilized. This study examined variations in shared use practices, and associations with perceived barriers. METHODS: Surveys were completed by a nationally representative sample of 640 public elementary schools across the United States. Administrators reported on their school's practices related to the shared use of indoor and outdoor facilities, and perceived barriers to sharing. Multivariate logistic regression models were used to examine associations between barriers and practices. RESULTS: Liability or legal concerns, staffing expenses, and facility operation costs were most frequently reported as barriers, while lack of adequate facilities and perceived lack of community interest were less common. Cost concerns and perceived lack of community interest were most strongly associated with lack of sharing. CONCLUSIONS: Although liability or legal concerns are common, such concerns are not necessarily associated with less sharing when other factors are taken into account. Administrators' perceptions about lack of community interest were associated with less sharing, but these perceptions may not accurately reflect the community's perspective. Active development of partnerships could increase access to school facilities.

Classroom-Based Physical Activity: Minimizing Disparities in School-Day Physical Activity Among Elementary School Students.

BACKGROUND: Evidence of the positive effects of school physical activity (PA) interventions, including classroom-based PA (CBPA), is rapidly growing. However, few studies examine how variations in scheduled PA opportunities and teacher-implemented CBPA affect students' PA outcomes. METHODS: Teachers at 5 elementary schools attended training on how to implement CBPA. Data on school-day PA opportunities [physical education (PE), recess, and CBPA] were obtained via calendar and teacher-recorded CBPA logs. Daily step counts were measured via accelerometry in 1346 students across 65 classrooms in first through fifth grades. RESULTS: PE, recess, and CBPA contributed significantly to students' daily steps. Males accrued more steps than females over the school day, during PE, and during recess. No gender disparity was seen in the amount of additional steps accrued during CBPA. Overall step counts were lower among fifth-grade students versus first-grade students, but CBPA attenuated this difference such that grade-level differences were not significant in fifth-grade students who received CBPA. CONCLUSIONS: Gender disparities in step totals were present on PE and recess days, but not on CBPA days. CBPA appears to provide equal PA benefits for both genders and to potentially minimize the decline in PA among older students.

Acute high-intensity exercise-induced cognitive enhancement and brain-derived neurotrophic factor in young, healthy adults.

Acute exercise can positively impact cognition. The present study examined the effect of acute high-intensity aerobic exercise on prefrontal-dependent cognitive performance and brain-derived neurotrophic factor (BDNF). Fifty-eight young adults were randomly assigned to one of two experimental groups: (a) an acute bout of high-intensity exercise (n=29) or (b) a non-exercise control (n=29). Participants in the exercise group improved performance on inhibitory control in Stroop interference and on cognitive flexibility in Trail Making Test (TMT) Part-B compared with participants in the control group and increased BDNF immediately after exercise. There was a significant relationship between BDNF and TMT Part-B on the pre-post change following exercise. These findings provide support for the association between improved prefrontal-dependent cognitive performance and increased BDNF in response to acute exercise. We conclude that the changes in BDNF concentration may be partially responsible for prefrontal-dependent cognitive functioning following an acute bout of exercise.

VII. The history of physical activity and academic performance research: informing the future.

The study of physical activity, physical fitness, and academic performance research are reviewed from a historical perspective, by providing an overview of existing publications focused on children and adolescents. Using rigorous inclusion criteria, the studies were quantified and qualified using both meta-analytic and descriptive evaluations analyses, first by time-period and then as an overall summary, particularly focusing on secular trends and future directions. This review is timely because the body of literature is growing exponentially, resulting in the emergence of new terminology, methodologies, and identification of mediating and moderating factors. Implications and recommendations for future research are summarized.

Impact of trained champions of comprehensive school physical activity programs on school physical activity offerings, youth physical activity and sedentary behaviors.

OBJECTIVE: A quasi-experimental cluster-controlled design was used to test the impact of comprehensive school physical activity program (CSPAP) professional development on changes in school physical activity (PA) offerings, moderate-to-vigorous physical activity (MVPA) and sedentary behaviors of 9-14 year-old children during school. METHODS: Two groups of Louisiana elementary and middle school physical education teachers (N=129) attended a CSPAP summer workshop (95 in 2012=intervention, 34 in 2013=control) and were assessed on school PA offerings (teacher-reported; pre, mid, and post). During the 2012-2013 school year, intervention teachers received CSPAP support while implementing new school PA programs. MVPA and sedentary behaviors were assessed (accelerometry; baseline and post) on a sample of 231 intervention, 120 control students from 16 different schools. RESULTS: Multivariate analysis of covariance indicated that intervention teachers reported significantly more PA offerings during school (3.35 vs. 2.37) and that involve staff (1.43 vs. 0.90). Three-level, mixed model regressions (stratified by sex) indicated that students overall spent less time in MVPA and more time being sedentary during school, but the effects were significantly blunted among intervention students, especially boys. CONCLUSIONS: This study provides preliminary evidence for CSPAP professional development programs to influence school-level PA offerings and offset student-level declines in MVPA and increases in sedentary behavior.