Physical Activity for Everyone (PA4E1) Implementation Trial: supporting secondary schools in low-income communities to prevent the decline in adolescent physical activity.

Schools allocated to the intervention condition will implement a multi-component physical activity intervention (PA4E1). Secondary schools will be supported to implement seven practices to enhance physical activity opportunities within the school environment. Practices span the domains of the Health Promoting Schools Framework: 1. Curriculum practices: teach practical physical education (PE) lessons using practices to enhance PE quality and increase student moderate-to-vigorous physical activity (MVPA) levels, development of personal physical activity plans for students, and a ten-week enhanced sport program; 2. School environment practices: regular scheduled and supervised recess and lunchtime physical activity opportunities, and the development of a school physical activity policy; 3. Community and parental practices: school promotion of physical activity to families, and promotion and engagement of community physical activity providers. Schools will be provided with support to implement practices over two years using strategies outlined below. A PA4E1 efficacy/ effectiveness trial involving 10 secondary schools (5 intervention, 5 control) (ACTRN 12612000382875) showed the program delivered over two years resulted in an improvement in daily minutes of MVPA and a reduction in adiposity. Schools were supported to implement the seven physical activity practices with six support strategies, including location of a change agent within the schools one day per week. This implementation trial will involve scaling up the intervention to a larger number of schools. Several amendments to the support strategies to better suit implementation in a larger number of schools have been made based on: i) literature reviews; ii) focus groups with school executives and PE teachers involved in the effectiveness trial; and iii) observations of secondary school PA practices identifying further barriers and enablers to practice implementation which were then addressed by an expert advisory group applying the Theoretical Domains Framework and selecting appropriate, evidence based implementation support strategies and delivery modes (e.g. face to face, telephone support, online learning, apps). The implementation trial will consist of seven support strategies: 1. Establishment of an in-school champion – Instead of the external consultant model used in the initial PA4E1 trial, an existing in-school teacher will be appointed by the school executive to be the program champion. This influential teacher will be allocated half a day per week for 24 months to lead the planning and implementation of the physical activity (PA) practices within the school (funding to allow this release is provided by the project). 2. Obtaining executive and leadership support - As per the initial PA4E1 trial, a school sport and PA committee will lead and oversee the implementation of the intervention within each school. 3. Teacher professional learning - The face-to-face training offered in the PA4E1 effectiveness trial to all PE teachers will be replaced by accredited education sector courses where these are available. Representatives from each school will participate in professional learning in three areas: 1) a course on enhancing PA by developing a policy/procedure that provides students with opportunity to participate in 150 minutes/week PA (12 month on-line course, approx 1 x 1 hour modules per month for 12 months, combination of practical and theory based learning run through Department of Education (DOE), School Sport Unit – accredited. Templates to assist schools in developing a school physical activity policy will be provided); 2) a course covering delivery of an enhanced school sport program (1 day face to face training offered through the DOE School Sport Unit, accredited. Training notes and resources required to deliver the enhanced school sport program such as circuit cards will be provided to participants. It is anticipated that 3-4 staff from each school will attend the training course to enable delivery at the school level. Training courses will be scheduled by the DOE School Sport Unit, across NSW, with school booking in to the most convenient location.); and 3) training on enhancing activity in practical PE lesson (specifically developed for trial and delivered through an Online Portal). Teachers will be asked to complete 2 short modules/presentations (15 minutes per module) per school term over the first year of intervention. Online training will be supplemented with group discussions at PE staff meetings following each online training). Via the in-school program champion, PE and other teachers will be provided with facilitated online training in the PA components relevant to their role, e.g. delivering active PE lessons and implementing personal physical activity plans in to their lesson. 4. Tools and resources – Based on the PA4E1 trial, physical activity equipment (e.g. balls) will be provided to the intervention schools, and curriculum materials (e.g. templates for personal PA plans), sport program manuals, and sample policies and planning templates will be provided through an Online Portal developed specifically for the program. 5. Prompts and reminders - The school champion and Project Support Officer (see below) will provide prompts to schools and teaching staff to undertake intervention strategies. Prompts will also be built into school communication processes through the Online Portal and documents such as electronic calendar reminders and agenda items in meetings. 6. Implementation support - Each school will receive support from health district staff for the duration of the intervention (Project Support Officer). At least monthly contacts (via email, telephone or in person) will support schools to develop their sport and physical activity procedures (this support was not provided in initial trial). 7. Implementation performance monitoring and feedback - School PA policies and practices will be audited termly by Health District support staff through the Online Portal, with feedback reports regarding implementation progress towards compliance being provided. The school champion will be prompted to develop an action plan for the following term to meeting the PA4E1 program targets.