Background: Physical inactivity in the U.S. poses a significant risk of developing chronic health factors associated with cardiovascular disease. Children from rural communities are especially vulnerable to inactivity. The Hoosier Sport program aims to address this by working to increase physical activity in 6th and 7th grade students in a rural Indiana middle school. Hoosier Sport uses sport participation coupled with health education delivered by college-service learning students to establish healthy behaviors that children can sustain throughout their life. The purpose of this prospective longitudinal study was to evaluate the implementation of Hoosier Sport in a rural middle school, using a multi-component evaluation approach. Methods: This prospective program evaluation study utilized The Consolidated Framework for Implementation Research (CFIR) to assess feasibility outcomes such as recruitment, retention, fidelity, attendance, acceptability, and cost. CFIR was incorporated through surveys completed by Hoosier Sport team members to identify facilitators and barriers. Fidelity was measured using SOSPAN and SOFIT tools. SOSPAN (System for Observation of Staff Promotion of Activity and Nutrition) monitored staff interactions with children during physical education classes. SOFIT (System of Observing Fitness Instruction Time) evaluated the duration and type of activities in each lesson context. For our descriptive analysis, we calculated means and standard deviation for continuous variables and percentages for categorical variables. Results: All feasibility measures met or exceeded the a priori threshold, indicating high success. Fidelity was high among college student implementers and child participants. SOSPAN showed that staff did not use physical activity as punishment, engaged in physical activity 62.5% of the time, provided verbal encouragement 87.5% of the time, and used elimination games only 2.5% of the time. SOFIT revealed significant promotion of moderate-to-vigorous physical activity, with 94% during the 4-week strength training intervention and 95% during the 4-week basketball intervention. The barrier buster tool identified general agreement with most statements, indicating promising system-level acceptability. Conclusion: The study results demonstrate successful feasibility, high fidelity, and promising system-level acceptability. These findings underscore the importance of continued refinement and repeated evaluation of the program in alignment with the ORBIT model. The use of college student implementers presents a sustainable model that benefits all participants involved.
