Adapted Comprehensive School Physical Activity Program

Physical activity (PA) is a key potentially modifiable, protective pathway to supporting youth physical health and resilience. Schools are considered central to promotion of PA and the CDC recommends they adopt a Comprehensive School PA Program (CSPAP), an evidence-based framework for how to increase PA before, during, and after school. However, only about 3% of US secondary schools have PA practices that include all domains of the CSPAP framework. CSPAP-based interventions are particularly critical for student populations that may not have other opportunities to engage in health-promoting physical activity, sports or outdoor recreation. There is thus a critical need to determine how to effectively support all schools in increasing PA opportunities. We have developed and conducted feasibility testing of an adaptation of CSPAP to meet the needs of a range of students, and are proposing a Hybrid Type I implementation-effectiveness trial of this adapted CSPAP using a stepped-wedge design to compare schools when they are in the intervention versus control phases. We hypothesize that this intervention will increase PA opportunities for students, and they will engage in significantly more (accelerometer-measured) physical activity, demonstrate greater gains in fitness/physical literacy, and report better psychosocial functioning, during the intervention phase versus the control phase. We will also examine differential effects of all student level outcomes by demographic characteristics. Using a mixed-methods approach, we will explore facilitators to successful implementation and maintenance so as to inform continued intervention improvement, and scalability. This project would inform best practices related to school-based promotion of youth PA with the goal of informing scalable strategies to promote youth PA opportunities, health and well-being.