- Research article
- Open Access
‘It’s not because we don’t believe in it...’: Headteachers’ perceptions of implementing physically active lessons in school
BMC Public Health volume 19, Article number: 1674 (2019)
Implementation of school-based physical activity (PA) programmes has proven to be difficult, particularly due to schools’ focus on academic performance and lack of organisational support for PA interventions. However, physically active lessons (PA integrated into academic lessons) holds promise as a teaching method that increases children’s PA levels without reducing academic time. Headteachers play a significant role in facilitating change in school, but little is known about headteachers’ attitudes towards physically active lessons and their benefits. The purpose of this study was to explore headteachers’ perceptions of physically active lessons, and identify factors affecting headteachers’ acceptance or rejection of physically active lessons implementation.
A total of 29 semi-structured telephone interviews were conducted with headteachers in primary and secondary schools in the city of Stavanger, Norway. Adopting a phenomenological approach, qualitative data were analysed using inductive content analysis.
Although most of the headteachers believed that physically active lessons could contribute positively to pupils’ health and learning, only four of 29 schools decided to proceed with implementation. Physically active lessons were more likely to be adopted when the intervention addressed a clearly defined priority area at the school. Change overload and lack of in-depth knowledge of physically active lessons’ function and intent appeared to be the most important factors for choosing not to implement physically active lessons.
One of the major challenges for headteachers was deciding which of the many proposed changes the school should prioritise. If physically active lessons was to be prioritised by headteachers it is very important to communicate thoroughly to the headteachers what the schools can achieve by implementing physically active lessons and how the innovation aligns with school policies and goals. Given the flexibility inherent in physically active lessons and the schools’ differing needs and priorities, it was important to emphasise to headteachers that physically active lessons could be adapted to different local school contexts.
In Norway, 9- and 15-year-olds engage in sedentary behavior between 7.5 and 9 h per day, respectively, and 46–72% do not reach the recommended 60 min of daily physical activity (PA) [1, 2]. Globally, it is recommended that all schools develop policies to address PA during the school day for increasing children and young people’s PA . Despite a growing movement to develop and adopt PA interventions in school, adoption of school-based PA interventions has proven to be challenging. Schools tend to prioritise academic performance over health-related outcomes, and they often lack organisational support for PA interventions [4,5,6].
Physically active lessons are designed to increase children’s PA levels without reducing academic time by integrating PA into lessons in learning areas other than physical education (Watson et al., 2017). Recent systematic reviews and meta-analyses have related physically active lessons in school to improved health, enhanced cognitive function and increased academic performance [7,8,9,10].
The Active School Programme originated in the city of Stavanger, Norway in 2012, with the goal of increasing children’s PA level in school, in order to improve health and learning. The core intervention component was physically active lessons. After a successful pilot study in 2013–14 , a 10-month cluster randomised controlled trial in primary schools was conducted in 2014–15. It was found that increased PA in school tended to benefit children’s cognitive function, as well as increase aerobic fitness for the least fit children [12, 13]. Results from process evaluation showed that physically active lessons were highly appreciated by both teachers and children . Similar findings have also been reported by others [15, 16].
Despite physically active lessons’ apparent effectiveness as a method to increase children’s daily PA, and its facilitative role regarding prioritised academic goals, little is known about the factors that affect school adoption of physically active lessons. Teachers are the most important agents for bringing change and innovation in educational practice , but the importance of the headteachers’ role in school improvement work, including choosing between different programmes, has also been acknowledged [18,19,20]. Given headteachers’ significant role, information about adoption factors such as headteachers’ attitudes towards physically active lessons and prioritisation, would be useful for developing targeted strategies for increasing physically active lessons adoption and implementation. Thus, the aim of this study was to explore headteachers’ perceptions of physically active lessons, and to identify factors affecting headteachers’ approval or rejection of physically active lessons implementation.
Schools readiness for adoption
In the Norwegian context, increased PA for children and youth has been high on the political, educational and research agendas, and a recent report stated that schools are one of the dominant locations for sedentary behavior, especially due to sedentary traditional teaching in the classroom . With this background, the Norwegian government recently added a goal of including one hour of daily physical activity for all children in school, without extending the school day or compromising teachers’ pedagogical autonomy . This implies that schools have considerable autonomy in organisation of physical activity, and their priorities and ability to implement change are likely to impact adoption of physically active lessons.
Introducing new interventions in school is a complex and challenging process. According to the literature on planned change, the implementation process consists of three phases: initiation, implementation and institutionalisation [19, 20]. The initiation phase addresses schools’ initial considerations of whether they are ready to adopt an intervention . According to Leithwood (2018), surprisingly little research has investigated headteachers’ response to external change initiatives. Spillane et al.  suggest that a headteacher’s response to an external change initiative is influenced by their existing knowledge, the vision they have for their own school and the beliefs and values they hold about what is important to them professionally. Previous research has shown that headteachers were more willing to adopt a physical activity intervention if it addressed educational outcomes in addition to health promotion [5, 24, 25]. Furthermore, Domitrovich et al.  noted that interventions that aligned directly with a school’s mission, priority areas and existing practise, are more likely to be prioritised.
While headteachers must answer to external expectations, they also rely on teachers’ motivation to perform the necessary work. Teachers are more likely to be committed to implementing an intervention if they have played an active role in the decision-making process and perceive that the intervention meets prioritised needs . Previous research has shown that teachers were more likely to involve themselves in a school development activity when the headteacher played an active role . Hall and Hord  have, through extensive empirical research of headteacher leadership, identified three distinct change facilitator styles. The initiator is always thinking ahead and makes decisions based on what they believe will benefit the pupils. The manager focuses on formal policies and protecting staff, and the responder lets others take the lead and tends to downplay the significance of proposed change.
Design and participants
The current study has a qualitative research design with an inductive approach where patterns and themes were identified from the data . Data were collected through semi-structured telephone interviews. This interview type is an appropriate method that provides in-depth knowledge of headteachers’ perceptions and prioritisation regarding adoption and implementation of physically active lessons .
To expand the use of physically active lessons, in the autumn 2017, all 40 primary and secondary schools in the municipality of Stavanger, Norway were invited by the “Active School” project team to implement physically active lessons and contribute to the project’s website that provides free access to high quality lessons. After a short briefing meeting with all headteachers, where rationale for physically active lessons was presented, invitations for application were sent by e-mail from local school authorities, who encouraged their schools to participate. All participants received written information about the study and gave their written consent to participate in the interviews. The study was approved by the Norwegian Social Science Data Services.
Telephone interviews were conducted during the spring of 2018. Headteachers received an invitation to participate in telephone interviews through mail and follow-up reminders. Five headteachers from the schools that had participated in the effectiveness evaluation in 2014–15, and four new employees without knowledge of the request were excluded, and two headteachers did not respond. In total, 29 of 40 headteachers in primary and secondary schools in Stavanger participated. Sixty-two percent were female and 38% were male, and the mean age was 53 years (ranging from 39 to 70 years). Participating schools were all from urban areas, within an average distance of 7 km from the local university. A summary of headteachers` demographic is presented in Table 1.
A semi-structured interview guide with open-ended questions was developed on the basis of central components identified in the literature about introducing new practices in school [19, 20]. Interview questions were sent by mail ahead of the telephone interviews and an appointment was scheduled for each interview. The telephone interviews were scheduled for 15–20 min, and lasted between 7 and 24 min (average 16 min). The interviews requested data on perceptions, prioritisation and response to the request to introduce physically active lessons.
Data from telephone interviews were recorded and transcribed in full. The transcripts were read and reread by the interviewer to ensure accuracy of the data. Data were analysed using a qualitative content analysis, focusing on the manifest content . This approach focuses on subject and context, and is designed to describe similarities and differences in transcripts from e.g., interviews . The analysis was an iterative process, with all data processed in the computer programme QSR NVIVO11. Initially, each interview transcript was analysed as a single case. All text from the interviews was divided into meaning units that were condensed to abstracting data from the full body of transcripts, and thereafter coded using an inductive approach. A short summary of each interview was written. Similarities and differences in headteachers’ responses were identified. Patterns were labelled and grouped into categories and subcategories. In the later stages, existing theoretical perspectives such as the Quality Implementation Framework , focusing on the first phase of implementation, addressing critical steps before the implementation begins (conducting a need, innovation-organisational fit and capacity assessment), were integrated to get a more complete understanding of the data.
To ensure trustworthiness of the coding and interpretation of the data initially, findings were discussed among authors as recommended by Kvale et al. . Quotations from interviews are used to illustrate the findings. To safeguard confidentiality as much as possible, some information is omitted. Only the position as headteacher is given. The interviews were conducted in Norwegian and selected quotations were subsequently translated to English.
In total, four of 29 schools decided to proceed with implementation of physically active lessons. Headteachers’ perceptions and prioritisation were assessed by initial considerations, as were their perceptions of need of the intervention, compatibility with plans and work, and capacity to implement. Table 2 summarises the themes, main categories, subcategories and positive/negative quotes identified for headteachers’ perceptions and prioritisation regarding implementation of physically active lessons.
Perceptions of need
Headteachers believed that physically active lessons could contribute positively to pupils’ learning and health. Primary school headteachers felt that physically active lessons could address children’s need for a varied teaching approach. Secondary school headteachers felt that physically active lessons could address more general concern about adolescents’ physical and mental health, referring to observations of increased sedentary behaviour. In total, 25 teachers in four schools agreed to implement physically active lessons. Of the reasons headteachers mentioned for acceptance of physically active lessons, first and foremost was the possibility of adding to existing knowledge in a prioritised area. Additionally, headteachers accepted physically active lessons based on a decision made to introduce more PA and play-based learning for the youngest children.
Perceptions of compatibility
The main view of the headteachers was that physically active lessons were consistent with the national curriculum. There were some different perceptions regarding whether physically active lessons were in line with the local school authority’s policy, due to the fact that physical activity was not explicitly described as a priority area in the municipal quality plan. However, most of the headteachers perceived physically active lessons as a useful tool and aligned the innovation to a variety of prioritised areas, including variation in teaching approach, practical supported teaching, relationship competence, and physical and mental health. Most of the headteachers perceived facilitating increased physical activity in school as an important task. However, when considering the need for adopting physically active lessons, a majority of the participants reported they already had sufficient activities to increase physical activity in school (e.g., access to sports halls, outdoor school, and physical activity during recess). Furthermore, two secondary school headteachers considered physically active lessons to be too childish for young people.
Perception of school capacity
Despite the value placed on physically active lessons and the fact that most of the headteachers perceived the innovation to be suited to the school’s priority areas, it was obvious that challenges associated with school development and prioritisation between competing daily tasks were demanding. The participants frequently mentioned focus on national tests and academic achievement as limiting factors for participation in new projects. Furthermore, a few headteachers mentioned that lack of documented learning outcome and funding influenced their decision to reject physically active lessons. Headteachers’ capacity to support implementation was also a challenge. The majority of headteachers had not informed or discussed the possibility of adopting physically active lessons with the teachers in their school, and the decision not to participate was made by the headteacher either alone, or together with management. Although many headteachers talked about previous successful change work, they sensed that the teachers were generally weary of change, and that it was therefore challenging to motivate teachers to support new change initiatives. However, some headteachers reported that individual teachers had started using physically active lessons on their own initiative.
The aim of the study was to investigate headteachers’ perceptions of physically active lessons, and identify factors affecting acceptance or rejection of physically active lessons implementation. Even though most of the headteachers believed that physically active lessons could contribute positively to pupils’ health and learning, only four of 29 schools decided to proceed with implementation. Physically active lessons were more likely to be adopted in schools where the intervention met defined priority areas at the school. Change overload and lack of in-depth knowledge of physically active lessons’ function and intent appeared to be the most important factors for refusing to implement physically active lessons.
Perception of need
Most of the headteachers had the perception that physically active lessons could contribute positively to pupils’ health and learning. According to Greenberg et al. , perception of benefits for the target audience is an important factor affecting a decision to adopt a programme. Furthermore, the results indicated that primary school headteachers acknowledged that pupils have different learning styles, and that PA is important for children’s wellbeing and motivation for learning. In support, a recent study found that addition of physically active lessons was associated with a significant increase in academic performance for low-performing children , and simultaneously benefitted all demographic subgroups . However, secondary school headteachers considered physically active lessons more as a means of integrating PA for health into the school day, and less as a means of improving learning. Physically active lessons provide the means to achieve a dose of PA sufficient to improve health while also improving learning [7, 33]. However, the results of this study indicate that PA and learning, to some extent, are understood as two separate activities and not integrated into a single activity as intended by physically active lessons. This finding indicates lack of clarity about goals and means, which Fullan  emphasises is a persistent challenge in implementation processes.
Perceptions of compatibility
Many headteachers perceived physically active lessons as compatible with the national curriculum. However, there were different interpretations of local school policy, which affected some of the headteachers’ priorities. The decision not to adopt physically active lessons may be an expression of a leadership style that emphasises the administrative aspect of leadership, which is committed to following the correct application of rules and policy and does not typically initiate attempts to move beyond the basis of what is required . An interesting finding is that while most of the headteachers perceived facilitating PA as an important task in school, studies from other countries have reported the opposite [24, 25]. The fact that the majority of schools reported that they already had strategies for increased PA beyond physical education support this finding. Furthermore, many of the participants perceived physically active lessons to be in line with work already going on in the school. According to Domitrovich et al. , it is easier to implement new initiatives within existing practise. Nevertheless, when considering adopting physically active lessons, it looked like the majority of headteachers ticked off “we already do that in our school” on an imaginary list. However, most of the PA strategies they mentioned were not aligned to teaching and learning. According to Spillane et al. (2006, p. 50–51), people tend to give more credence to information that confirms rather than challenges or refutes their understanding. The results of this study indicated that the headteachers were not convinced that physically active lessons were necessary to implement, given that pupils had plenty of opportunities for PA during the school day. This finding indicates that the majority of headteachers lacked an in-depth understanding of physically active lessons’ function and intent.
The results indicated that physically active lessons are more likely to be adopted in schools where the innovation meets a clearly defined priority or improvement area at the school. Schools as implementing organisations are faced with overloaded improvement agendas. If physically active lessons is to be prioritised, it must not only be perceived as important, but also important relative to other needs [20, 22]. It is important that headteachers understand what the innovation consist of and what using it entails to be able to make an informed and well-thought-out decision about adoption of physically active lessons. But as Fullan (2016, p. 70) has pointed out: “people often don’t know what they don’t know”. As a consequence, school leaders need to be thoroughly informed about physically active lessons’ function and intent, and programme developers need to help schools understand how physically active lessons can be embedded in school policy and goals. Furthermore, it must be emphasised that physically active lessons are “a part of” achieving prioritised academic and educational goals, and not “an addition to” their workload.
Perception of school capacity
The majority of headteachers had the perception that physically active lessons could contribute positively to pupils’ health and learning. However, the perception of benefits for the pupils was apparently not sufficient to trigger school engagement, since only four of twenty-nine schools (three primary and one secondary) actually adopted physically active lessons.
A common thread throughout the interviews was headteachers’ perceptions of change overload. The headteachers seemed to be influenced by both perceived pressure from other school development projects, and teachers’ lack of motivation to conduct new change initiatives. In support, previous research has shown that headteachers face many expectations, leading to tension with many dilemmas . Although many headteachers describe previous positive change experience and climate for change, which indicates general capacity for change, , they generally considered it challenging to motivate teachers to adopt new change initiatives. The fact that the majority of headteachers did not inform the teachers about the request to participate in the “Active School” project, supports this finding. The decision not to inform the teachers may reflect a manager leadership style, which emphasises protecting staff and tending to need more knowledge and time to prepare for an efficient implementation . Indeed, some headteachers called for stronger evidence for outcomes relevant for them. Faced with overloaded improvement agendas, this strategy may also serve to protect teachers from random change initiatives, thus contributing to balanced change and stability . Starting multiple change projects simultaneously may result in too little time spent on each project and not enough time to carry out the learning process needed for successful implementation. Only a few headteachers mentioned funding as a motivating factor for choosing a specific programme. This finding indicates that funding is not crucial for acceptance, though it makes it easier to accept change initiatives.
Many headteachers experienced lack of capacity to lead change work. Some did report that teachers had started to teach physically active lessons of their own initiative, regardless of participation in the “Active School” project. This kind of leadership may reflect a Responder facilitator who tends to minimise the significance of proposed change and leave the pedagogical work to the teachers . However, even though “innovation champions” are acknowledged as important for sustainable implementation , headteachers need to be involved and draw attention to the importance and relevance of the project [20, 26].
Strengths and limitations
To our knowledge, this is the first study to examine headteachers’ perspectives on adoption and implementation of physically active lessons, and the results move beyond teacher and pupil views that dominate the current literature . Another strength is a large number of interviews, resulting in achieving data saturation . While the study outcomes are Norwegian-centric, results may be used to influence physically active lessons implementation in culturally similar countries. A limitation was that the participants were aware that the lead author who conducted the interviews was also a member of the “Active School” project team. This may have influenced them to respond more positively towards physically active lessons than they would otherwise have done. It should also be mentioned that data was obtained in a university city where there is a greater pressure to recruit schools for research projects than in more rural areas. That is, schools in Stavanger may be exposed to a great number of research requests, contributing to increased reporting of change overload.
The majority of headteachers believed that physically active lessons could contribute positively to pupils’ health and learning. However, perceptions of benefits for the pupils were not sufficient since only four of 29 schools adopted physically active lessons. There were different opinions as to whether the innovation was in line with local school policies, and the results indicate that physically active lessons were more likely to be adopted in schools where the innovation met a clearly defined priority area at the school. Change overload and lack of in-depth knowledge of physically active lessons’ function and intent, appeared to be the most important factors for rejection of physically active lessons. Schools as implementing organisations have numerous of goals. To make headteachers better qualified to make decisions about adopting physically active lessons, it is very important to specify what schools can achieve by implementing physically active lessons, and how the innovation aligns with school policies and goals. Furthermore, physically active lessons facilitative role regarding achieving prioritised educational goals, and not solely increased teacher workload, must be emphasised. Given the flexibility inherent in physically active lessons, and schools’ different needs, it is important to emphasise that physically active lessons can be adapted to the individual schools’ improvement priorities. This study points to the usefulness of the Quality Implementation Framework in studying headteachers` perceptions regarding an implementation of physically active lessons. Consistent with this model, a planned introduction, focusing on knowledge relevant to school leaders and teachers and offering practical demonstration focused on adapting to context, may facilitate greater buy-in and implementation of physically active lessons.
Availability of data and materials
The dataset analysed during the current study are available from the corresponding author on reasonable request.
Concern based adoption model
Level of use
Dalene KE, Anderssen SA, Andersen LB, Steene-Johannessen J, Ekelund U, Hansen BH, et al. Secular and longitudinal physical activity changes in population-based samples of children and adolescents. Scand J Med Sci Sports. 2018;28(1):161–71.
Steene-Johannessen J, Anderssen SA, Bratteteig M, Dalhaug ME, Andersen ID, Andersen OK, et al. Mapping physical activity, sedentary time and physical fitness in child and adoelcents 2018 (YoungCan3). Oslo: The Norwegian Directorate of Health; 2019. https://www.fhi.no/publ/2019/kartlegging-av-fysisk-aktivitet-sedat-tid-og-fysisk-form-blant-barn-og-unge/.
World Health Organization. Global action plan on physical activity 2018-2030, More active people for a healthier world. Geneva: World Health Organization (WHO); 2018.
Naylor PJ, Nettlefold L, Race D, Hoy C, Ashe MC, Wharf Higgins J, et al. Implementation of school based physical activity interventions: a systematic review. Prev Med. 2015;72:95–115.
Christian D, Todd C, Davies H, Rance J, Stratton G, Rapport F, et al. Community led active schools programme (CLASP) exploring the implementation of health interventions in primary schools: headteachers' perspectives. BMC Public Health. 2015;15(1).
Donnelly JE, Hillman CH, Greene JL, Hansen DM, Gibson CA, Sullivan DK, et al. Physical activity and academic achievement across the curriculum: results from a 3-year cluster-randomized trial. Prev Med. 2017;99:140–5.
Watson A, Timperio A, Brown H, Best K, Hesketh KD. Effect of classroom-based physical activity interventions on academic and physical activity outcomes: a systematic review and meta-analysis. Int J Behav Nutr Phys Act. 2017;14(1).
Martin R, Murtagh EM. Effect of active lessons on physical activity, academic, and health outcomes: a systematic review. Res Q Exerc Sport. 2017;88(2):149–68.
Singh AS, Saliasi E, van den Berg V, Uijtdewilligen L, de Groot RHM, Jolles J, et al. Effects of physical activity interventions on cognitive and academic performance in children and adolescents: a novel combination of a systematic review and recommendations from an expert panel. Br J Sports Med. 2019;53(10):640–7.
Daly-Smith AJ, Zwolinsky S, McKenna J, Tomporowski PD, Defeyter MA, Manley A. Systematic review of acute physically active learning and classroom movement breaks on children’s physical activity, cognition, academic performance and classroom behaviour: understanding critical design features. BMJ Open Sport Exerc Med. 2018;4(1).
Skage I, Dyrstad SM. The implementation of physically active lessons: a case study. Fysioterapeuten. 2016;5:20–5.
Kvalø SE, Bru E, Brønnick K, Dyrstad SM. Does increased physical activity in school affect children's executive function and aerobic fitness? Scand J Med Sci Sports. 2017;27:1833–41.
Seljebotn PH, Skage I, Riskedal A, Olsen M, Kvalø SE, Dyrstad SM. Physically active academic lessons and effect on physical activity and aerobic fitness. The active school study: a cluster randomized controlled trial. Prev Med Rep. 2019;13:183–8.
Dyrstad SM, Kvalø SE, Alstveit M, Skage I. Physically active academic lessons: acceptance, barriers and facilitators for implementation. BMC Public Health. 2018;18(1):322.
McMullen JM, Macphail A, Dillon M. "I want to do it all day!"—students’ experiences of classroom movement integration. Int J Educ Res. 2019;94:52–65.
Stylianou M, Kulinna PH, Naiman T. because there’s nobody who can just sit that long’: Teacher perceptions of classroom-based physical activity and related management issues. Eur Phys Educ Rev. 2016;22(3):390–408.
Hall GE, Hord SM. Implementing change. Patterns, principles, and Potoles. 4rd ed. New Jersey: Pearson Education, Inc.; 2015.
Domitrovich CE, Bradshaw CP, Poduska JM, Hoagwood K, Buckley JA, Olin S, et al. Maximizing the implementation quality of evidence-based preventive interventions in schools: a conceptual framework. Adv Sch Ment Health Promot. 2008;1(3):6–28.
Greenberg MT, Domitrovich CE, Gracyk PA, Zins JE. The Study of Implementation in School-Based Preventive Interventions: Theory, Research, and Practice. Rockville: US Department of Health and Humane Services; 2005.
Fullan M. The NEW meaning of educational change. 5th ed. London: Teachers College Press; 2016.
Norwegian Goverment. Political platform for the norwegian Goverment. In: regjeringen.no. https://www.regjeringen.no/no/dokumenter/politisk-plattform/id2626036/.
Meyers D, Durlak J, Wandersman A. The quality implementation framework: a synthesis of critical steps in the implementation process. Am J Community Psychol. 2012;50(3):462–80.
Spillane JP, Reiser BJ, Reimer T. Policy implementation and cognition: reframing and refocusing implementation research. Rev Educ Res. 2002;72(3):387–431.
Van den Berg V, Salimi R, RHM d G, Jolles J, MJM C, Singh A. “It’s a Battle … You Want to Do It, but How Will You Get It Done?”: Teachers’ and Principals’ Perceptions of Implementing Additional Physical activity in School for Academic Performance. Int J Environ Res Public Health. 2017;14(10):1160.
Todd C, Christian D, Davies H, Rance J, Stratton G, Rapport F, et al. Headteachers' prior beliefs on child health and their engagement in school based health interventions: a qualitative study. BMC Res Notes. 2015;8(1).
Midthassel UV, Bru E, Idse T. The Principal's role in promoting school development activity in Norwegian compulsory schools. Sch Leadersh Manag. 2000;20(2):247–60.
Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105–12.
Brinkmann S. The Interview. In: Creswell JW, Poth CN, editors. Qualitative Inquiry and Research Design: Choosing Among Five Traditions. Thousand Oaks, CA: SAGE Publications; 2018. p.76–97.
Graneheim UH, Lindgren BM, Lundman B. Methodological challenges in qualitative content analysis: a discussion paper. Nurse Educ Today. 2017;56:29–34.
Kvale S, Brinkmann S, Anderssen TM, Rygge J. Interviews: learning the craft of qualitative research interviewing. 3rd ed. Thousand Oaks: Sage; 2015.
Resaland GK, Moe VF, Bartholomew JB, Andersen LB, McKay HA, Anderssen SA, et al. Gender-specific effects of physical activity on children's academic performance: The active smarter kids cluster randomized controlled trial. Prev Med. 2018;106:171–6.
Bartholomew JB, Jowers EM, Roberts G, Fall AM, Errisuriz VL, Vaughn S. Active Learningincreases Children's physical activity across demographic subgroups. Transl J Am Coll Sports Med. 2018;3(1):1–9.
Daly-Smith A, Quarmby T, Archbold VSJ, Routen AC, Morris JL, Gammon C, et al. Implementing physically active learning: future directions for research, policy, and practice. J Sport Health Sci. 2019.
Møller J, Eggen A, Fuglestad OL, Langfeldt G, Presthus AM, Skøvset S, et al. Successful school leadership: the Norwegian case. J Educ Adm. 2005;43(6):584–94.
Flaspohler P, Duffy J, Wandersman A, Stillman L, Maras MA. Unpacking prevention capacity: an intersection of research-to-practice models and community-centered models. Am J Community Psychol. 2008;41(3–4):182–96.
Mulford B. Balance and learning: crucial elements in leadership for democratic schools. Leadersh Policy Sch. 2003;2(2):109–24.
The Authors would like to acknowledge Per Helge Seljebotn, Martha Olsen, Annette Riskedal, Inger Andersen and Petter Davidsen (all are physiotherapist in the Municipally of Stavanger). The authors would also like to thank Jørn Pedersen (chief municipal education office), and all the headteachers that participated, making this work possible.
Municipally of Stavanger, The Research Council of Norway and University of Stavanger funded the study.
Ethics approval and consent to participate
The Norwegian Social Science data Services approved the study (project number 50993). Headteachers gave their written consent to participate in the interviews.
Consent for publication
The authors declare that they have no competing interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
About this article
Cite this article
Skage, I., Dyrstad, S.M. ‘It’s not because we don’t believe in it...’: Headteachers’ perceptions of implementing physically active lessons in school. BMC Public Health 19, 1674 (2019). https://doi.org/10.1186/s12889-019-8021-5
- Physically active lessons