Creating Active Schools: What Influences Continuous Implementation Following Adoption?

Area of Science:

• Public Health
• Educational Research
• Implementation Science

Background:

• Limited evidence exists on the long-term sustainability of whole-school physical activity programs.
• The Creating Active Schools (CAS) program utilizes the CAS Framework to drive organizational and cultural change for physical activity.
• This study assesses the medium-term implementation of the CAS program over two academic years.

Purpose of the Study:

• To evaluate the medium-term implementation and sustainability of the Creating Active Schools (CAS) program.
• To understand the factors influencing the integration of whole-school physical activity initiatives within schools.
• To identify key components that support the sustained adoption of physical activity programs in educational settings.

Main Methods:

• A qualitative descriptive approach was utilized.
• Semi-structured focus groups were conducted with 35 participants from 30 schools after two years of CAS implementation.
• Thematic analysis employed a codebook method, integrating inductive and deductive approaches aligned with implementation research frameworks.

Main Results:

• The CAS program demonstrated increased reach and staff buy-in, with participants becoming confident advocates for physical activity.
• Schools progressed from creating new initiatives to embedding and sustaining existing efforts, though some required reinforcement.
• Peer-to-peer learning and knowledge exchange within communities of practice were crucial in mitigating external system influences and fostering agency.

Conclusions:

• Medium-term success of whole-school physical activity programs depends on acknowledging the broader educational context and system dynamics.
• Communities of practice and robust supportive structures are vital for sustaining school-based physical activity initiatives.
• The CAS program's success highlights the importance of integrated approaches to embedding physical activity within school cultures.