Abstract
ISSUE ADDRESSED: Schools are a key setting for influencing children's physical activity and sedentary behaviour. The broad adoption of guideline-informed initiatives is essential to achieve population-wide health benefits. However, there is limited evidence on the implementation of recommended physical activity initiatives in Australian primary schools. This study aims to assess the implementation of these initiatives and their associations with school characteristics. METHODS: A cross-sectional study surveyed a nationally representative sample of Australian primary school principals (August 2022-October 2023) regarding 32 physical activity initiatives across four opportunities for physical activity: in the classroom; outside the classroom/during break times; outside of school/involving families; and other. Initiatives were identified from recent systematic reviews aligned with Australian and global guidelines. Prevalence estimates were weighted to the national school population, and logistic regression models examined associations with school characteristics (school size, remoteness, socio-economic status). RESULTS: Of the 669 participating schools, 360 completed the physical activity survey, with implementation rates ranging from 4% to 98%. The most implemented initiative inside the classroom was 'Physical activity units of work in PDHPE/HPE' (98%); outside the classroom/during break times was 'School infrastructure that supports physical activity during breaks' (96%); and outside of school/involving families was 'School provides end-of-trip facilities to encourage active school travel' (75%). Nine initiatives were associated with school size (6 initiatives), remoteness (4 initiatives), or socio-economic status (1 initiative). CONCLUSIONS: Implementation rates of the 32 physical activity initiatives varied substantially and most initiatives had similar rates across school characteristics (school size, remoteness, socio-economic status). SO WHAT?: This first national study provides crucial information on the implementation of individual physical activity initiatives in Australian primary schools, highlighting areas where policy and practice investment is needed to support implementation.