Weatherson Katie A, Gainforth Heather L, Jung Mary E
School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan, ART 360-1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
School of Health and Exercise Sciences, Faculty of Health and Social Development, University of British Columbia, Okanagan, ART 129-1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
Implement Sci. 2017 Mar 27;12(1):41. doi: 10.1186/s13012-017-0570-3.
Given the potential impact school-based daily physical activity (DPA) policies can have on the health outcomes of Canadian children, it is surprising that such little research has examined the implementation and student-level effectiveness of these policies, and that even less have used theory to understand the barriers and facilitators affecting uptake of this policy by teachers. This review descriptively summarizes the implementation status, approaches used to implement DPA, and the effectiveness of DPA at increasing the physical activity of children at school. In addition, the Theoretical Domains Framework (TDF) was used to explore the barriers and facilitators to DPA implementation.
A scoping review of English articles using ERIC, CINAHL, and Google Scholar (2005 to 2016) was conducted. Only studies that evaluated the implementation and/or student-level effectiveness of DPA policies in Canadian elementary schools were included. Only articles that examined DPA implementation barriers and facilitators by teachers, principals, and/or administration were eligible for the TDF analysis. Data on study characteristics and major findings regarding implementation status, implementation approach used, and impact on student's physical activity were extracted and were summarized descriptively, including study quality indicators. Two coders extracted and categorized implementation barriers and facilitators into TDF domains.
The search resulted in 66 articles being retrieved and 38 being excluded for not meeting the eligibility criteria, leaving 15 eligible for review (10 of which examined barriers and facilitators to implementation from DPA deliverers' perspective). Eleven of 15 studies examined the Ontario DPA policy, and 2 studies were from both Alberta and British Columbia. Thirteen studies examined implementation, and only two examined effectiveness. DPA implementation status, approaches to delivery, and effectiveness on student's PA levels are inconsistent across the three provinces. A total of 203 barriers/facilitators were extracted across the ten implementation studies, most of which related to the environmental context and resources (ECR; n = 86; 37.4%), beliefs about consequences (n = 41; 17.8%), and social influences (n = 36; 15.7%) TDF domains.
With the limited research examining the DPA policy in Canada, the current status and approaches used to implement DPA and the student-level effectiveness is not well understood; however, this review revealed that DPA deliverers often report many barriers to DPA implementation. Most importantly, in conducting a TDF-based analysis of the barriers/facilitators affecting implementation, this review provides a theoretical basis by which researchers and policy-makers can design interventions to better target these problems in the future.
A protocol for this review was not registered.
鉴于基于学校的日常体育活动（DPA）政策可能对加拿大儿童的健康状况产生潜在影响，令人惊讶的是，很少有研究考察这些政策的实施情况和学生层面的效果，而且更少有人运用理论来理解影响教师采纳该政策的障碍和促进因素。本综述以描述性方式总结了DPA的实施现状、实施方法以及DPA在增加儿童在校体育活动方面的效果。此外，还运用了理论领域框架（TDF）来探究DPA实施的障碍和促进因素。
对使用教育资源信息中心（ERIC）、护理学与健康领域数据库（CINAHL）和谷歌学术搜索（2005年至2016年）的英文文章进行了范围综述。仅纳入评估加拿大小学DPA政策实施情况和/或学生层面效果的研究。只有那些考察教师、校长和/或管理人员对DPA实施障碍和促进因素的文章才有资格进行TDF分析。提取了关于研究特征以及实施现状、所采用的实施方法和对学生体育活动影响的主要研究结果，并进行描述性总结，包括研究质量指标。两名编码员将实施障碍和促进因素提取并归类到TDF领域。
检索到66篇文章，其中38篇因不符合纳入标准而被排除，剩余15篇符合综述要求（其中10篇从DPA实施者的角度考察了实施障碍和促进因素）。15项研究中有11项考察了安大略省的DPA政策，2项研究来自阿尔伯塔省和不列颠哥伦比亚省。13项研究考察了实施情况，只有2项考察了效果。三个省份在DPA的实施现状、实施方式以及对学生体育活动水平的影响方面存在不一致。在10项实施研究中总共提取了203个障碍/促进因素，其中大部分与环境背景和资源（ECR；n = 86；37.4%）、对后果的信念（n = 41；17.8%）以及社会影响（n = 36；15.7%）等TDF领域相关。
鉴于在加拿大对DPA政策的研究有限，目前对DPA的实施现状、实施方法以及学生层面的效果尚不清楚；然而，本综述表明DPA实施者经常报告DPA实施存在诸多障碍。最重要的是，通过对影响实施的障碍/促进因素进行基于TDF的分析，本综述提供了一个理论基础，研究人员和政策制定者未来可据此设计干预措施，以更好地解决这些问题。
本综述未进行注册。
