Opportunities for Policy Implementation and Advocacy

Abstract

Physical activity (PA) policies have the potential to ensure adequate opportunities for children to develop PA behaviors for a lifetime. Examples include mandating that schools provide recess and physical education for a specified amount of time per week; ensuring that physical education teachers are licensed; providing activity breaks in academic classrooms; and mandating the implementation of policies at federal, state, and local levels. Collectively, these policies help to promote and support Comprehensive School Physical Activity Programs (CSPAP). However, there is little guidance on how PA policies can be implemented at the school and district level, limiting their impact on promoting student behaviors. Therefore, the purpose of this paper is to provide an overview of research conducted on CSPAP policy development, adoption, and implementation and how best to support local implementation efforts in schools to increase PA and its impact on children’s health. We provide pragmatic recommendations for how school and district leadership can use implementation science principles to assess current policy implementation and advocate for more comprehensive PA policies which support systems change.

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Opportunities for Policy Implementation and
Advocacy
Gabriella M. McLoughlin, Charlene Burgeson, Jillian Papa & Justin B. Moore
To cite this article: Gabriella M. McLoughlin, Charlene Burgeson, Jillian Papa & Justin B. Moore
(2022) Opportunities for Policy Implementation and Advocacy, Journal of Physical Education,
Recreation & Dance, 93:5, 43-50, DOI: 10.1080/07303084.2022.2053485
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Gabriella M. MclouGhlin, charlene burGeson, Jillian PaPa and Justin b. Moore
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JOPERD 43

44 Volume 93 Number 5 may-JuNe 2022
Comprehensive school physical activity programs (CSPAP)
comprise five components (physical education [PE], phys-
ical activity [PA] during school, PA before and after school,
staff involvement, and family and community engagement)
designed to promote increased levels of PA throughout the school
day (Centers for Disease Control and Prevention [CDC], 2013). As
such, CSPAPs have considerable potential to positively impact the
PA of youth in attendance if adopted and implemented properly
(Burns etal., 2017; Webster & Carson, 2019). The CSPAP model
embraces PE as its cornerstone, recognizing the role that PE teachers
play in spearheading initiatives related to PA as an extension of the
PE program (Carson & Webster, 2020). More broadly, high-quality
PE programs and CSPAPs are just two approaches that can be
adopted within a Whole School, Whole Community, Whole Child
model (CDC, 2014). Specifically, the Whole School, Whole
Community, Whole Child model emphasizes the integration of learn-
ing and health to support development of the whole child in a more
holistic manner. Robust PE and CSPAP programs can indeed support
this initiative through expanding opportunities to participate in PA
within and outside the school day (McLoughlin, Graber, etal., 2020).
Because intention and planning are key to implementation, the
adoption of CSPAP policies at the district level is a necessary (but
insufficient) step in the implementation of effective practices
(Lounsbery, 2017). In the United States, state-level CSPAP policy
adoption could support and inform district-level adoption and
implementation efforts, but state-level adoption of CSPAP supportive
policies has taken on a fractured form (State of Childhood Obesity,
2020). Specifically, some components (e.g., PE mandates) or anteced-
ents of CSPAPs have been adopted (e.g., recommended time for PA
opportunities during the school day), but complete CSPAP policies
that address all five components are nonexistent (State of Childhood
Obesity, 2020). As such, more research is needed to inform CSPAP
policy development, adoption and implementation if schools are to
provide synergistic opportunities for youth to engage in health-pro-
moting PA as they grow intellectually.
The CSPAP Policy Context. Within the United States, no federal
policy exists to mandate time or frequency of PE or PA in schools
(State of Childhood Obesity, 2020). At the state level, almost all
states (n = 48; 96%) and Washington, DC, had enacted some form
of PE policy requiring PE in the school curriculum as of 2015
(Michael et al., 2019; National Association of Chronic Disease
Directors, 2014). Recent evidence highlights the importance of rig-
orous state policies on school-based practices, in that state PE time
requirements and daily requirements were associated with school-re-
quired PE as part of the School Nutrition and Meal Cost Study
(Piekarz-Porter etal., 2021). Pertaining to PA more generally, only
31 states (62%) and Washington, DC, had enacted some form of
policy for promotion of PA in school settings (National Association
of Chronic Disease Directors, 2014). Despite lower rates of adoption
for PA, researchers have documented associations between state-level
policy and corresponding child obesity rates, in that states with
stronger wellness policies are associated with lower prevalence of
overweight and obesity (Nanney etal., 2010). Furthermore, school-
level policies pertaining to PA are associated with student activity
behaviors (Leigh Ann etal., 2019), highlighting the role of state- and
local-level policies to foster healthy behaviors.
Unfortunately, despite emerging evidence that stresses the impor-
tance of CSPAP policy and programming in schools, little evidence
exists regarding how state-level policies are subsequently imple-
mented in schools/districts and what factors are most influential to
adoption (Emmons & Chambers, 2021). Further, extant research
has highlighted consistent barriers such as lack of time, administra-
tive support and personnel for policy implementation (Francis etal.,
2018; Howie & Stevick, 2014; Schuler etal., 2018; Weatherson
etal., 2017). One case study example from a statewide policy in
Georgia for school PA highlighted the need to establish grassroots
outreach and advocacy, collaborations with external partners, and
a shifting organizational climate toward PA promotion to facilitate
policy implementation (Lyn etal., 2017). However, these data were
not linked to actual implementation quality; thus, it is not possible
to understand what factors influenced implementation in higher
implementing schools versus those having trouble. As such, the dis-
sonance between state-level policy and school- and district-level
practices warrants further attention.
Measurement of School-Level CSPAP Planning and
Implementation. School-level practices demonstrate the degree of
implementation of district and state policies and national best prac-
tices. At the school level, two key aspects of measuring use of a
CSPAP are planning and implementation. Schools need to develop
a plan for “how” to develop, implement and evaluate a CSPAP, and
implementation outlines “what” the school is doing to provide PE
and PA through a CSPAP.
There is currently one source for national surveillance data about
CSPAP: CDC’s School Health Profiles surveys, known as “Profiles,”
which are a system of surveys assessing school health policies and
practices in states, large urban school districts, and territories (CDC,
2018). The surveys are conducted biennially by education and health
agencies among middle and high school principals and lead health
education teachers (CDC, 2018). Along with other school health
components, Profiles provide a platform to monitor the status of PE
and PA. The most recently published Profiles data are from 2018.
For measurement of CSPAP planning, school principals/administra-
tors were asked: “During the past year, has any school health council,
committee or team at your school developed a written plan for
implementing a CSPAP (a multi-component approach that provides
opportunities for students to be physically active before, during, and
after school)?” Findings demonstrated that most schools do not have
a written CSPAP plan (CDC, 2018). Across states, the range was
20.5% to 55.7% with a median of 30.8%, and across large urban
school districts, the range was 17.8% to 63.4% with a median of
49.5%. For Profiles 2020, the question was modified to, “Does your
school have a written plan for providing opportunities for students
to be physically active before, during, and after school?” These data
are still being analyzed and will provide recent evidence for the
prevalence of CSPAP.
Measurement of CSPAP implementation is complex because it
requires questions about each CSPAP component. The 2020 Profiles
principal survey asks a series of CSPAP questions about required
PE; PA in classrooms during the school day; PA during the school
Gabriella M. McLoughlin (gabriella.mcloughlin@temple.edu) is an
Assistant Professor in the College of Public Health at Temple University and
holds a faculty position with the Implementation Science Center for Cancer
Control and Prevention Research Center, Brown School at Washington
University in St. Louis. Charlene Burgeson is a chief program ofcer and
Active Schools executive director of Action for Healthy Kids in Chicago, IL.
Jillian Papa is a director of research and evaluation for Action for Healthy
Kids in Chicago, IL. Justin B. Moore is an associate professor in the
Department of Implementation Science, Department of Epidemiology &
Prevention, Division of Public Health Sciences at Wake Forest School of
Medicine in Winston–Salem, NC.

JOPERD 45
day (not including PE and classroom PA), such as recess, lunchtime
intramural activities or PA clubs; before-, during and after-school
PA; and interscholastic sports. To get a full picture of CSPAP imple-
mentation, in addition to analyzing data from each question indi-
vidually, the data need to be analyzed across questions. To date, no
report or paper has been published that provides a holistic view of
CSPAP implementation from Profiles data. Further, a major limita-
tion is that the Profiles surveys do not extend down to the elementary
school level, with little information about CSPAP implementation
at this stage. Currently little is known about school-level CSPAP
planning and collective implementation of multiple and all CSPAP
components, and this gap needs to be addressed to increase the
quantity and quality of CSPAPs.
Other questionnaires exist for the purpose of a school conducting
its own CSPAP self-assessment. The most used questionnaire, and
one that is available for all school levels, is the CDC’s School Health
Index: A Self-Assessment and Planning Guide (SHI), with versions
for both elementary and secondary schools (CDC, 2018). The SHI
assesses key aspects of the school health environment and requires
schools to assess their implementation level of a school health best
practice strategy on a 4-point scale (0 = not in place, 1 = under devel
-
opment, 2 = partially in place, 3 = fully in place). One of the modules
is for PE and PA programs. Some national organizations, such as
Action for Healthy Kids and the Alliance for a Healthier Generation,
have developed their own modified versions of the SHI for use with
the schools in their program network. Though CDC does not collect
SHI data from users, some organizations that use the SHI do collect
schools’ data with consent. Another school CSPAP self-assessment
tool is the valid and reliable Comprehensive School Physical Activity
Program Questionnaire (CSPAP-Q; Stoepker, Dauenhauer, Carson,
& Moore, 2021).
Regarding the relationships between school-level policies and
student-level PA behavior, Active Schools provides access to the Iowa
State University’s Youth Activity Profile (Action for Healthy Kids,
n.d.). This online student self-assessment tool guides students
(Grades 3–12) through a series of questions about their activity
behaviors across the school day and outside of school. Based on the
answers provided, the software produces estimates for time spent in
PA at school and home as well as sedentary pursuits and provides
student and teacher reports. This tool has shown strong validity and
reliability at the group level (e.g., class, grade, school), demonstrating
utility for CSPAP policy evaluation (Saint-Maurice et al., 2017;
Saint-Maurice & Welk, 2013, 2015). A tool that assesses students’
school-based PA participation data is useful for analyzing associa-
tions between district policy, school-level practices and intended
outcomes (e.g., 60 min of PA each day). Support and accountability
for CSPAP are important at all levels: national, state, district and
school. National best practices (CDC, 2019) should guide state and
district policy and school-level practice. To ensure accountability, it
is critical to have a mechanism for assessing school-level practice
against existing policy and, in the absence of policy, to self-assess
against national best practices. In the following sections, we intro-
duce ways in which school practitioners can utilize these data sources
to evaluate their programs and advocate for comprehensive policies
to promote student PA.
An Implementation Science Perspective to Promote Systems
Change. Policy research has much to contribute to the CSPAP move-
ment. A body of literature exists to inform efforts to develop effective
policies related to PA that can guide CSPAP-related efforts. Similarly,
a great deal is known about the process of promoting adoption of
policy at the state level that can be applied to CSPAP policies
(Dauenhauer etal., 2019; Piekarz-Porter etal., 2021). However, if
such policies are successfully developed and adopted at the state and
district levels, the chasm between policy and practice at the local
level must also be traversed (Brownson, Eyler, et al., 2018;
Turgeon, 2013).
This is where implementation science frameworks and method-
ologies become of great importance (Allen etal., 2020; Brownson
Colditz, et al., 2018a, 2018b; Emmons & Chambers, 2021). It is
estimated that it takes roughly 17 years for innovations to be adopted
into health and education systems (Brownson, Colditz, et al., 2018a,
2018b) mainly due to the lack of attention paid toward how evi-
dence-based interventions, such as CSPAP, are implemented in the
real world. The field of implementation science addresses this prob-
lem by providing theories, models and frameworks to guide the
uptake of programs into their intended setting. One of the challenges
with CSPAP research to date is the heavy focus on student behavioral
outcomes alone, without much consideration for how CSPAPs are
implemented, to promote student PA. Thus, many contextual out-
comes that relate to implementation are neglected; these are often
what determines an intervention’s success on PA behavior and are
vital to better understanding how CSPAPs work. The Implementation
Outcomes Framework by Proctor and colleagues (Proctor et al.,
2011) describes important implementation outcomes of acceptabil-
ity, appropriateness, acceptability, cost, feasibility, fidelity/compli-
ance, penetration and sustainability. Definitions can be found in
Table 1 along with pragmatic ways to assess these outcomes.
Through such lens of implementation, schools/districts can select
which outcomes might work best for them based on readiness and
capacity to implement PA policies.
Implementation science strategies are designed to promote the
systematic uptake of evidence-based practices into day-to-day rou-
tines by targeting professional and organizational behaviors (Powell
etal., 2012; Proctor etal., 2013). These approaches have been suc-
cessfully applied to CSPAP implementation, but the practice is not
widespread (McLoughlin, Candal etal., 2020; McLoughlin, Massey
et al., 2021; Moore etal., 2018, 2021). For example, the Consolidated
Framework for Implementation Research (CFIR) is a metaframe-
work that provides a comprehensive, quantifiable catalog of 26
constructs (with 13 subconstructs) across five domains that are rel-
evant to the implementation of complex interventions such as
CSPAPs (Damschroder etal., 2009). The five domains encompass
characteristics of the intervention, the outer setting (i.e., outside
policy, factors outside the school setting), the inner setting (factors
within the school setting), individuals delivering the intervention (PE
teachers, classroom teachers, administration), and the implementa-
tion process (engaging stakeholders, carrying out CSPAP
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46 Volume 93 Number 5 may-JuNe 2022
programming). The CFIR is one of the most used models in imple-
mentation science; it provides a comprehensive framework for the
assessment of constructs relevant to the success of an intervention
relative to the acceptability, feasibility and effectiveness of an inter-
vention. Frameworks such as CFIR could be valuable tools for
CSPAP policy implementation in schools.
Implementation frameworks are useful for CSPAP policy adop-
tion at the district level, because they can help practitioners catalog
and manage the complexities and nuances of local policy adoption.
Implementation frameworks, like CFIR, can provide a foundation
to guide the identification of factors that can be assessed to inform
planning, evaluation, and monitoring during the adoption process.
Monitoring and evaluation are crucial to successful CSPAP imple-
mentation (Singletary etal., 2019), and utilization of a framework
such as CFIR can provide value in guiding construct and measure-
ment selection. Ideally, implementation frameworks can guide the
entire CSPAP process, informing needs assessment, program imple-
mentation and impact evaluation.
Role of School Practitioners in CSPAP Policy
Implementation
Despite the lack of empirical research highlighting the optimal
implementation approaches for CSPAP programming, there are
several ways in which school and district-level staff can take imme-
diate action in developing PA policies. Regarding policy formation
and assessment, the SHAPE America – Society of Health and Physical
Educators’ CSPAP policy continuum provides a way for schools to
assess their wellness policies as they pertain to PA promotion
(SHAPE America, n.d.). Second, school professionals can elect to
join their school/district wellness committee, which is a pragmatic
way to advocate for and promote CSPAP program development and
implementation. Below we provide a case example of a comprehen-
sive school wellness program and the capacity-building process to
facilitate policy implementation and achieve systems change.
Practical Example Through School Wellness Policy Imple-
mentation. One example of how school wellness teams can be lev-
eraged to create systems change is the School Wellness Integration
Targeting Child Health (SWITCH®) program (www.iowaswitch.
org). The SWITCH program is grounded in a capacity-building
approach, whereby enrolled schools (elementary and middle; Grades
4–8) are trained in comprehensive school wellness program and
policy implementation, which includes CSPAPs in addition to pro-
moting high-quality nutrition and decreased noneducational screen
time behaviors. The success of this program is predicated on how
wellness teams can work to (a) meet and plan how to implement
SWITCH as a core team, (b) integrate educational resources (PE,
classroom, and lunchroom curricular modules) across the school
setting, (c) engage students in advocacy and self-monitoring of their
Table 1.
An Example of the Application of the Implementation Outcomes Framework to Comprehensive
School Physical Activity Program (CSPAP) Policy Adoption at the District Level
Implementation Outcome Description Practical Assessment
Acceptability Degree to which stakeholders find CSPAP
acceptable within their school setting
Conversations with school staff and other
stakeholders needed to secure buy-in for
additional PA programs
Adoption Intentions to implement CSPAP Survey to schools regarding intent to implement
any of the CSPAP components
Appropriateness Degree of compatibility with current infrastructure Conversations with school staff and other
stakeholders needed to secure buy-in for
additional PA programs
Cost Time and money needed to implement CSPAP in
all of its parts
Brief calculations of (1) personnel time and (2)
costs of equipment/space or other costs
associated with expanding PA opportunities
Feasibility Perceived feasibility of CSPAP implementation Conversations with key implementers (i.e., PE
teachers, classroom teachers, other integral
staff)
Fidelity/compliance Implementation of CSPAP according to
component best practices
Brief rubric to assess how CSPAP components
are implemented (likely context specific)
Penetration Reach of CSPAP within school settings Use data from fidelity with counts of frequency to
estimate number of classrooms reached and
number of additional opportunities for
participation
Sustainability Degree of CSPAP sustainment over time Tracking CSPAP program element
implementation and observing trends each
semester
More information on the implementation outcomes framework can be found in the article by Proctor et al. (2 011 ).

JOPERD 47
own health behaviors, and (d) engage parents and external stake-
holders to create a bridge between the school and home setting (Chen
etal., 2018; McLoughlin, Candal etal., 2020; McLoughlin, Vazou
etal., 2021).
Through an iterative training, implementation and continuous
evaluation process, schools are able to tailor components of SWITCH
that make logical sense to meet the needs of their school stakehold-
ers, thus enhancing the likelihood of success and sustainability over
time. For example, schools can choose to promote PA in their context
through walking clubs before school, employing a youth ambassa-
dors’ approach for student advocacy, engaging staff through friendly
competition and fitness challenges, or simply implementing class-
room modules to encourage active learning, among other ideas. The
same outcome of PA participation and enjoyment is therefore met
through a variety of ways. In the context of CSPAP programming,
schools may therefore seek to adopt/implement one of the compo-
nents (in addition to PE and recess which are typically mandated)
at a time and decide how best to develop programming that aligns
with the contextual needs of their school and stakeholders. Below,
we describe ways in which schools/districts can begin the policy
implementation and advocacy process based on the needs capacity
of their specific contexts through an implementation science lens.
How Can Schools/Districts Assess Implementation and Advocate
for PA Policy? In this section, we provide practical guidance for
school and district leaders to develop a CSPAP implementation plan,
grounded in implementation science concepts and frameworks such
as Plan Do Study Act (Roberts etal., 2002). We outline some key
steps below:
1. Assess current CSPAP implementation efforts. School/district
representatives can utilize existing assessment tools such as the
Profiles, SHI or CSPAP-Q measures to understand what currently
exists. These assessments will provide a baseline indicator for
schools/districts regarding PA programming and help to establish
readiness/capacity for expanding or adding PA opportunities in the
school system.
2. Use data to set goals. Based on data from the assessments,
stakeholders can identify feasible ways to expand or increase CSPAP
quality. This might be something already in place, such as classroom
PA breaks or an after-school running club; sometimes adding some-
thing new is not always feasible or necessary (Webster etal., 2020).
If the findings show that minimal programs are in place, try to think
of one component that would be most achievable.
3. Select important implementation outcomes. In Table 1 we pro-
vide an overview of the most salient outcomes based on Proctor’s
framework (Proctor et al., 2011) and simple, pragmatic ways to
assess achievement of these outcomes. Selecting one or two imple-
mentation outcomes to focus on will help guide the implementation
processes and practices needed to achieve those goals. If CSPAP
leaders are not confident in the level of buy-in from stakeholders,
perhaps focusing on outcomes such as acceptability and appropri-
ateness would be most important. If a school has some CSPAP pro-
gramming in place already, sustainability and/or cost may be
important outcomes to focus on.
4. Assess determinants of PA policy implementation. Table 2 pro-
vides a subset of CFIR constructs as they apply to the adoption and
implementation of CSPAP in a school district. Although not all CFIR
constructs may be relevant to CSPAP policy (e.g., relative advantage),
many have salience and should ideally be assessed prior to the adop-
tion and implementation process. These determinants can be assessed
through group meetings, conversations with CSPAP leaders and
others within the school setting, and through more rigorously
developed measures (found through Consolidated Framework for
Implementation Research, n.d).
5. Implement and evaluate CSPAP goals. Whether the goal is to
add something new or increase quality of existing CSPAP program-
ming, stakeholders should establish an implementation plan with
those who will oversee PA programming. The implementation out-
comes chosen in step 3 will be important in helping to establish who
needs to do what and how. Results from these implementation efforts
will help guide future planning and goal setting and the degree to
which policies in place (if any) are feasible or require more logistical
support to be implemented.
Ideally, schools/districts should try to complete these five steps
regularly (i.e., once each academic year) to understand how their PA
policies are being implemented and/or how they can develop dis-
trict-level policies that align with CSPAP components. Such efforts
are important because evaluation and monitoring are key aspects of
the triennial assessment (United States Department of Agriculture,
Food and Nutrition Service, 2016) and can help schools/districts
without many PA policies in place to advocate for funding and
support to develop and enforce comprehensive policy approaches
to promote PA among youth (Webster etal., 2020).
Role of Teacher Educators in CSPAP Implementation. Teacher
educators can play an important role in CSPAP implementation by
preparing PA practitioners for their roles as advocates within the
school system (Stoepker, Dauenhauer, Carson, MucMullen, etal.,
2021). For example, coursework on PA policy, advocacy and lead-
ership can be required at the undergraduate and master’s levels that
will equip PA practitioners with the tools necessary to understand,
translate and advocate CSPAP policies at the local level. Similarly,
coursework and other practical experiences with process, impact
and outcome assessment would prepare PA practitioners for the task
of assessing CSPAP policy implemenation (see Figure 1). Finally,
teacher educators can instill, both formally and informally, a sense
of ownership over school-based PA policies and provide students
with the training and tools to assume leadership roles in PA policy
implementation.
Nationwide Support for CSPAP Policy Implementation and
Advocacy. Action for Healthy Kids (AFHK), a national nonprofit
organization that provides support to districts and schools on their
health and well-being initiatives, supports CSPAP and comprehen
-
sive wellness policy implementation through a series of trainings
and professional development opportunities. Districts can apply
to receive grant funding to support development and implementa-
tion of CSPAP and broader wellness programming across their
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48 Volume 93 Number 5 may-JuNe 2022
schools. Through this mechanism, schools within funded districts
then complete AFHK’s abbreviated version of the CDC SHI tool
(CDC, 2018). However, any school in the United States can access
and complete AFHK’s SHI within the AFHK portal. Although not
structured around the CSPAP components specifically, there are
several questions that relate to PA and PE on the AFHK online
index (Action for Healthy Kids, n.d.). Upon completion of the
index, schools receive a report that provides their SHI results over-
all, benchmarked against their district-, state- and national-level
implementation trends. In addition, schools are provided with a
list of strengths and areas of needed improvement to address with
their school health team and/or administrators. The capacity-build-
ing framework developed by AFHK represents perhaps the most
comprehensive and accessible opportunity for school professionals
to receive professional development for CSPAP policy implemen-
tation and advocacy.
Conclusion
Despite significant progress in defining CSPAP components,
establishing an evidence base for component-specific strategies,
and developing evaluation frameworks and measures, the science
behind CSPAP policy implementation is in its infancy. Little knowl-
edge exists to inform federal and state policy development, adop-
tion and implementation at the local level. The role of PE within
CSPAPs is critical, but research and practice has demonstrated that
Table 2.
An Example of the Application of the CFIR to CSPAP Policy Adoption at the District Level
CFIR Domain CFIR Construct Application to CSPAP
Intervention characteristics Evidence strength and
quality
Perception of the quality and validity of evidence used to justify the
adoption of CSPAP policy and implementation of related
procedures.
Adaptability The extent that CSPAP implementation strategies can be tailored to
characteristics of the needs of the district and individual schools.
Outer setting Cosmopolitanism The extent to which the schools are connected to local partner
organizations (e.g., the health department) that can provide support
for CSPAP activities.
External policies and
incentives
The external policies, regulations, mandates, and guidelines that
support or inhibit CSPAP adoption and implementation.
Inner setting Implementation climate The capacity for change at the school and district level and the extent
that CSPAP activities will be supported, acknowledged, and
rewarded within the school district.
Relative priority The shared perception of teachers, administrators, parents, and other
stakeholders of the importance of CSPAP policy adoption and
implementation.
Characteristics of individuals Knowledge and beliefs
about the intervention
Teachers, administrators, parents, and other stakeholders’ familiarity
with and attitudes toward CSPAP policy.
Self-efficacy Teachers and administrators’ beliefs in their ability to conduct the
activities necessary to adopt and implement CSPAP policies.
Process Planning The degree to which strategies for implementing CPSAP policies have
been developed, and their quality.
Champions The individuals who lead the charge to adopt and implement CSPAP
policies through logistic support and advocacy to overcome
resistance at the school or district level.
Only a subsample of domains was chosen from the complete CFIR model. For more information can be found in Consolidated Framework
for Implementation Research (n.d.).
Figure 1.
A five-step approach to assess CSPAP policy implementation

JOPERD 49
PE teachers may not be best positioned to lead CSPAP implemen-
tation; a top-down approach that engages administration may be
more necessary to increase adoption (McLoughlin et al., 2020;
Webster etal., 2015). More research is needed to fill this knowledge
gap if effective CSPAPs are to be implemented and sustained in
school settings. However, progress can be accelerated by building
on lessons from policy research and the field of implementation
science so that the goal of providing all children with access to
opportunities to participate in at least 60 min of daily PA can be
achieved.
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