• Behaviours that prompt primary school teachers to adopt and implement physically active learning: a meta synthesis of qualitative evidence.

      Daly-Smith, Andrew; Morris, J.L.; Norris, E.; Williams, T.L.; Archbold, V.; Kallio, J.; Tammelin, T.H.; Singh, A.; Mota, J.; von Seelen, J.; et al. (2021-11-20)
      Physically active learning (PAL) - integration of movement within delivery of academic content - is a core component of many whole-of-school physical activity approaches. Yet, PAL intervention methods and strategies vary and frequently are not sustained beyond formal programmes. To improve PAL training, a more comprehensive understanding of the behavioural and psychological processes that influence teachers' adoption and implementation of PAL is required. To address this, we conducted a meta-synthesis to synthesise key stakeholders' knowledge of facilitators and barriers to teachers' implementing PAL in schools to improve teacher-focussed PAL interventions in primary (elementary) schools. We conducted a meta-synthesis using a five-stage thematic synthesis approach to; develop a research purpose and aim, identify relevant articles, appraise studies for quality, develop descriptive themes and interpret and synthesise the literature. In the final stage, 14 domains from the Theoretical Domain Framework (TDF) were then aligned to the final analytical themes and subthemes. We identified seven themes and 31 sub-themes from 25 eligible papers. Four themes summarised teacher-level factors: PAL benefits, teachers' beliefs about own capabilities, PAL teacher training, PAL delivery. One theme encompassed teacher and school-level factors: resources. Two themes reflected school and external factors that influence teachers' PAL behaviour: whole-school approach, external factors. Ten (of 14) TDF domains aligned with main themes and sub-themes: Knowledge, Skills, Social/Professional Role and Identity, Beliefs about Capabilities, Beliefs about Consequences, Reinforcement, Goals, Environmental Context and Resources, Social influences and Emotion. Our synthesis illustrates the inherent complexity required to change and sustain teachers' PAL behaviours. Initially, teachers must receive the training, resources and support to develop the capability to implement and adapt PAL. The PAL training programme should progress as teachers' build their experience and capability; content should be 'refreshed' and become more challenging over time. Subsequently, it is imperative to engage all levels of the school community for PAL to be fully integrated into a broader school system. Adequate resources, strong leadership and governance, an engaged activated community and political will are necessary to achieve this, and may not currently exist in most schools.
    • Commentary on a recent article on the effects of the 'Daily Mile' on physical activity, fitness and body composition: addressing key limitations

      Daly-Smith, Andrew; Morris, J.L.; Hobbs, M.; McKenna, J. (2019-05-22)
      A recent pilot study by Chesham et al. in BMC Medicine established some initial effects of the Daily Mile™ using a quasi-experimental repeated measures design, with valid and reliable outcome assessments for moderate-to-vigorous physical activity, fitness and body composition. Their contribution is important and welcome, yet, alone, it is insufficient to justify the recent UK-wide adoption of the Daily Mile within the Childhood Obesity Plan. The study concluded that the Daily Mile had positive effects on moderate-to-vigorous physical activity, fitness and body composition, suggesting that intervention effectiveness was confirmed. However, only some of the significant limitations of the work were addressed. Herein, we identify and discuss six key limitations, which, combined, suggest a more tentative conclusion. In summary, evidence supporting the effectiveness of the Daily Mile is in its infancy and requires refinement to fully justify its widespread adoption. Further, we need to be cautious considering that the full range of its impacts, both positive and negative, remain to be fully established.
    • The Conforming, The Innovating and The Connecting Teacher: A qualitative study of why teachers in lower secondary school adopt physically active learning

      Øystein, L.; Tjomsland, H.E.; Leirhaug, P.E.; McKenna, J.; Quaramby, T.; Bartholomew, J.; Jenssen, E.S.; Daly-Smith, Andrew; Resaland, G.K. (2021-09)
      This paper explores why teachers adopt physically active learning (PAL). Data were collected through ‘go-alongs’ supplemented by individual interviews with 13 teachers in seven Norwegian lower secondary schools. Data were then analysed thematically. Results indicated that as well as to enhance their teaching and pupils' learning, teachers adopt PAL to adhere to school policy (The Conforming Teacher), to be an innovative educator (The Innovating Teacher), and, because it matches past positive personal experiences (The Connecting Teacher). The findings can be used to shape PAL teacher training programs to increase the likelihood of adoption.
    • The Daily Mile™ initiative: Exploring physical activity and the acute effects on executive function and academic performance in primary school children

      Morris, J.L.; Daly-Smith, Andrew; Archbold, V.S.J.; Wilkins, E.L.; McKenna, J. (2019-11)
      For schools to consider physical activity (PA) interventions, improvements must be shown in PA and additional educational benefits such as executive function (EF) and academic performance (AP). Over 8800 schools worldwide have implemented The Daily Mile™ (TDM), without any formal assessments of its impact. Rigorous and high-quality studies are needed to explore TDM's contribution to moderate-to-vigorous PA (MVPA) guidelines and potential impact on EFs and AP. Methods: Children (14 classes, n = 303, age mean = 8.99 ± 0.5) from 11 primary schools already implementing TDM consented. At the individual level, children were randomly assigned using a 4-block process to either TDM or continued academic lessons (TDM n = 158, control n = 145). Children completed pre and post, EF tests (Trail Making Task; Digit Recall; Flanker; Animal Stroop) and a maths fluency test (Maths Addition and Subtraction, Speed and Accuracy Test). Accelerometers assessed MVPA using 15-s-epochs and Evenson cut-points. Results: Using multi-level modelling, TDM revealed significantly greater MVPA (+10.23 min) and reduced sedentary time (−9.28 min) compared to control (p ≤ 0.001, d = 4.92, 3.61 retrospectively). Maths fluency interacted with condition and time (p = 0.031, d = 0.25); post hocs revealed no significances over time (p > 0.05). No differences in EFs (all p > 0.05). Conclusions: This study is the first assessing the acute effects of TDM compared to continued academic lessons. TDM revealed no significant improvements in maths fluency or EF. These findings question justifying the widespread adoption of TDM based on enhanced cognition claims. Nonetheless, TDM may provide 10 min of MVPA, achieving a third of the daily in school recommendations to meet overall daily recommendations.
    • Effects of Maths on the Move on Children’s Perspectives, Physical Activity, and Maths Performance

      Morris, J.L.; Archbold, V.S.J.; Bond, S.J.; Daly-Smith, Andrew (2022-01)
      Purpose To assess the impact of a six-week ‘Maths on the Move’ (MOTM) physically active learning programme on primary school children’s physical activity (PA) levels and maths performance. Method Randomised control trial. Year 5 children’s PA was assessed using accelerometry for five consecutive school days at baseline and during the final intervention week (final sample: n=97, age M=9.61±0.29, 52.6% female). Two maths performance tests were used; one assessing mathematical content taught during MOTM and one assessing math’s fluency (MASSAT). Both tests were conducted at baseline and following the intervention (week seven). Focus groups were conducted in week seven with intervention children (n=12), randomly choosing an even split of children classified with pre-intervention low or high PA levels. Results On average, during a typical 45-49 minutes MOTM lesson, children obtained an additional five minutes of moderate-to-vigorous PA and 5.7 minutes of light PA counteracted by a reduction of 9.5 minutes of time spent sedentary compared to children that remained in the classroom (control condition). The maths attainment test performance significantly improved over time for children in the MOTM compared to the control (+6.1 versus +0.9, p≤0.0001, d=1.507). No significant improvements were found in the MASSAT total score. Seven emerging themes were derived from the child focus groups. Children felt the MOTM sessions resulted in social and environmental improvements, which improved learning during the sessions. Children described the MOTM sessions as enjoyable, fun, engaging and invigorating – resulting in positive associations to learning and activity. Conclusion Collectively, the findings identify the MOTM programme improves pupil’s PA levels, academic outcomes and identifies pupil’s willingness, enjoyment, and engagement.
    • Implementing physically active learning: Future directions for research, policy, and practice

      Daly-Smith, Andrew; Quarmby, T.; Archbold, V.S.J.; Routen, A.C.; Morris, J.L.; Gammon, C.; Bartholomew, J.B.; Resaland, G.K.; Llewellyn, B.; Allman, R.; et al. (2020-01)
      To identify co-produced multi-stakeholder perspectives important for successful widespread physically active learning (PAL) adoption and implementation. A total of 35 stakeholders (policymakers n = 9; commercial education sector, n = 8; teachers, n = 3; researchers, n = 15) attended a design thinking PAL workshop. Participants formed 5 multi-disciplinary groups with at least 1 representative from each stakeholder group. Each group, facilitated by a researcher, undertook 2 tasks: (1) using Post-it Notes, the following question was answered: within the school day, what are the opportunities for learning combined with movement? and (2) structured as a washing-line task, the following question was answered: how can we establish PAL as the norm? All discussions were audio-recorded and transcribed. Inductive analyses were conducted by 4 authors. After the analyses were complete, the main themes and subthemes were assigned to 4 predetermined categories: (1) PAL design and implementation, (2) priorities for practice, (3) priorities for policy, and (4) priorities for research. The following were the main themes for PAL implementation: opportunities for PAL within the school day, delivery environments, learning approaches, and the intensity of PAL. The main themes for the priorities for practice included teacher confidence and competence, resources to support delivery, and community of practice. The main themes for the policy for priorities included self-governance, the Office for Standards in Education, Children's Services, and Skill, policy investment in initial teacher training, and curriculum reform. The main themes for the research priorities included establishing a strong evidence base, school-based PAL implementation, and a whole-systems approach. The present study is the first to identify PAL implementation factors using a combined multi-stakeholder perspective. To achieve wider PAL adoption and implementation, future interventions should be evidence based and address implementation factors at the classroom level (e.g., approaches and delivery environments), school level (e.g., communities of practice), and policy level (e.g., initial teacher training).
    • Introducing physically active lessons in UK secondary schools: feasibility study and pilot cluster-randomised controlled trial

      Gammon, C.; Morton, K.; Atkin, A.; Corder, K.; Daly-Smith, Andrew; Quarmby, T.; Suhrcke, M.; Turner, D.; van Sluijs, E. (2019-05)
      Assess feasibility, acceptability and costs of delivering a physically active lessons (PAL) training programme to secondary school teachers and explore preliminary effectiveness for reducing pupils' sedentary time. Secondary schools in East England; one school participated in a pre-post feasibility study, two in a pilot cluster-randomised controlled trial. In the pilot trial, blinding to group assignment was not possible. Across studies, 321 randomly selected students (51% male; mean age: 12.9 years), 78 teachers (35% male) and 2 assistant head teachers enrolled; 296 (92%) students, 69 (88%) teachers and 2 assistant head teachers completed the studies. PAL training was delivered to teachers over two after-school sessions. Teachers were made aware of how to integrate movement into lessons; strategies included students collecting data from the environment for class activities and completing activities posted on classroom walls, instead of sitting at desks. Quantitative and qualitative data were collected to assess feasibility and acceptability of PAL training and delivery. Outcomes were assessed at baseline and ~8 weeks post-training; measures included accelerometer-assessed activity, self-reported well-being and observations of time-on-task. Process evaluation was conducted at follow-up. In the feasibility study, teachers reported good acceptability of PAL training and mixed experiences of delivering PAL. In the pilot study, teachers' acceptability of training was lower and teachers identified aspects of the training in need of review, including the outdoor PAL training and learning challenge of PAL strategies. In both studies, students and assistant head teachers reported good acceptability of the intervention. Preliminary effectiveness for reducing students' sedentary time was not demonstrated in either study. No evidence of preliminary effectiveness on the primary outcome and mixed reports of teachers' acceptability of PAL training suggest the need to review the training. The results do not support continuation of research with the current intervention. ISRCTN38409550.
    • Moderate-to-vigorous physical activity in primary school children: inactive lessons are dominated by maths and English

      Daly-Smith, Andrew; Hobbs, M.; Morris, J.L.; Defeyter, M.A.; Resaland, G.K.; McKenna, J. (MDPI, 2021-01)
      Background: A large majority of primary school pupils fail to achieve 30-min of daily, in-school moderate-to-vigorous physical activity (MVPA). The aim of this study was to investigate MVPA accumulation and subject frequency during academic lesson segments and the broader segmented school day. Methods: 122 children (42.6% boys; 9.9 ± 0.3 years) from six primary schools in North East England, wore uniaxial accelerometers for eight consecutive days. Subject frequency was assessed by teacher diaries. Multilevel models (children nested within schools) examined significant predictors of MVPA across each school-day segment (lesson one, break, lesson two, lunch, lesson three). Results: Pupils averaged 18.33 ± 8.34 min of in-school MVPA, and 90.2% failed to achieve the in-school 30-min MVPA threshold. Across all school-day segments, MVPA accumulation was typically influenced at the individual level. Lessons one and two—dominated by maths and English—were less active than lesson three. Break and lunch were the most active segments. Conclusion: This study breaks new ground, revealing that MVPA accumulation and subject frequency varies greatly during different academic lessons. Morning lessons were dominated by the inactive delivery of maths and English, whereas afternoon lessons involved a greater array of subject delivery that resulted in marginally higher levels of MVPA.
    • A pedometer-based physically active learning intervention: The importance of using preintervention physical activity categories to assess effectiveness

      Morris, J.L.; Daly-Smith, Andrew; Defeyter, M.A.; McKenna, J.; Zwolinsky, S.; Lloyd, S.; Fothergill, M.; Graham, P.L. (2019-08)
      Purpose: To assess physical activity outcomes of a pedometer-based physically active learning (PAL) intervention in primary school children. Methods: Six paired schools were randomly allocated to either a 6-week teacher-led pedometer-based physically active learning intervention or a control (n = 154, female = 60%, age = 9.9 [0.3] y). Accelerometers assessed total daily sedentary time, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Preintervention mean daily MVPA minutes grouped participants as Low Active (<45 min/d) and High Active (≥45 min/d). Results: From the final sample size, the intervention (n = 52) significantly improved LPA versus control (n = 31, P = .04), by reducing sedentary time. More intervention (+10%) than control (+3%) pupils met the 60 minutes per day guidelines. In both intervention subgroups, pupils spent less time in LPA (P < .05) versus control. The greatest nonsignificant increase was found in the Low Active pupils MVPA levels. Conclusions: Improvements in LPA were statistically significant in the intervention versus control group. In subgroup analysis, Low Active pupils in the intervention showed the greatest beneficial effects and the Most Active pupils may have replaced MVPA and sedentary time with LPA. The intervention group housed clusters of pupils showing variable responsiveness, justifying routine examination of subgroup variability in future studies.
    • 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.

      Daly-Smith, Andrew; Zwolinsky, S; McKenna, J.; Tomporowski, P.D.; Defeyter, M.A.; Manley, A. (2018)
      To examine the impact of acute classroom movement break (CMB) and physically active learning (PAL) interventions on physical activity (PA), cognition, academic performance and classroom behaviour. Systematic review. PubMed, EBSCO, Academic Search Complete, Education Resources Information Center, PsycINFO, SPORTDiscus, SCOPUS and Web of Science. Studies investigating school-based acute bouts of CMB or PAL on (PA), cognition, academic performance and classroom behaviour. The Downs and Black checklist assessed risk of bias. Ten PAL and eight CMB studies were identified from 2929 potentially relevant articles. Risk of bias scores ranged from 33% to 64.3%. Variation in study designs drove specific, but differing, outcomes. Three studies assessed PA using objective measures. Interventions replaced sedentary time with either light PA or moderate-to-vigorous PA dependent on design characteristics (mode, duration and intensity). Only one study factored individual PA outcomes into analyses. Classroom behaviour improved after longer moderate-to-vigorous (>10 min), or shorter more intense (5 min), CMB/PAL bouts (9 out of 11 interventions). There was no support for enhanced cognition or academic performance due to limited repeated studies. Low-to-medium quality designs predominate in investigations of the acute impacts of CMB and PAL on PA, cognition, academic performance and classroom behaviour. Variable quality in experimental designs, outcome measures and intervention characteristics impact outcomes making conclusions problematic. CMB and PAL increased PA and enhanced time on task. To improve confidence in study outcomes, future investigations should combine examples of good practice observed in current studies. CRD42017070981.
    • Teacher Perceptions of Fundamental Movement Skills and their Assessment in Primary Schools

      Eddy, L.H.; Hill, L.J.B.; Mon-Williams, M.; Preston, N.; Daly-Smith, Andrew; Medd, G.; Bingham, D.D. (2021)
      Evidence suggests that children struggle to acquire age-appropriate fundamental movement skills (FMS), despite their importance for facilitating physical activity. This has led to calls for routine school-based screening of children’s FMS. However, there is limited research exploring schools’ capacity to conduct such assessments. This study investigated what factors might affect the adoption and implementation of FMS assessments in primary schools. School staff (n=853) completed an online questionnaire developed using the Capability, Opportunity, Motivation and Behaviour (COM-B) model. A majority reported that knowledge of pupils’ FMS ability would be beneficial (65.3%), and 71.8% would assess FMS if support was provided. Barriers included: Capability – few possessed knowledge of FMS (15%); Opportunity – teachers reported 30-60 minutes as acceptable for assessing a class, a substantially shorter period than current assessments require; Motivation – 57.2% stated FMS assessments would increase workload stress. Solutions to these issues are discussed using the COM-B theoretical framework.
    • Teachers' Perspectives on the Acceptability and Feasibility of Wearable Technology to Inform School-Based Physical Activity Practices

      Wort, G.K.; Wiltshire, G.; Peacock, O.; Sebire, S.; Daly-Smith, Andrew; Thompson, D. (2021-11-18)
      Background: Many children are not engaging in sufficient physical activity and there are substantial between-children physical activity inequalities. In addition to their primary role as educators, teachers are often regarded as being well-placed to make vital contributions to inclusive visions of physical activity promotion. With the dramatic increase in popularity of wearable technologies for physical activity promotion in recent years, there is a need to better understand teachers' perspectives about using such devices, and the data they produce, to support physical activity promotion in schools. Method: Semi-structured interviews were conducted with 26 UK-based primary school teachers, exploring their responses to children's physical activity data and their views about using wearable technologies during the school day. Interview discussions were facilitated by an elicitation technique whereby participants were presented with graphs illustrating children's in-school physical activity obtained from secondary wearable technology data. Interview transcripts were thematically analyzed. Results: Most teachers spoke positively about the use of wearable technologies specifically designed for school use, highlighting potential benefits and considerations. Many teachers were able to understand and critically interpret data showing unequal physical activity patterns both within-and between-schools. Being presented with the data prompted teachers to provide explanations about observable patterns, emotional reactions-particularly about inequalities-and express motivations to change the current situations in schools. Conclusion: These findings suggest that primary school teachers in the UK are open to integrating wearable technology for measuring children's physical activity into their practices and can interpret the data produced by such devices. Visual representations of physical activity elicited strong responses and thus could be used when working with teachers as an effective trigger to inform school practices and policies seeking to address in-school physical inactivity and inequalities.
    • Using a multi-stakeholder experience-based design process to co-develop the Creating Active Schools Framework

      Daly-Smith, Andrew; Quarmby, T.; Archbold, V.S.J.; Corrigan, N.; Wilson, D.; Resaland, G.K.; Bartholomew, J.B.; Singh, A.; Tjomsland, H.E.; Sherar, L.B.; et al. (2020-02)
      UK and global policies recommend whole-school approaches to improve childrens' inadequate physical activity (PA) levels. Yet, recent meta-analyses establish current interventions as ineffective due to suboptimal implementation rates and poor sustainability. To create effective interventions, which recognise schools as complex adaptive sub-systems, multi-stakeholder input is necessary. Further, to ensure 'systems' change, a framework is required that identifies all components of a whole-school PA approach. The study's aim was to co-develop a whole-school PA framework using the double diamond design approach (DDDA). Fifty stakeholders engaged in a six-phase DDDA workshop undertaking tasks within same stakeholder (n = 9; UK researchers, public health specialists, active schools coordinators, headteachers, teachers, active partner schools specialists, national organisations, Sport England local delivery pilot representatives and international researchers) and mixed (n = 6) stakeholder groupings. Six draft frameworks were created before stakeholders voted for one 'initial' framework. Next, stakeholders reviewed the 'initial' framework, proposing modifications. Following the workshop, stakeholders voted on eight modifications using an online questionnaire. Following voting, the Creating Active Schools Framework (CAS) was designed. At the centre, ethos and practice drive school policy and vision, creating the physical and social environments in which five key stakeholder groups operate to deliver PA through seven opportunities both within and beyond school. At the top of the model, initial and in-service teacher training foster teachers' capability, opportunity and motivation (COM-B) to deliver whole-school PA. National policy and organisations drive top-down initiatives that support or hinder whole-school PA. To the authors' knowledge, this is the first time practitioners, policymakers and researchers have co-designed a whole-school PA framework from initial conception. The novelty of CAS resides in identifying the multitude of interconnecting components of a whole-school adaptive sub-system; exposing the complexity required to create systems change. The framework can be used to shape future policy, research and practice to embed sustainable PA interventions within schools. To enact such change, CAS presents a potential paradigm shift, providing a map and method to guide future co-production by multiple experts of PA initiatives 'with' schools, while abandoning outdated traditional approaches of implementing interventions 'on' schools.
    • A whole system approach to increasing children's physical activity in a multi-ethnic UK city: a process evaluation protocol

      Hall, Jennifer; Bingham, Daniel D.; Seims, Amanda; Dogra, Sufyan A.; Burkhardt, Jan; Nobles, J.; McKenna, J.; Bryant, M.; Barber, Sally E.; Daly-Smith, Andrew (2021-12-18)
      Engaging in regular physical activity requires continued complex decision-making in varied and dynamic individual, social and structural contexts. Widespread shortfalls of physical activity interventions suggests the complex underlying mechanisms of change are not yet fully understood. More insightful process evaluations are needed to design and implement more effective approaches. This paper describes the protocol for a process evaluation of the JU:MP programme, a whole systems approach to increasing physical activity in children and young people aged 5-14 years in North Bradford, UK. This process evaluation, underpinned by realist philosophy, aims to understand the development and implementation of the JU:MP programme and the mechanisms by which JU:MP influences physical activity in children and young people. It also aims to explore behaviour change across wider policy, strategy and neighbourhood systems. A mixed method data collection approach will include semi-structured interview, observation, documentary analysis, surveys, and participatory evaluation methods including reflections and ripple effect mapping. This protocol offers an innovative approach on the use of process evaluation feeding into an iterative programme intended to generate evidence-based practice and deliver practice-based evidence. This paper advances knowledge regarding the development of process evaluations for evaluating systems interventions, and emphasises the importance of process evaluation.
    • ‘You get some very archaic ideas of what teaching is … ’: primary school teachers’ perceptions of the barriers to physically active lessons

      Quarmby, T.; Daly-Smith, Andrew; Kime, N. (2019-04)
      Physically active lessons present a key paradigm shift in educational practice. However, little is known about the barriers to implementing physically active lessons. To address this, 31 practising primary teachers (23 = female) from 9 primary schools across West Yorkshire, England, were engaged in focus group interviews. Drawing on the socio-ecological model, findings revealed that barriers influencing the implementation of physically active lessons are multifaceted. Teacher’s confidence and competence, concerns over classroom space, preparation time and resources, coupled with the wider school culture that is influenced by governors and parents, reinforce a didactic approach and act as barriers to physically active lessons.