Developing and Testing an Implementation Strategy for Active Learning to Promote Physical Activity in Children

The purpose of this study is to develop an implementation strategy to improve the use and sustainment of active learning in elementary schools and to conduct a feasibility study to evaluate the impact of the developed implementation strategy on the implementation and effectiveness of active learning.

Study Overview

• Status: Completed
• Conditions: Physical Activity
• Intervention / Treatment: Behavioral: Implementation strategy for active learning to promote physical activity; Behavioral: Usual implementation support

• Study Type: Interventional
• Enrollment (Actual): 301
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • The University of Texas Health Science Center at Houston

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• lead teachers who teach kindergarten to fifth grade
• children in kindergarten to fifth grade

Exclusion Criteria:

• non English or Spanish speaking

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Implementation strategy for active learning to promote physical activity	Behavioral: Implementation strategy for active learning to promote physical activity; The experimental arm includes using a multifaceted implementation strategy to support the use of classroom-based physical activity approaches. The strategy consists of a series of leadership trainings designed to help them support teachers, teacher trainings to build skills, and a monthly newsletter to reinforce implementation and provide access to existing resources.
Active Comparator: Usual implementation support	Behavioral: Usual implementation support; Usual support consists of the potential to access general resources from the district wellness department. These resources include access to funds to send staff to external trainings and general guidance for how to use active learning approaches.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability of Active Learning Among Teachers as Assessed by the Acceptability of Implementation Measure (AIM)	The Acceptability of Implementation Measure (AIM) total score is from 1 to 5, with higher scores representing higher levels of acceptability.	Baseline
Acceptability of Active Learning Among Teachers as Assessed by the Acceptability of Implementation Measure (AIM)	The Acceptability of Implementation Measure (AIM) total score is from 1 to 5, with higher scores representing higher levels of acceptability.	Approximately 7 months after baseline
Acceptability of Active Learning Among Teachers as Assessed by the Acceptability of Implementation Measure (AIM)	The Acceptability of Implementation Measure (AIM) total score is from 1 to 5, with higher scores representing higher levels of acceptability.	Approximately 13 months after baseline
Implementation Fidelity as Assessed by Self-reported Implementation Logs to Assess Dose of Delivery	Implementation logs will be completed weekly throughout the study and dose of delivery is the number of minutes per day of active learning used.	Baseline
Implementation Fidelity as Assessed by Self-reported Implementation Logs to Assess Dose of Delivery	Implementation logs will be completed weekly throughout the study and dose of delivery is the number of minutes per week of active learning used.	Approximately 7 months after baseline
Implementation Fidelity as Assessed by Self-reported Implementation Logs to Assess Dose of Delivery	Implementation logs will be completed weekly throughout the study and dose of delivery is the number of minutes per day of active learning used.	Approximately 13 months after baseline
Implementation Fidelity as Assessed by Teacher Survey of Dose of Delivery	Dose of delivery is the number of minutes per day of active learning used.	Baseline
Implementation Fidelity as Assessed by Teacher Survey of Dose of Delivery	Dose of delivery is the number of minutes per day of active learning used.	Approximately 7 months after baseline
Implementation Fidelity as Assessed by Teacher Survey of Dose of Delivery	Dose of delivery is the number of minutes per day of active learning used.	Approximately 13 months after baseline
Student Physical Activity as Indicated by Number of Minutes Per Day Spent in Moderate and Vigorous Physical Activity as Assessed by the Actigraph GT3X+ Accelerometer		Baseline
Student Physical Activity as Indicated by Number of Minutes Per Day Spent in Moderate and Vigorous Physical Activity as Assessed by the Actigraph GT3X+ Accelerometer		Approximately 7 months after baseline
Student Physical Activity as Indicated by Number of Minutes Per Day Spent in Moderate and Vigorous Physical Activity as Assessed by the Actigraph GT3X+ Accelerometer		Approximately 13 months after baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Health fitness as assessed by FitnessGram (body mass index)		baseline
Health fitness as assessed by the FitnessGram (body mass index)		6 months
Health fitness as assessed by the FitnessGram (body mass index)		12 month follow up
Health fitness as assessed by number of participants who meet the FitnessGram aerobic capacity standard		baseline
Health fitness as assessed by number of participants who meet the FitnessGram aerobic capacity standard		6 month follow up
Health fitness as assessed by number of participants who meet the FitnessGram aerobic capacity standard		12 month follow up
Academic Performance as assessed by Test scores	Score ranges from 0 to 100, with a higher score indicating a better outcome.	Baseline
Academic Performance as assessed by Test scores	Score ranges from 0 to 100, with a higher score indicating a better outcome.	6 month follow up
Academic Performance as assessed by Test scores	Score ranges from 0 to 100, with a higher score indicating a better outcome.	12 month follow up
Implementation Fidelity as assessed by direct observation to assess adherence	Direct observation will be conducted by trained staff throughout the study.Fidelity adherence is indicated by the percentage of occurrence of teacher-directed active learning during an observation period. This is determined by the total number of intervals of teacher directed classroom movement activities relative to the total number of intervals of observation. A higher percentage indicates a greater adherence to active learning.	6 month follow up
Implementation Fidelity as assessed by direct observation to assess quality	Direct observation will be conducted by trained staff throughout the study. Fidelity quality is indicated based on the student response. This is determined by the approximate percent of students in the class who are participating in active learning averaged across the active learning sessions used. A higher percentage of student participation indicates a higher quality of active learning delivery.	6 month follow up
Implementation Fidelity as assessed by direct observation to assess quality	Direct observation will be conducted by trained staff throughout the study. Fidelity quality is indicated based on the student response. This is determined by the approximate percent of students in the class who are participating in active learning averaged across the active learning sessions used. A higher percentage of student participation indicates a higher quality of active learning delivery.	12 month follow up
Implementation Fidelity as assessed by direct observation to assess adherence	Direct observation will be conducted by trained staff throughout the study. Fidelity adherence is indicated by the percentage of occurrence of teacher-directed active learning during an observation period. This is determined by the total number of intervals of teacher directed classroom movement activities relative to the total number of intervals of observation. A higher percentage indicates a greater adherence to active learning.	12 month follow up

Collaborators and Investigators

• Sponsor: The University of Texas Health Science Center, Houston
• Collaborators: National Heart, Lung, and Blood Institute (NHLBI)
• Investigators: Principal Investigator: Timothy J Walker, PhD, The University of Texas Health Science Center, Houston

Publications and helpful links

General Publications

• Walker TJ, Kohl HW 3rd, Bartholomew JB, Green C, Fernandez ME. Using Implementation Mapping to develop and test an implementation strategy for active learning to promote physical activity in children: a feasibility study using a hybrid type 2 design. Implement Sci Commun. 2022 Mar 7;3(1):26. doi: 10.1186/s43058-022-00271-9.
• Walker TJ, Craig DW, Pfledderer CD, Lee M, Onadeko K, Saving EE, Bartholomew JB, Fernandez ME. Feasibility and acceptability of an implementation strategy to enhance use of classroom-based physical activity approaches in elementary schools: a mixed methods study. BMC Public Health. 2025 Nov 27. doi: 10.1186/s12889-025-25333-0. Online ahead of print.

Study record dates

Study Major Dates

• Study Start (Actual): August 4, 2023
• Primary Completion (Actual): November 22, 2024
• Study Completion (Actual): November 22, 2024

Study Registration Dates

• First Submitted: September 8, 2021
• First Submitted That Met QC Criteria: September 8, 2021
• First Posted (Actual): September 17, 2021

Study Record Updates

• Last Update Posted (Estimated): January 14, 2026
• Last Update Submitted That Met QC Criteria: December 19, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Implementation of Physical Activity Programs in Schools
• Additional Relevant MeSH Terms: Behavior; Motor Activity
• Other Study ID Numbers: HSC-SPH-20-0861; K01HL151817 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No