Background
Methods
Study design
Data collection
Identification of adopters
Policy content and context
Policy evaluation
Data analyses
Characterization of adopters
Policy content
Policy context
Policy evaluation
Results
Characterization of adopters and policy content
Province | Grade | Minutes and distribution | Type of PA | Delivery of PA1 | Strength2 | Date adopted3 | Date implemented | Key adoption factors | Monitoring of implementation and impact |
---|---|---|---|---|---|---|---|---|---|
Innovators 2003-2006
| |||||||||
Grades 1-9 | ≥30 mins/d; may be offered in smaller time segments | PA should vary in form and intensity | Activities organized by the school; can include instructional or non-instructional hours (school-based) | Weak | Aug, 2003 | Sept, 2005 | Convergence of Kingdon’s 3 policy streams: problem, solution, and policy; strongly influenced by the actions of the Minister of Learning | School authorities responsible to monitor implementation; DPA survey of educators conducted by AB Education | |
Grades 1-8 | ≥20 mins/d; sustained | Sustained MVPA | During instructional hours | Moderate | Oct, 2005 | Oct, 2005, with full implementation by end of 2005/06 school year | DPA in schools was part of the 1998 Health and PE curriculum, the Active2010 sport and PA strategy and Living School, and was supported by the Chief Medical Officer of Health | School Boards responsible to monitor DPA implementation | |
Early adopters, 2006-2010
| |||||||||
Grades 11-12 | 1 PE/Health Education credit required per grade including PA practicum of ≥ 55 hrs | PA practicum focusses on MVPA + ≥ 1 of: strength, endurance, flexibility | In-, out- or a combination of in- and out-of-class/school time with adult sign off for out-of-class/school PA | Moderate | Apr, 2007 | Sept, 2008 | The Healthy Kids, Healthy Futures Task Force Report recommended mandating PE for grades 11-12 | Students must complete a personal fitness portfolio; teachers document student-level completion on report cards | |
Kinder-garten | 15 mins/d (half-day)30 mins/d (full day); may be offered in smaller time segments of ≥ 10 mins | Includes endurance, strength and/or flexibility activities | Part of students’ educational program; can include instructional or non-instructional hours (school-based) | Weak | Sept, 2007 | Sept, 2008 | Action Schools! BC was an early model of DPA that proved efficacious and was disseminated across BC | School Boards develop their own policies and procedures to track DPA implementation; teachers document student-level achievement on term and final report cards | |
Grades 1-7 | 30 mins/d; may be offered in smaller time segments of ≥ 10 mins | Includes endurance, strength and/or flexibility activities | Part of students’ educational program; can include instructional or non-instructional hours (school-based) | Weak | Sept, 2007 | Sept, 2008 | Action Schools! BC was an early model of DPA that proved efficacious and was disseminated across BC | School Boards develop their own policies and procedures to track DPA implementation; teachers document student-level achievement on term and final report cards | |
Grades 8-9 | 30 mins/d; may be offered in smaller time segments of ≥ 10 mins OR 150 mins/wk | Includes endurance, strength and/or flexibility activities OR MVPA | Part of students’ educational program; can include instructional or non-instructional hours (school-based) OR In- or out- of school PA documented by student | Weak | Sept, 2007 | Sept, 2008; as of Sept, 2011 schools select 30 mins/d DPA OR 150 mins MVPA/wk | Action Schools! BC was an early model of DPA that proved efficacious and was disseminated across BC | School Boards develop their own policies and procedures to track DPA implementation; teachers document student-level achievement on term and final report cards | |
Grades 10-12 | 150 mins/wk | MVPA | In- or out- of school PA documented by student | Moderate | Sept, 2007 | Sept, 2008 | Action Schools! BC was an early model of DPA that proved efficacious and was disseminated across BC | School Boards develop their own policies and procedures to track DPA implementation; teachers document student-level achievement on term and final report cards; graduation requirement | |
Early majority, 2010 - 2014
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All students | 30 mins/d | MVPA | Not specified; School Boards expected to develop new or strengthen existing PA policies consistent with general government guidelines | Weak | Feb, 2010 | Sept, 2010 (optional) | The SK population health strategy, SK in motion, and implementation of Quality Daily PE focused attention on the need for greater PA in schools | School Boards responsible to ensure that policy results in increased PA for all children |
Policy context
Date [reference] | Event |
---|---|
Alberta
| |
The Health and Physical Education Council of the AB Teachers’ Association releases 2 position papers calling for 30 minutes of Quality Daily PE in AB schools. | |
1989 [9] | The Health and Physical Education Council of the AB Teachers’ Association develops Schools Come Alive to increase students’ awareness and skills for active living. |
1990 [54] | The AB Coalition for Healthy School Communities is created to facilitate networking and information sharing among those with an interest in comprehensive school health. |
1995 [53] | Schools Come Alive releases a strategic plan to make PA and PE priorities in AB schools. |
1998 [63] | AB’s Active Living Strategy recommends that AB schools create opportunities for students to be physically active each school day. |
2000 [64] | AB releases a new PE curriculum emphasizing PA and attainment of life-long active living. |
2001 [53] | Schools Come Alive creates Ever Active Schools as a pilot project to encourage active living initiatives in schools. |
2001 [57] | The Coalition for Active Living reports PA has declined in Canada partly because PE has been cut in schools. |
2001 [60] | The Mazankowski report suggests students should have the opportunity for regular exercise as part of every school day. |
2002 [61] | Delegates at the AB Future Summit propose re-introducing daily PA into the school curriculum. |
2003 [62] | AB’s Commission on Learning recommends a new wellness program for students from kindergarten to grade 12 that includes some form of daily activity. |
AB Learning announces a daily PE policy for students in grades 1–12 (later corrected to DPA). | |
AB implements a DPA policy for grades 1–9. Plans to implement DPA in high schools are cancelled. | |
Ontario
| |
1998 [17] | ON releases a Health and PE curriculum requiring student participation in daily, sustained, moderate or vigorous PA (with minimum time expectations for some grades). |
2001-02 [69] | ON develops a Stakeholder Sport Action Plan to support the Canadian Sport Policy1. |
2002 [73] | The Ministry of Health and Long-Term Care proposes a school-based, province-wide initiative for primary prevention of diabetes. |
ON implements a Healthy Schools Program. | |
2004 [73] | A comprehensive school health initiative called Living School is launched, and includes DPA. |
2004 [72] | The Chief Medical Officer of Health releases a report recommending policies be developed to support the ACTIVE2010 Sport and Physical Activity Strategy, and that quality daily PE and PA opportunities be provided in schools. |
2004 [69] | ON’s ACTIVE2010 Sport and Physical Activity Strategy supports implementation of 20 minutes of DPA in elementary schools. |
2005 [68] | ON announces a DPA policy for grades 1–8. |
2006 [68] | Full implementation of the DPA policy is expected by the end of the 2005–06 school year. |
British Columbia
| |
1983 [86] | The Directorate of Agencies for School Health (DASH) BC is established and later introduces the concept of comprehensive school health in BC schools. |
1989 [86] | A Government Office of Health Promotion is established in BC. |
1992 [86] | A Healthy Schools program is launched throughout BC. |
2002 [86] | The Healthy Schools program ends. |
Stakeholder consultations to identify the strategic agenda for action on PA in BC schools leads to development of Action Schools! BC. | |
The BC Provincial Health Officer’s report recommends a re-commitment to support Healthy Schools initiatives. | |
Action Schools! BC is evaluated and proves acceptable, feasible and efficacious. | |
2003-04 [93] | BC develops a chronic disease prevention strategy, Healthy BC 2010. |
2004 [92] | Widespread dissemination of Action Schools! BC is funded through the Healthy Schools Program. |
The BC Healthy Living Alliance circulates The Winning Legacy to each Ministry to advocate for multi-level interventions (including school-based initiatives) to curb chronic disease. | |
2005 [93] | Healthy BC 2010 is renamed ActNowBC and aims to make BC a North American leader in healthy living and physical fitness. |
2006 [95] | The BC Medical Association recommends 30 minutes of DPA in schools to the BC Select Standing Committee on Health. |
2006 [96] | The Select Standing Committee on Health recommends that every student be required to participate in DPA and that Action Schools! BC be expanded. |
2007 [97] | The BC government announces that DPA will be mandated in all BC schools (kindergarten to grade 12). |
2008 [97] | A DPA policy is implemented in all BC schools. |
Manitoba
| |
1975 [74] | A MB Physical Education Working Group proposes that all MB schools be required to offer 40 minutes of PE per day, including 20 minutes of vigorous PA. |
2000 [75] | MB adopts an integrated approach to PE/Health Education programming that recognizes the value of regular PA. |
2000 [76] | The Healthy Child MB Strategy is implemented that focusses on creating child-centered public policy. |
2000 [77] | Nurses-in-Schools is introduced to support public health in schools. |
2002 [78] | The MB Physical Activity Action Plan recommends mandating daily PE from kindergarten to grade 12. |
2003 [77] | Nurses-in-Schools expands to become MB Healthy Schools, a program that draws on the principles of comprehensive school health. |
2005 [80] | The Healthy Kids, Healthy Futures Task Force Report recommends changes to the MB PE/Health Education curriculum and a voluntary in motion program to engage students in 30 minutes of DPA. |
2005 [79] | The MB government pledges to implement all 47 of the Task Force’s recommendations. |
MB in motion is launched to increase PA in MB. | |
2005 [84] | Healthy Schools and MB in motion partner to offer Healthy Schools in motion to support 30 minutes of DPA for all students. |
The MB government mandates the amount of time students in kindergarten to grade 10 must spend in PE/Health Education classes. | |
2008 [79] | The MB government implements a PE/Health Education curriculum for students in grades 11–12. Students in grades 11–12 are required to complete 2 PE/Health Education credits for graduation, including ≥ 55 hours of MVPA per credit. |
Saskatchewan
| |
2001 [98] | SchoolPLUS is released, outlining a vision for schools to meet the needs of the ‘whole’ child. |
2001 [99] | In response to the Clear Lake Accord1, SK releases a provincial strategy with a goal of ensuring schools provide DPA called A Physically Active SK. |
2003 [101] | SK in motion is launched to increase PA across the province. |
2004 [100] | The SK population health strategy outlines a plan to support regular PA in schools. |
SK in motion changes its focus to school-aged children and promotes 30 minutes of PA at home, 30 minutes at school and 30 minutes in the community. In motion schools provide ≥ 30 minutes of DPA. | |
Quality Daily PE is reported to be widely implemented in SK. | |
2010 [105] | A provincial DPA policy is announced for all schools. |
2010 | Voluntary2 implementation of the DPA policy begins. |
Innovators, 2003–2006
Early adopters, 2006–2010
Early majority, 2010–2014
Non-adopters
Canada
Policy evaluation: Findings from the systematic review
Adoption and diffusion
Study | Type of evaluation | Study design | Time frame | Population and setting | Measures | Outcome variables | Results |
---|---|---|---|---|---|---|---|
Alberta
| |||||||
Gladwin et al., 2008 [56] | Adoption | Qualitative | Not stated | 20 purposively selected key informants involved in school-based PA policy processes; review of policy documents and websites. | Semi-structured interviews and document reviews. | Policy processes that resulted in adding DPA, but not active transportation initiatives to the school curriculum. | DPA succeeded because Kingdon’s 3 streams (problem, solution, politics) converged, largely through the actions of the Minister of Learning who used his ministerial power to link the solution with the political stream. |
ONTARIO
| |||||||
Implementation and impact | Cross-sectional | Apr-Jun, 2010; Sept-Dec, 2010; Apr-Jun, 2011 | 865 grade 5–6 students from 18 elementary schools in Toronto, ON. All schools invited to participate, 18 schools selected from among interested schools based upon neighborhood type and SES. | Students completed a survey, wore accelerometers for 7 days and had height and weight measured. Parents completed a survey and travel diary for their children. Principals completed a school health environment survey. Teachers provided classroom schedules to identify DPA and PE times. | 1) Time spent in light-to-vigorous PA. Whether schools were in the initiation, action or maintenance stage of DPA. 2) Total PA counts and MVPA mins on school days and during school hours. | 1) 11.1% of schools were in the initiation phase of DPA, 88.9% were in the action phase and none were in the maintenance phase. Students were not more physically active in schools that were in the action phase. 2) 49% of students were provided DPA every school day. Frequency of DPA positively associated with total PA and MVPA mins/d on weekdays and during the school day. Students who participated in DPA 5 d/wk had higher total counts and intensity of PA, and time spent in MVPA on school days and during the school day. PA bouts averaged 7.1 mins and none were ≥ 20 mins. Those who accumulated ≥ 1 bout of MVPA were more active and fewer were overweight and obese. | |
Impact | Cross-sectional | 2007-08 | Convenience sample of 2326 grade 1–4 students/parents from 30 elementary schools in ON. Schools were purposively selected within public and separate school boards located in major geographic regions. | Students/parents completed a survey and students’ height and weight were measured. Administrators completed a school health environment survey. | Student activity levels (low, moderate, high) and BMI (normal, overweight, obese). Whether schools were in the initiation, action or maintenance stage of DPA. | 1) DPA implementation was not associated with the odds of being overweight or obese. 2) DPA implementation was not associated with the odds of being highly or moderately active. | |
Implementation and impact | Cross-sectional | 2007-08 | Convenience sample of 2379 (studies 1–2) or 1264 (study 3) grade 5–8 students from 30 schools in ON. Schools were purposively selected within public and separate school boards located in major geographic regions. | Students completed a survey. Administrators completed a school health environment survey. | Student activity levels (low, moderate, high) and BMI (normal, overweight, obese). Whether schools were in the initiation, action or maintenance stage of DPA. DPA implementation models. | 1) 0% of schools were in the initiation phase of DPA, 80% were in the action phase and 20% were in the maintenance phase. Implementation of DPA was not associated with the odds of being moderately or highly active. 2) DPA implementation models were: 70% offered DPA only on days without PE class, 20% offered DPA in addition to daily PE class, 10% offered DPA as part of daily PE class. DPA implementation models were not associated with the odds of being moderately or highly active. 3) DPA implementation was not associated with the odds of being overweight. | |
Patton, 2012 [135] | Implementation | Cross-sectional | Not stated | 145 teachers within 37 randomly selected schools in the Thames Valley District School Board, ON. | Teachers completed a survey. | Implementation and perspectives of DPA. | 15.6% always conducted DPA on days when PE was not scheduled, 50.7% said there was not adequate time to conduct DPA, 60.9% said DPA should be integrated within the curriculum, 64.6% reported that administrators rarely or never monitored DPA. |
Robertson-Wilson and Levesque, 2009 [166] | Implementation | Qualitative | 2005-07 | Publicly available policy and other documents related to DPA implementation. | Document reviews. | Whether DPA implementation strategies fit Hogwood and Gunn’s 10 preconditions for perfect implementation. | Several preconditions (e.g. allocation of resources, task specification) have been considered, whereas others (e.g. sustainability of resources, evaluation plans, extent to which policy is valued) require additional attention to ensure optimal DPA implementation. |
British Columbia
| |||||||
Watts et al., 2014 [137] | Implementation and impact | Cross-sectional, pre-post design | 2007-08 and 2011–12 school years | Administrator surveys in all districts that consented. 2007–08: 384 elementary and 118 middle/high schools; 2011–12: 351 elementary and 125 middle/high schools. | Administrators completed a survey on PA practices at their school for grades 6, 8 and 10 students. | Mins and delivery format of PE, stakeholder support and level of implementation of DPA policies. | Implementation of DPA policies was 65%, 56% and 51% for grades 6, 8 and 10. Schools had higher odds of providing ≥ 150 mins PE/wk and provided more mins of PE to grade 8 and 10 students in 2011–12. Schools had higher odds of providing PA linearly to grade 8 and in a semester format to grade 10 students in 2011–12. Staff and parental support for PA policies increased in all schools, student support declined in elementary and increased in middle/high schools, principal support was unchanged. |
Masse et al., 2013 [119] | Implementation | Qualitative | 2010-11 school year | Principals and teacher/school informants (n = 50) from a variety of school types and settings (n = 17 schools). | Semi-structured interviews. | Factors that impeded or facilitated implementation of DPA policies. | Perceived implementation ranged from 14%-90%. Schools implemented DPA policies through prescriptive and non-prescriptive approaches. DPA policies provided an advantage relative to the status quo, were compatible with school philosophies, and provided observable benefits. It was difficult to understand DPA policies, to fit them into already full schedules and policies increased teacher workload. Availability of resources and support were key facilitators. |
Manitoba
| |||||||
Hobin et al., 2014 [148] | Impact | Longitudinal | Baseline measures were conducted in 2008 with annual follow-up to 2011 or completion of grade 12. | Convenience sample of grades 9–10 PE classes within 31 randomly selected secondary schools (n = 447 students) across MB. | Students completed a survey at baseline and wore accelerometers for 7 days once a year. | MVPA mins/d overall, and in students from schools in rural/urban and low/high SES areas. | The MVPA trajectories of adolescents declined 11.3%/yr from baseline to the last measurement. Students with low or moderate baseline MVPA and those attending schools in low SES and rural areas had slower rates of decline in MVPA. |
Implementation
Impact
Province | Year | DPA policy? | Approximate mean # steps taken | Comparison with other provinces/territories | Change compared to 2005–07 and 2007-09 |
---|---|---|---|---|---|
NU1 | 2009-11 | No | >13,000 | Not reported | Not reported |
YK | 2009-11 | No | 12,3002 | More steps than NF, NS, NB | No change |
NWT | 2009-11 | No | 12,2002 | More steps than NF | No change |
BC | 2009-11 | Implemented in 2008 | 12,1002 | More steps than NF, PEI, NS, NB Fewer steps than NU | No change |
MB | 2009-11 | Implemented in 2008 | 12,1002 | More steps than NF, PEI, NS, NB | No change |
ON | 2009-11 | Implemented in 2005 | 11,7002 | More steps than NF Fewer steps than NU | No change |
Canadian average | 2009-11 | No national policy | 11,600 | n/a | Not reported |
AB | 2009-11 | Implemented in 2005 | 11,5002 | Fewer steps than NU | No change |
SK | 2009-11 | Implemented in 2010 | 11,5002 | Fewer steps than NU | Significant decline compared to 2005-07 |
QC | 2009-11 | No | 11,4002 | Fewer steps than NU | No change |
NB | 2009-11 | No | 11,2002 | Fewer steps than MB, BC, YK, NU | No change |
PEI | 2009-11 | No | 11,2002 | Fewer steps than MB, BC, NU | No change |
NS | 2009-11 | No | 11,1002 | Fewer steps than MB, BC, YK, NU | No change |
NF | 2009-11 | No | 10,8003 | Fewer steps than ON, MB, BC, YK, NWT, NU | No change |