Sustainable implementation of school-based physical activity: A four-stage Delphi consensus process

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In 2014 a major reform of the Danish public-school system made it mandatory that physical activity (PA) form part of the syllabus for all year groups corresponding on average to 45 minutes per day. The aim is to promote health and well-being among children and youth and to support motivation and learning in school subjects. However, there still seem to be an implementation gap between stated activity goals of the reform and prevailing practice.

Therefore, the purpose of this study was to identify and examine important factors for sustainable implementation of school-based PA in a Danish context.

A modified Delphi design was chosen as methodological approach consisting of four rounds. In the first round, a scoping review was conducted assessing both scientific and grey literature in the area. In the second round, a group of national experts were identified using the snowball-sampling method. Via a web-based questionnaire, the experts were asked to rate the importance of the various implementation factors identified in the literature. In the third round, a purposeful sample of the national experts were interviewed to elaborate on their questionnaire answers. And finally, in the fourth round, a workshop was held with the national expert-group – to condense the identified and prioritized factors to the ones of greatest importance.

More than 1500 factors impacting implementation of school-based PA were identified in the literature. These were condensed into a total amount of 63 factors, arranged into nine overall categories, and prioritized by the national expert group in the questionnaire (1.School leadership, 2.Co-workers, 3.Resources, 4.Policy level, 5.Organizational/cultural level, 6.Pupils, 7.Physical surroundings, 8.Intervention context, and 9.External factors). Based on five expert interviews, outliers from the questionnaire was examined. Finally, at the workshop, five of the nine overall categories were rated as particularly relevant and important (School leadership, Co-workers, Policy level, Resources and Organizational/cultural level).

All nine overall categories are deemed as decisive for sustainable implementation of school-based PA. However, School leadership were singled out as a particular important category, since commitment at this level is deemed a pre-requisite for many of the other factors.
Translated title of the contributionImplementering af skolebaseret fysisk aktivitet
Original languageEnglish
Publication date2018
Number of pages1
Publication statusPublished - 2018
EventISBNPA 2018 Annual Meeting - Hong Kong
Duration: 3. Jun 20186. Jun 2018


ConferenceISBNPA 2018 Annual Meeting
CityHong Kong


  • implementation
  • Delphi method
  • School


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