Physical activity in the classroom: Using RE-AIM to evaluate a national school reform – a mixed methods study

Abstract

Background In 2014, the Danish Government introduced a wide-ranging school reform that applied to all public schools in Denmark. A distinctive feature of the reform was that it became mandatory to implement an average of 45 minutes of daily physical activity within the curriculum. Using the RE-AIM framework as an evaluation tool, the objective of the current study was to evaluate the reach, effectiveness, adoption, implementation, and maintenance of mandatory physical activity within curriculum at ten Danish schools. Methods A complementary mixed methods approach using accelerometers, questionnaires, and semi-structured interviews was conducted. A total of 11 representative school were invited to participate, including 993 students, 131 teachers, and 11 school managers. Students were invited to wear an accelerometer for seven consecutive days. Teachers were invited to participate in a questionnaire and school managers were encouraged to take part in a semi-structured interview. Results A total of 10 schools were included in the analysis, including 846 students, 76 teachers, and 10 school managers. Results showed that, on average, 45.2% of the students were active at least 45 minutes daily within curriculum. Teacher and school management interest in physical activity, competencies development, and shared decision-making were identified as central factors for adoption of the requirement. Scheduling physical activity within timetables and collaborations with external parties were found to influence the implementation dimension. Finally, internal coordination, motivated school staff, and school management priority were identified as centrals factors for maintenance. Conclusions This study provides an evaluation on a national physical activity requirement in Danish public schools. When introcuding a wide-ranging national requirement on physical activity within curriculum, school managers need to prioritize and support the implementation process. Teachers need to be involved in the decision processes, in order to ensure motivation and local ownership. The study also highlight the benefits of an internal coordinator as well as development of a shared strategy among schools, municipalities, and other stakeholders in order to succeed with the implementation.