Xiaomei Zhang, Muhammad Khalid Anser, Rolle Remi Ahuru, Zizai Zhang, Michael Yao-Ping Peng, Romanus Osabohien, Mumal Mirza
Do Predictors of Health Facility Delivery Among Reproductive-Age Women Differ by Health Insurance Enrollment? A Multi-Level Analysis of Nigeria's Data
Frontiers in public health
wholeofschool approach best promote physical activity school however multicomponent programming often complex difficult deliver school settings need better understand components wholeofschool approach implemented practice objectives mixed methods study 1 qualitatively explore physical activity approaches implementation elementary schools 2 quantitatively assess implementation levels 3 examine associations schoollevel physical activity promotion academic ratings used exploratory sequential mixed methods design conducted semistructured qualitative interviews elementary school staff texas school district used directed content analysis explore physical activity approaches implementation using qualitative findings designed survey quantitatively examine implementation physical activity approaches distributed elementary staff district wide used pearson correlation coefficients examine association amount physical activity opportunities present individual schools schoollevel academic ratings completed 15 interviews 7 principalsassistant principals 4 physical educators 4 classroom teachers elementary school teachers staff indicated pe recess implementation driven topdown state district policies implementation classroombased approaches school programming active transport largely driven bottomup teachers school leaders teachers staff also discussed implementation challenges across approaches survey respondents n 247 22 schools indicated 546 schools implementing 135 minweek physical education 727 implementing 30 minday recess classroombased approaches less common twentyfour percent schools reported accessible school programs 727 reported accessible school programs 27 promoted active transport direct association number physical activity opportunities provided schoollevel academic ratings r22 053 p 001 schools provided physical activity opportunities consistent wholeofschool approach although variability schools implementation challenges present leveraging existing school assets providing schoolspecific implementation strategies may beneficial supporting successful physical activity promotion elementary schools