Purpose: Whole system approaches to public health challenges such as low physical activity levels have the potential to create sustained behaviour change at a population level and tackle health inequalities. However, there is currently little evidence of the nature or effectiveness of adopting whole system approaches. This study evaluated whether a whole system physical activity intervention (JU:MP) was effective at improving physical activity in five- to eleven-year-olds. Methods: A before and after controlled study with two-arms (JU:MP intervention and control), was conducted in Bradford, United Kingdom with data collected at baseline and 24-months follow-up. Habitual physical activity was measured via accelerometry. The primary outcome was difference in moderate-to-vigorous intensity physical activity (MVPA) between groups at 24-months. Secondary outcomes included: sedentary time (ST), counts per minute (CPM), BMI z-score, waist circumference, social, emotional, and behavioural health, and quality-of-life. An exploratory analysis compared intervention effects between sub-groups. Results: 1,453 children were recruited. 330 children with valid wear-time at baseline and 24-months (JU:MP group n = 175, control group n = 155) were included in the final analysis of physical activity outcomes. The JU:MP group improved levels of MVPA (+4.99 minutes/day, confidence interval (CI) = 1.01, 8.96, standardised mean difference (SMD) = 0.29), ST (–8.69 minutes/day, CI = –16.76, –0.61, SMD = –0.20), and CPM (+32.72, CI = 5.93, 59.53, SMD = 0.28) compared to controls. There were minor differences between groups in all secondary outcomes, favouring the JU:MP group. Exploratory sub-group analysis revealed that MVPA improved for boys (+7.34 minutes/day, CI = 0.70, 13.99, SMD = 0.36) and South Asian heritage children (+7.20 minutes/day, CI = 1.67, 12.72, SMD = 0.52) in the JU:MP group compared to the control group. Conclusions: Whole system approaches hold considerable promise for addressing children’s levels of physical activity at scale, whilst also tackling inequalities. Support/Funding Source: This study was supported by Sport England’s Local Delivery Pilot – Bradford; weblink: https://www.sportengland.org/campaigns-and-our-work/local-delivery. Sport England is a non-departmental public body under the Department for Digital, Culture, Media and Sport. Keywords: Physical activity, whole system, children, inequalities, before and after trial

IntroductionThe concept of physical literacy has been defined differently across the world. To create a consensus statement and definition of physical literacy for England, it was felt important to incorporate the views and opinions of children and young people who are often the focus of interventions to increase physical activity and physical literacy. The aim of this qualitative study was to understand what physical literacy means to children by exploring their perceptions of meaningful physical activity and what they think will be needed to continue to be active for life.MethodsThrough a series of directed tasks and thematic analysis, several important considerations are discussed. These included the pertinence of social relationships-whether it was to share experiences, support and encourage friends, or learn from your family.Results and DiscussionChildren discussed how physical activity positively affects their emotions and the importance of enjoyment in continuing to engage in movement for the rest of their lives. In addition, there was an awareness of the benefits for mental and physical health, which indicated the prominence of knowing these benefits in engaging. The findings offer some important contributions from children to better understand what physical literacy means in England.

Background Public health students can contribute to improving population health outcomes; however, this remains an under-researched area. This review aims to assess the extent of the literature related to health promotion interventions led by public health students. This includes what these interventions are and how they are being conducted, as well as their impact on targeted populations. Methods A scoping review was conducted according to JBI guidelines. A search strategy was developed using the population, context, concept framework. MEDLINE, CINAHL, Embase and Google Scholar were consulted. The selection process involved the screening of titles and abstracts against the inclusion criteria, followed by a full-text screening and data extraction by two reviewers. Disagreements were solved by consensus. Results 191 studies were identified, but only five of these were included. The target populations included the general public, university students, and minority groups. Students were trained or supervised by experienced staff. The interventions were delivered using diverse means, including innovative approaches through social media. The student-led interventions increased access to preventive services (screening, vaccinations) and improved health knowledge within the target groups. Conclusion Public health students make impactful contributions by increasing both the access to and the use of preventive services, as well as by promoting health knowledge. Our study contributes to the professionalisation of public health, highlighting for the first time the role of public health students in improving health outcomes. Furthermore, our study sheds light on the students’ impact on the reduction of health inequalities, particularly amongst minority groups.

Introduction: Whole system approaches to public health challenges such as low physical activity levels have the potential to create sustained behaviour change at a population level and tackle health inequalities. However, there is currently little evidence of the nature or effectiveness of adopting whole system approaches. This study evaluated whether a whole system physical activity intervention (JU:MP), was effective at improving physical activity in five- to eleven-year-olds. Methods: A before and after controlled study with two-arms (JU:MP intervention and control), was conducted in Bradford, UK with data collected at baseline and 24-months follow-up. Habitual physical activity was measured via accelerometry. The primary outcome was difference in moderate-to-vigorous intensity physical activity (MVPA) between groups at 24-months. Secondary outcomes included: sedentary time (ST), counts per minute (CPM), BMI z-score, waist circumference, social, emotional and behavioural health, and quality-of-life. An exploratory analysis compared intervention effects between sub-groups. Results: 1,453 children were recruited. 330 children with valid wear-time at baseline and 24-months (JU:MP group n=175, control group n =155) were included in the final analysis of physical activity outcomes. The JU:MP group improved levels of MVPA (+4.99 minutes/day, (CI = 1.01, 8.96), standardised mean difference (SMD) = 0.29), ST ( -8.69 minutes/day, CI = -16.76, -0.61), SMD = -0.20) and CPM (+32.72, CI = 5.93, 59.53, SMD = 0.28) compared to controls. There were minor differences between groups in all secondary outcomes, favouring the JU:MP group. Exploratory sub-group analysis revealed that MVPA improved for boys (+7.34 minutes/days, CI = 0.70, 13.99, SMD = 0.36) and South Asian heritage children (+7.20 minutes/day, CI = 1.67, 12.72, SMD = 0.52) in the JU:MP group compared to the control group. Conclusion: whole system approaches hold considerable promise for addressing children's levels of physical activity at scale, whilst also tackling inequalities. ### Competing Interest Statement The JU:MP whole system approach was delivered by a consortium of partners on behalf of Active Bradford funded by Sport England. During the study period, Active Bradford was a not-for-profit company limited by guarantee. In 2024 Active Bradford became a charity and from 2025 will host the JU:MP approach. SEB and JW sit on the Directors and Members Boards of Active Bradford respectively. JW was not directly involved in the development or delivery of the intervention. SEB, JH, AS and ADS were involved in the evidence-based development of JU:MP but not the operational delivery of the intervention. JB was the implementation Director for the JU:MP whole system approach and was directly responsible for the delivery of JU:MP. To ensure independence, JB was not involved in the collection or analysis of the data. DB, ZH, GS, and RRCM declare no conflicts of interest. ### Clinical Trial ISRCTN14332797 ### Funding Statement This study was funded by Sport Englands Local Delivery Pilot. Sport England is a non-departmental public body under the Department for Digital Culture Media and Sport (DCMS). The authors involvement was also supported by the National Institute for Health Research (NIHR) Yorkshire and Humber Applied Research Collaboration (ARC) the Bristol Biomedical Research Centre (BRC) and the UK Prevention Research Partnership (MRS0375271) an initiative funded by UK Research and Innovation Councils the Department of Health and Social Care (England) and the UK devolved administrations and leading health research charities.The views expressed in this publication are those of the authors and not necessarily those of Sport England, the DCMS or the NIHR ARC BRC or UKPRP. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study and all processes were given ethical approval by the University of Bradford Research Ethics Committee (Humanities, Social, and Health Sciences Research Ethics Panel; reference: (E891, July 2021). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The dataset that was generated and analysed during the current study is available from the corresponding author upon reasonable request.

Whole system approaches to public health challenges such as low physical activity levels have the potential to create sustained behaviour change at a population level and tackle health inequalities. However, there is currently little evidence of the nature or effectiveness of adopting whole system approaches. This study evaluated whether a whole system physical activity intervention (JU:MP), was effective at improving accelerometry measured physical activity in five- to eleven-year-olds. A non-randomised controlled trial with two-arms (JU:MP intervention and control), was conducted in multi-ethnic and socioeconomically deprived areas of Bradford, UK with data collected at baseline and 24-months follow-up. Habitual physical activity was measured via accelerometry. Mixed effects regression models identified group differences at 24 months. The primary outcome was moderate-to-vigorous intensity physical activity (MVPA). Secondary outcomes included: accelerometery measured - sedentary time (ST), counts per minute (CPM); BMI z-score, waist circumference, and children’s social, emotional and behavioural health, and quality-of-life via parental and teacher completed questionnaires. An exploratory analysis compared intervention effects between sub-groups. 1,453 children were recruited. 330 children with valid wear-time at baseline and 24-months (JU:MP group n = 175, control group n = 155) were included in the final analysis of physical activity outcomes. The JU:MP group improved levels of MVPA (+ 4.99 min/day, (CI = 1.01, 8.96), standardised mean difference (SMD) = 0.29), ST ( -8.69 min/day, CI = -16.76, -0.61), SMD = -0.20) and CPM (+ 32.72, CI = 5.93, 59.53, SMD = 0.28) compared to controls. There were minor differences between groups in all secondary outcomes, favouring the JU:MP group. Exploratory sub-group analysis revealed that MVPA improved for boys (+ 7.34 min/days, CI = 0.70, 13.99, SMD = 0.36) and South Asian heritage children (+ 7.20 min/day, CI = 1.67, 12.72, SMD = 0.52) in the JU:MP group compared to the control group. This study provides evidence that a whole system, community-based intervention can improve physical activity levels in primary school-aged children, particularly among boys and South Asian children, in deprived and ethnically diverse settings. The findings suggest that whole systems approaches may be effective in mitigating age-related declines in activity and addressing inequalities at scale. This study was retrospectively registered with the ISRCTN registry (ISRCTN14332797) on 17/02/2022. Available at: https://www.isrctn.com/ISRCTN14332797.

ABSTRACT Global guidance is driving systems thinking to the forefront of research, policy, and practice. To achieve this, we need to consider how things work to ensure successful implementation. The use of the implementation research logic model as a contemporary tool to aid the planning, reporting, synthesizing, executing, and evaluating of the novel Creating Active Schools (CAS) program is illustrated. A five-step iterative process, underpinned by the implementation research logic model, was undertaken to hypothesize and identify conceptual pathways between the CAS: 1) program determinants, 2) program components and actions, 3) implementation strategies, 4) mechanisms of action, and 5) outcomes. Throughout development, school-based and CAS stakeholders engaged in reviewing appropriate implementation theories, models and frameworks, terminology, and content. An in-depth CAS logic model was created to detail the CAS program and underpinning mechanisms. This article provides novel insights into how contemporary implementation tools can be applied and adapted to enhance the planning, reporting, synthesizing, executing, and evaluating of complex interventions and strategies. The CAS logic model provides a blueprint for future school-based interventions to develop evidence-based logic models and to increase the likelihood of acceptance, feasibility, and sustainability.

Abstract Purpose Physical literacy has gained considerable traction across physical activity, sport, health, and education sectors, leading to an abundance of definitions and interpretations worldwide. However, implementing and advocating for physical literacy becomes challenging when the concept holds different meanings for different individuals and organisations. ‘Uniting’ perspectives on the concept could catalyse efforts to adopt, support and promote physical literacy in practice. This study aimed to develop a physical literacy consensus statement for England that was accessible for those working in research, policy, and practice. Methods Phase one included a review of the evidence, a first national stakeholder consultation, and focus groups with children and young people. Phase two included a modified-Delphi methodology and co-development of the draft statement with an expert panel of sixty researchers and stakeholders from around fifty organisations. Phase three included a second national consultation on the draft statement. Phase four involved further co-development and an online survey with the expert panel to revise the statement. Results Consensus was established on a definition: Physical literacy is our relationship with movement and physical activity throughout life. The statement also included five key messages encompassing (1) Understanding physical literacy, (2) Why physical literacy matters, (3) Supporting physical literacy, (4) Our experiences affect our physical literacy, and (5) Physical literacy is personal. Conclusion The consensus statement is for sector professionals and practitioners and provides a shared understanding of what physical literacy, why it is important and how it can be supported. By understanding, supporting, and adapting to the diverse needs and preferences of everyone, practitioners can play a pivotal role in enhancing physical literacy - an intrinsic driver for engagement in movement and physical activity behaviours. Future research should evaluate the implementation and the impact of the consensus statement. Funding The National Lottery and Sport England

AIM:Assess whether school-based teacher-led screening is effective at identifying children with motor difficulties. METHODS:Teachers tested 217 children aged between 5 and 11 years old, after a one hour training session, using a freely available tool (FUNMOVES). Four classes (n = 91) were scored by both researchers and teachers to evaluate inter-rater reliability. Researchers assessed 22 children using the Movement Assessment Battery for Children (MABC-2; considered to be the 'gold standard' in Europe for use as part of the diagnostic process for Developmental Coordination Disorder) to assess concurrent and predictive validity. RESULTS:Inter-rater reliability for all individual activities within FUNMOVES ranged from 0.85-0.97 (unweighted Kappa; with 95%CI ranging from 0.77-1). For total score this was lower (κ = 0.76, 95%CI = 0.68-0.84), however when incorporating linear weighting, this improved (κ = 0.94, 95%CI = 0.89-0.99). When evaluating FUNMOVES total score against the MABC-2 total score, the specificity (1, 95%CI = 0.63-1) and positive predictive value (1; 95%CI = 0.68-1) of FUNMOVES were high, whereas sensitivity (0.57, 95%CI = 0.29-0.82) and negative predictive values (0.57, 95%CI = 0.42-0.71) were moderate. Evaluating only MABC-2 subscales which are directly related to fundamental movement skills (Aiming & Catching, and Balance) improved these values to 0.89 (95%CI = 0.52-1) and 0.93 (95%CI = 0.67-0.99) respectively. INTERPRETATION:Teacher-led screening of fundamental movement skills (via FUNMOVES) is an effective method of identifying children with motor difficulties. Such universal screening in schools has the potential to identify movement difficulties and enable earlier intervention than the current norm.

PURPOSE: Physically Active learning (PAL) and Movement Breaks (MBs) are popular methods for encouraging increased Physical Activity (PA) within curriculum time. Both have also been claimed to enhance pupil’s cognitive and academic performances. However, existing research evidence is inconsistent in finding support for such claims and there are no studies directly comparing the two methods. Consequently, this study investigated the acute effects of lessons taught using PAL or incorporating MBs on pupil’s Cognitive and Academic Performances (AP) and PA Levels. METHOD: 355 children (aged 8-10 years) from three schools in Northern England participated in a cluster-randomised trial. Classes of pupils were assigned to participate in one of the three types of, 45 min long, mathematics lesson (Lesson-type: PAL, MB or Traditional). Physical activity during lessons was measured using accelerometery and pre- and post-lesson participants completed a battery of standardised assessments assessing of their Maths Fluency (measure of AP) and Cognitive (Attentional) Control. RESULTS: Compared to Traditional (sedentary) lessons, PAL and MB lessons were associated with pupils being significantly more Moderately to Vigorously Physically Active during lesson time (95% CI: +9.86 to 11.06 min). PAL lessons also reduced time spent sedentary by a significantly larger margin than lessons incorporating a MB (95% CI: -16.60 to 21.70 min). However, variation over time in Maths Fluency and Attentional Control measures were not significantly moderated by Lesson-Type, with Bayes Factors indicating evidence in favour of null hypothesis (All Time X Lesson-Type interactions had a BF10 ranging from 0.29 to 0.04). CONCLUSIONS: Both PAL and MBs effectively increase student’s PA levels during curriculum time. These benefits do not come at the expense of academic or cognitive performances but neither do these outcomes appear acutely enhanced.

BackgroundThere is a lack of evidence of stakeholder perspective and understanding of physical literacy among relevant stakeholders from England. As part of research commissioned by Sport England to develop a physical literacy consensus statement for England, this study presents findings from the first national consultation with stakeholders in England.MethodsOne hundred and ninety-three individual stakeholders (50.3%) from education, community sport, national governing bodies of sport, physical activity and sport coaching sectors completed an online survey consisting of fixed item and open ended questions designed to examine their knowledge, understanding, perceptions and practices relating to physical literacy.ResultsResponses from stakeholders suggested there was confusion in use of the term physical literacy in practice and confusion regarding the definition of physical literacy. Most respondents suggested they were involved in physical literacy related activity and understood the term. However, when probed the physical literacy related activity they referred to was likely not actually physical literacy related. Understanding of the term physical literacy was inconsistent in general. Stakeholders considered the affective, social, physical and cognitive areas (domains) of learning to be most important for developing a positive relationship with movement, sport and physical activity for life.ConclusionsWhile stakeholders are aware of the term “physical literacy” and hold value of it within their practice, there remain key misconceptions relating to what physical literacy is, and debate as to whether any existing definitions truly capture the construct of physical literacy.

BACKGROUND:Daily physical activity is vital for the health and development of children. However, many children are inactive. Previous attempts to achieve sustained increases in daily physical activity in children have been ineffective. Join Us: Move Play (JU:MP) is a whole-system, complex, community-based intervention aiming to increase the physical activity levels of children aged 7 to 11 years who live in areas of Bradford, England, which are multicultural and have high levels of deprivation. OBJECTIVE:The purpose of this quasiexperimental controlled trial is to assess whether the JU:MP program increases primary school children's physical activity. METHODS:The study has a 2-arm, quasiexperimental, nonblinded, nonequivalent group design and will be conducted with primary school children aged 5 to 11 years at 3 timepoints, including baseline (before intervention), 24 months (during intervention), and 36 months (after intervention). Children attending primary schools within the intervention area will be invited to participate. Children attending similar schools within similar neighborhoods based on school and community census demographics (deprivation, free school meals, and ethnicity) outside of the JU:MP geographical area will be invited to participate in the control condition. At each timepoint, consenting participants will wear an accelerometer for 7 consecutive days (24 hours a day) to measure the primary outcome (average daily moderate-to-vigorous physical activity). Multivariable mixed effects linear regression will be applied to estimate differences in the primary outcome between the 2 arms at 24 months and 36 months on an intention-to-treat basis. The secondary outcome analysis will explore changes in socioemotional well-being (teacher reported), quality of life (parental/carer reported), and other contextual factors (parents/carer reported), as well as segments of the day activity, sleep, sedentary screen time, frequency of places to be active, parent practices (nondirective support and autonomy support), social cohesion, and neighborhood walking/exercise environment. RESULTS:Recruitment occurred from July 2021 to March 2022, and baseline data were collected from September 2021 to March 2022. As of March 2022 (end of baseline data collection), a total of 1454 children from 37 schools (17 intervention schools and 20 control schools) have been recruited. The first follow-up data collection will occur from September 2023 to March 2024, and the second and final follow-up data collection will occur from September 2024 to March 2025. Data analysis has not begun, and the final results will be published in December 2025. CONCLUSIONS:This article describes the protocol for a quasiexperimental controlled trial examining a novel whole-system intervention. TRIAL REGISTRATION:ISRCTN ISRCTN14332797; https://www.isrctn.com/ISRCTN14332797. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/43619.

Background: Previous research has explored the effectiveness of wearable activity trackers (wearables) for increasing child physical activity (PA) levels, but there have been mixed results. The use of theoretical frameworks and co-design techniques are recognised ways of increasing an intervention's acceptability and effectiveness. Aims: This study aims to use co-design workshops and an evidence-based theoretical framework (the Behaviour Change Wheel) to develop a family-based PA intervention using wearables.Methods: Three stages of intervention development outlined by the Behaviour Change Wheel were used. Co-design workshops with seven families (11 parents and 12 children) and seven PA experts were conducted where stakeholders discussed how to overcome previously identified barriers to families being active and using wearables. This resulted in the intervention's components being developed, with each component's mechanisms of action (e.g. intervention functions and behaviour change techniques) being retrospectively identified.Results: The 'Move & Connect' intervention was developed, which targets family PA and wearable use. The intervention takes a flexible approach and includes eight components, including wearable devices (Fitbit Alta HR), support resources, an introductory workshop, collective challenges, goal setting and reviewing, engagement prompts, social support and health-related resources (e.g. educational videos). The intervention incorporates six intervention functions targeting PA and wearable use: education, training, modelling, persuasion, incentivisation and environmental restructuring and 24 behaviour change techniques, including goal setting, social comparison, feedback on behaviour and graded task. Conclusions: This is the first known study to use an evidence-based framework and co-design to develop a family-based wearable intervention. The identification of the intervention's mechanisms of action will prove useful when implementing and evaluating the 'Move & Connect' intervention and allow re-searchers to replicate its components. Crown Copyright (c) 2023 Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Background and purpose Increased time at home during the COVID-19 pandemic significantly decreased children’s physical activity. This systematic review aimed to evaluate the effectiveness of children’s home-based physical activity interventions, and identify ‘active ingredients’ underpinning these. Methods Databases searched—AMED, PsychINFO, CINAHL, Cochrane, EMBASE, PubMed/Medline, Scopus, SPORTDiscus and Web of Science, from inception until June 2022. Eligibility criteria–children aged 2–16 years, targeting home-based physical activity, a control group, and physical activity measured pre- and post- intervention. Studies were excluded if it was not possible to identify change in physical activity at home. The review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Study quality was evaluated using the quality assessment tool for quantitative studies. Study design, intervention characteristics, outcome data, behavior change theory, Behavior Change Techniques (BCTs) and process evaluation data were extracted and discussed using narrative syntheses. Results 13 studies (including 1,182 participants) from 25,967 were included. Interventions primarily involved active video games, with the addition of coaching or telehealth support (n = 5). Three of the 13 studies significantly increased children’s physical activity (1 = Moderate to vigorous physical activity, 2 = total volume, P <0.05). The largest effect size (d = 3.45) was for moderate to vigorous physical activity. 29% of BCTs were identified across included interventions; the most common being adding objects to the environment. The most effective intervention scored strong for design quality, incorporated telehealth coaching, and included the most commonly coded BCTs. Variation among studies and insufficient reporting of data made a meta-analysis unfeasible. Conclusion COVID-19 emphasized the importance of the home for physical activity. Whilst effectiveness of interventions was limited, building social support and self-efficacy are mechanisms that should be explored further. The review provides recommendations to improve the design and evaluation of future interventions. Trial registration Prospero registration number: CRD42020193110 .

Introduction Whole-systems approaches are being adopted to tackle physical inactivity. The mechanisms contributing to changes resulting from whole-systems approaches are not fully understood. The voices of children and families that these approaches are designed for need to be heard to understand what is working, for whom, where and in what context. This paper describes the protocol for the children and families’ citizen science evaluation of the Join Us: Move, Play (JU:MP) programme, a whole-systems approach to increasing physical activity in children and young people aged 5–14 years in Bradford, UK. Methods and analysis The evaluation aims to understand the lived experiences of children and families’ relationship with physical activity and participation in the JU:MP programme. The study takes a collaborative and contributory citizen science approach, including focus groups, parent–child dyad interviews and participatory research. Feedback and data will guide changes within this study and the JU:MP programme. We also aim to examine participant experience of citizen science and the suitability of a citizen science approach to evaluate a whole-systems approach. Data will be analysed using framework approach alongside iterative analysis with and by citizen scientists in the collaborative citizen science study. Ethics and dissemination Ethical approval has been granted by the University of Bradford: study one (E891—focus groups as part of the control trial, E982—parent–child dyad interviews) and study two (E992). Results will be published in peer-reviewed journals and summaries will be provided to the participants, through schools or directly. The citizen scientists will provide input to create further dissemination opportunities.

Background: The family environment plays a crucial role in child physical activity (PA). Wearable activity trackers (wearables) show potential for increasing children’s PA; however, few studies have explored families’ acceptance of wearables. This study investigated the acceptability of using wearables in a family setting, aligning experiences with components of the Technology Acceptance Model and Theoretical Domains Framework. Methods: Twenty-four families, with children aged 5–9 years, took part in a 5-week study, where all members were provided with a Fitbit Alta HR for 4 weeks. Acceptability was measured using weekly surveys and pre-post-questionnaires. Nineteen families participated in a focus group. Quantitative and qualitative data were integrated using the Pillar Integration Process technique. Results: Pillars reflected (1) external variables impacting wearable use and PA and (2) wearable use, (3) ease of use, (4) usefulness for increasing PA and other health outcomes, (5) attitudes, and (6) intention to use a wearable, including future intervention suggestions. Conclusions: Families found the Fitbit easy to use and acceptable, but use varied, and perceived impact on PA were mixed, with external variables contributing towards this. This study provides insights into how wearables may be integrated into family-based PA interventions and highlights barriers and facilitators of family wearable use.

Background: The school environment is an ideal setting for promoting physical activity (PA). Wearable activity trackers (wearables) have previously been implemented, in research, as intervention tools within the school-environment. However, the large-scale use and acceptance of wearables, in schools, is unknown. Methods: This study distributed a cross-sectional survey to school staff to investigate the prevalence of child and adolescent wearable use in schools, including when and how they are used, and school staff’s willingness to use them in the future (as implemented by school staff). This survey consisted of between 13 and 22 items, including closed-ended and open-ended questions. Closed-ended responses were displayed descriptively (wearable prevalence and characteristics), and open-ended qualitative responses were categorised using descriptive content analysis (how wearables are used). Results: 1087 school staff provided valid responses. Of those, 896 (82.4%) had never used a wearable as a teaching or support tool for their students, and 120 (11%) currently used- and 71 (6.5%) had previously used- a wearable as a teaching or support tool for their students. When wearables were used, school staff implemented their use regularly and during physical education lessons or throughout the entire school day. Wearables were used to monitor or increase student’s PA levels, or for student and staff educational purposes (e.g., academic learning, movement breaks). Most school staff were willing to use a wearable as a teaching or support tool to promote student’s PA, and/or learning about PA, in the future. Conclusions: This study is the first study to explore the widescale use and acceptance of children and adolescents using wearables in the school-setting. Findings may inform the development of future school-based interventions and public health initiatives for physical activity promotion, using wearables.

Background: National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School’s (CAS) programme on organisational changes to physical activity provision. Methods: In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change. Results: >70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour. Conclusions: This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.