Table 3 Summary of study findings

Gladwin et al., 2008 [56]

Adoption

Qualitative

Not stated

20 purposively selected key informants involved in school-based PA policy processes; review of policy documents and websites.

Semi-structured interviews and document reviews.

Policy processes that resulted in adding DPA, but not active transportation initiatives to the school curriculum.

DPA succeeded because Kingdon’s 3 streams (problem, solution, politics) converged, largely through the actions of the Minister of Learning who used his ministerial power to link the solution with the political stream.

1) Faulkner et al., 2014 [133]; 2) Stone et al., 2012 [136]

Implementation and impact

Cross-sectional

Apr-Jun, 2010; Sept-Dec, 2010; Apr-Jun, 2011

865 grade 5–6 students from 18 elementary schools in Toronto, ON. All schools invited to participate, 18 schools selected from among interested schools based upon neighborhood type and SES.

Students completed a survey, wore accelerometers for 7 days and had height and weight measured. Parents completed a survey and travel diary for their children. Principals completed a school health environment survey. Teachers provided classroom schedules to identify DPA and PE times.

1) Time spent in light-to-vigorous PA. Whether schools were in the initiation, action or maintenance stage of DPA. 2) Total PA counts and MVPA mins on school days and during school hours.

1) 11.1% of schools were in the initiation phase of DPA, 88.9% were in the action phase and none were in the maintenance phase. Students were not more physically active in schools that were in the action phase. 2) 49% of students were provided DPA every school day. Frequency of DPA positively associated with total PA and MVPA mins/d on weekdays and during the school day. Students who participated in DPA 5 d/wk had higher total counts and intensity of PA, and time spent in MVPA on school days and during the school day. PA bouts averaged 7.1 mins and none were ≥ 20 mins. Those who accumulated ≥ 1 bout of MVPA were more active and fewer were overweight and obese.

1) Leatherdale et al., 2013 [145]; 2) Leatherdale et al., 2014 [147]

Impact

Cross-sectional

2007-08

Convenience sample of 2326 grade 1–4 students/parents from 30 elementary schools in ON. Schools were purposively selected within public and separate school boards located in major geographic regions.

Students/parents completed a survey and students’ height and weight were measured. Administrators completed a school health environment survey.

Student activity levels (low, moderate, high) and BMI (normal, overweight, obese). Whether schools were in the initiation, action or maintenance stage of DPA.

1) DPA implementation was not associated with the odds of being overweight or obese. 2) DPA implementation was not associated with the odds of being highly or moderately active.

1) Leatherdale et al., 2010 [134]; 2) Hobin et al., 2010 [146]; 3) Leatherdale, 2010 [165]

Implementation and impact

Cross-sectional

2007-08

Convenience sample of 2379 (studies 1–2) or 1264 (study 3) grade 5–8 students from 30 schools in ON. Schools were purposively selected within public and separate school boards located in major geographic regions.

Students completed a survey. Administrators completed a school health environment survey.

Student activity levels (low, moderate, high) and BMI (normal, overweight, obese). Whether schools were in the initiation, action or maintenance stage of DPA. DPA implementation models.

1) 0% of schools were in the initiation phase of DPA, 80% were in the action phase and 20% were in the maintenance phase. Implementation of DPA was not associated with the odds of being moderately or highly active. 2) DPA implementation models were: 70% offered DPA only on days without PE class, 20% offered DPA in addition to daily PE class, 10% offered DPA as part of daily PE class. DPA implementation models were not associated with the odds of being moderately or highly active. 3) DPA implementation was not associated with the odds of being overweight.

Patton, 2012 [135]

Implementation

Cross-sectional

Not stated

145 teachers within 37 randomly selected schools in the Thames Valley District School Board, ON.

Teachers completed a survey.

Implementation and perspectives of DPA.

15.6% always conducted DPA on days when PE was not scheduled, 50.7% said there was not adequate time to conduct DPA, 60.9% said DPA should be integrated within the curriculum, 64.6% reported that administrators rarely or never monitored DPA.

Robertson-Wilson and Levesque, 2009 [166]

Implementation

Qualitative

2005-07

Publicly available policy and other documents related to DPA implementation.

Document reviews.

Whether DPA implementation strategies fit Hogwood and Gunn’s 10 preconditions for perfect implementation.

Several preconditions (e.g. allocation of resources, task specification) have been considered, whereas others (e.g. sustainability of resources, evaluation plans, extent to which policy is valued) require additional attention to ensure optimal DPA implementation.

Watts et al., 2014 [137]

Implementation and impact

Cross-sectional, pre-post design

2007-08 and 2011–12 school years

Administrator surveys in all districts that consented. 2007–08: 384 elementary and 118 middle/high schools; 2011–12: 351 elementary and 125 middle/high schools.

Administrators completed a survey on PA practices at their school for grades 6, 8 and 10 students.

Mins and delivery format of PE, stakeholder support and level of implementation of DPA policies.

Implementation of DPA policies was 65%, 56% and 51% for grades 6, 8 and 10. Schools had higher odds of providing ≥ 150 mins PE/wk and provided more mins of PE to grade 8 and 10 students in 2011–12. Schools had higher odds of providing PA linearly to grade 8 and in a semester format to grade 10 students in 2011–12. Staff and parental support for PA policies increased in all schools, student support declined in elementary and increased in middle/high schools, principal support was unchanged.

Masse et al., 2013 [119]

Implementation

Qualitative

2010-11 school year

Principals and teacher/school informants (n = 50) from a variety of school types and settings (n = 17 schools).

Semi-structured interviews.

Factors that impeded or facilitated implementation of DPA policies.

Perceived implementation ranged from 14%-90%. Schools implemented DPA policies through prescriptive and non-prescriptive approaches. DPA policies provided an advantage relative to the status quo, were compatible with school philosophies, and provided observable benefits. It was difficult to understand DPA policies, to fit them into already full schedules and policies increased teacher workload. Availability of resources and support were key facilitators.

Hobin et al., 2014 [148]

Impact

Longitudinal

Baseline measures were conducted in 2008 with annual follow-up to 2011 or completion of grade 12.

Convenience sample of grades 9–10 PE classes within 31 randomly selected secondary schools (n = 447 students) across MB.

Students completed a survey at baseline and wore accelerometers for 7 days once a year.

MVPA mins/d overall, and in students from schools in rural/urban and low/high SES areas.

The MVPA trajectories of adolescents declined 11.3%/yr from baseline to the last measurement. Students with low or moderate baseline MVPA and those attending schools in low SES and rural areas had slower rates of decline in MVPA.