Considerations for Individual-Level Versus Whole-School Physical Activity Interventions: Stakeholder Perspectives

Abstract

Strategies to address declining physical activity levels among children and adolescents have focused on ‘individual-level’ approaches which often fail to demonstrate impact. Recent attention has been on an alternative ‘whole-school’ approach to increasing physical activity that involves promoting physical activity throughout all aspects of the school environment. There is, however, a lack of evidence on how whole-school physical activity approaches could be implemented in the UK. This qualitative study explored perspectives of key stakeholders on potential reasons for the lack of impact of individual-level school-based interventions on children’s physical activity, and key considerations for adopting a whole-school approach. Nineteen semi-structured interviews were conducted with a range of stakeholders involved in the implementation of physical activity programmes in UK schools. Data were analysed using an inductive approach. Respondents suggested that individual-level school-based interventions to increase physical activity often failed to consult end users in the design and were typically implemented in environments unsupportive of long-term change. They subsequently outlined specific barriers and key facilitators for the adoption and implementation of whole-school approaches in UK settings and recommended a shift in research foci towards building an evidence base around educational outcomes and whole-school implementation insights.

Navigating the river(s) of systems change: a multi-methods, qualitative evaluation exploring the implementation of a systems approach to physical activity in Gloucestershire, England

“…14 These interventions seek to change individual behaviours, either through short-term educational approaches or through the provision of physical activity opportunities. 15 These approaches are also politically appealing because they require minimal political will to implement, they are relatively low cost, they are easy to measure and there is an evidence base that can be used to justify their delivery. [16][17][18][19][20][21] However, individual-level interventions can exacerbate, rather than reduce, health inequalities and seldom change the environments that people move and function within.…”

Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity

“…Consequently, many children miss out on the multiple benefits (e.g., body composition, social skills, mental health, academic achievement, motor skills development) of regular physical activity [ 3 ]. Schools are seen as a pragmatic setting in which physical activity interventions can be delivered to a large number of children [ 4 ]. However, studies demonstrate that UK-based primary school children are active for an average of 18.33 ± 8.34 min of moderate-to-vigorous physical activity (MVPA) in school time, with 90.2% failing to achieve the 30 min in-school physical activity target [ 5 , 6 ].…”

“…Increased emphasis on health-related policy goals for physical education (PE) and school sports from national and international governing bodies (Education Departments, WHO, International Society for Physical Activity and Health), has placed an onus on schools to identify and implement strategies that support pupils to be habitually active and work towards achieving the physical activity guidelines [ 8 , 9 , 10 , 11 ]. However, whilst these strategies suggest the need to increase opportunities for children to be active during school, current evidence highlights a continuing focus (and dependency) on single solutions aimed at an individual-level behaviour change or targeted populations (e.g., racial/ethnic minorities, girls) [ 4 ]. This results in the ongoing implementation of singular-level interventions that employ ‘quick-fixes’ and, thus, have little or no impact on sustainable or equitable physical activity changes [ 8 , 10 ].…”

Child and family experiences of a whole-system approach to physical activity: a citizen science evaluation protocol

“…To address this issue, the World Health Organisation (WHO) Global Action on Physical Activity (GAPPA) report proposes a systems-based approach, involving cross-government, multi-sectoral partnerships and community engagement (12). To enact effective systems-based approaches, it is recommended that programmes work closely with local people to develop solutions tailored to intended recipients' context and experience (13)(14)(15).…”

“…To address this issue, the World Health Organisation (WHO) Global Action on Physical Activity (GAPPA) report proposes a systems-based approach, involving cross-government, multi-sectoral partnerships and community engagement (12). To enact effective systems-based approaches, it is recommended that programmes work closely with local people to develop solutions tailored to intended recipients’ context and experience (13-15). Recently, Sport England (the arms-length body of government responsible for growing and developing grassroots sport and getting more people active across England) has invested £100 million across 12 Local delivery pilots (12).…”