Naylor Patti-Jean, Nettlefold Lindsay, Race Douglas, Hoy Christa, Ashe Maureen C, Wharf Higgins Joan, McKay Heather A
School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015 STN CSC, Victoria BC V8W 3P1, Canada.
Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, 2635 Laurel Street, Vancouver BC V5Z 1M9, Canada.
Prev Med. 2015 Mar;72:95-115. doi: 10.1016/j.ypmed.2014.12.034. Epub 2015 Jan 6.
Implementation science is an emerging area in physical activity (PA) research. We sought to establish the current state of the evidence related to implementation of school-based PA models to explore 1) the relationship between implementation and health outcomes, and 2) factors that influence implementation.
We searched 7 electronic databases (1995-2014) and included controlled studies of school-based PA programmes for healthy youth (6-18 y) measuring at least one physical health-related outcome. For objective 1, studies linked implementation level to student-level health outcome(s). For objective 2, studies reported factors associated with implementation.
There was substantial variability in how health outcomes and implementation were assessed. Few studies linked implementation and health outcomes (n=15 interventions). Most (11/15) reported a positive relationship between implementation and at least one health outcome. Implementation factors were reported in 29 interventions. Of 22 unique categories, time was the most prevalent influencing factor followed by resource availability/quality and supportive school climate.
Implementation evaluation supports scale-up of effective school-based PA interventions and thus population-level change. Our review serves as a call to action to 1) address the link between implementation and outcome within the school-based PA literature and 2) improve and standardize definitions and measurement of implementation.
实施科学是体育活动（PA）研究中的一个新兴领域。我们试图确定与实施基于学校的体育活动模式相关的现有证据状况，以探讨：1）实施与健康结果之间的关系；2）影响实施的因素。
我们检索了7个电子数据库（1995 - 2014年），纳入了针对健康青少年（6 - 18岁）的基于学校的体育活动项目的对照研究，这些研究测量了至少一项与身体健康相关的结果。对于目标1，研究将实施水平与学生层面的健康结果联系起来。对于目标2，研究报告了与实施相关的因素。
健康结果和实施的评估方式存在很大差异。很少有研究将实施与健康结果联系起来（n = 15项干预措施）。大多数（11/15）报告实施与至少一项健康结果之间存在正相关关系。在29项干预措施中报告了实施因素。在22个独特类别中，时间是最普遍的影响因素，其次是资源可用性/质量和支持性的学校氛围。
实施评估支持扩大有效的基于学校的体育活动干预措施，从而实现人群层面的改变。我们的综述呼吁采取行动：1）解决基于学校的体育活动文献中实施与结果之间的联系；2）改进并规范实施的定义和测量。
