School of Kinesiology and Physical Activity Sciences, Université de Montréal, Station Downtown, Montréal, Québec H3C 3J7, Canada.
Health Promot Int. 2022 Aug 1;37(4). doi: 10.1093/heapro/daac095.
The lack of physical activity (PA) amongst children is a public health concern in many industrialized countries. School-based daily physical activity (DPA) policies are a promising intervention for increasing PA levels amongst children. Informed by a logic model framework, this study examines the factors associated with meeting a 'top-down' DPA objective in the context of a 'bottom-up' implementation of a school-based DPA initiative in Quebec, Canada. An online survey assessing school-level inputs, outputs and outcomes was sent to all participating schools (415). Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression to evaluate potential associations between factors (inputs and outputs) and the school's adherence to providing at least 60 minutes of DPA (outcome). Adjusted ORs (AORs) and 95% CIs were calculated using a multivariate logistic regression to identify the best set of factors to predict adherence to the DPA objective. A total of 404 schools completed the questionnaire, amongst which 71% reported meeting the DPA target by implementing school-tailored activities. Three factors were identified as the best set of school inputs and outputs to predict meeting the objective: financial resources (per student) (AOR = 1.02; 95% CI 1.01-1.03), a shared vision amongst the school-team members that PA benefits learning outcomes (AOR = 1.94; 95% CI 1.04-3.19) and having conducted a detailed situational analysis (AOR = 1.89; 95% CI 1.00-3.58). Given that 'bottom-up' implementation might favour the development of policies that are more acceptable to stakeholders, our results should be considered by decision-makers and school administrators when implementing DPA initiatives.
在许多工业化国家，儿童缺乏身体活动（PA）是一个公共卫生关注点。基于学校的日常身体活动（DPA）政策是增加儿童身体活动水平的一种有前途的干预措施。本研究以逻辑模型框架为指导，在加拿大魁北克“自下而上”实施基于学校的 DPA 倡议的背景下，研究了与实现“自上而下”的 DPA 目标相关的因素。一项评估学校层面投入、产出和结果的在线调查被发送给所有参与学校（415 所）。使用逻辑回归计算粗比值比（OR）和 95%置信区间（CI），以评估因素（投入和产出）与学校遵守提供至少 60 分钟 DPA（结果）之间的潜在关联。使用多变量逻辑回归计算调整比值比（AOR）和 95%CI，以确定最佳因素组合来预测对 DPA 目标的遵守情况。共有 404 所学校完成了问卷，其中 71%报告通过实施针对学校的活动来实现 DPA 目标。确定了三个因素作为预测符合目标的最佳学校投入和产出组合：每名学生的财政资源（AOR=1.02；95%CI 1.01-1.03）、学校团队成员中认为 PA 有益于学习成果的共同愿景（AOR=1.94；95%CI 1.04-3.19）和进行了详细的情境分析（AOR=1.89；95%CI 1.00-3.58）。鉴于“自下而上”的实施可能有利于制定更受利益相关者接受的政策，决策者和学校管理人员在实施 DPA 计划时应考虑我们的研究结果。
