Rapid Realist Review of School-Based Physical Activity Interventions in 7- to 11-Year-Old Children

Meta-analysis of physical activity interventions in school settings have revealed low efficacy and that there is a need to explore implementation fidelity. The aim of this rapid realist review was to determine, what physical activity interventions in school settings for children aged 7- to 11-years-old works, for whom, and in what circumstances. The realist synthesis was conducted following RAMESES guidelines. Relevant studies were identified following a systematic search process and data from 28 studies was extracted for evidence to form context-mechanism-outcome configurations that were clustered and refined. Using the five-level socioecological model, the program theories were classified into the levels of intrapersonal (child), interpersonal (teachers), institutional (program content, school administration, and school environment), community (home and neighborhood), and policy. The school level led to most context-mechanism-outcome configurations related to school leadership and policy, workforce structure, program characteristics, and school environment. At each level, we identified features of interventions, alongside implementation considerations that might work to promote efficacy and sustainability. The need to recognize the school environment as part of a complex system with multi-level interaction and influences was a key finding. In line with realist philosophy, the researchers encouraged primary research to confirm, refute, and refine the program theories presente

“It Sounds Like a Drama:” Hearing Stories of Chronic Low Back Pain Through Poetic (Re)presentation

A poetic voice develops in different ways and from different sources. In this paper, a poetic voice is brought to the experiences of patients and family members as recounted in the first phase of a UK National Health Service funded Q-methodological study, the key outcomes of which are summarized. Their stories are presented as a single poetic performance text crafted from the analysis of combined transcripts of three focus group discussions. The performance bears witness to the sadness, frustration, and resolve of those living with chronic low back pain, and offers an additional hearing to that provided by the main study

Evaluation of Practice to Promote Physical Activity in Schools in a Unitary Authority in England

Objectives: To explore what actually happens in relation to physical activity promotion in primary and junior schools within one unitary authority and to relate this to Public Health England promising principles of practice to promote physical activity in schools. Study design: A qualitative approach was undertaken to explore practice in all primary and junior schools in the unitary authority of Southampton. Methods: All primary (n=36) and junior (n=8) schools in Southampton were involved in the study. Publicly available primary physical education and sport premium (PESP) funding reports (n=36) alongside a school survey (n=14) were collated. The collated qualitative data set was semantically coded and then a multi-layered approach including identification, reviewing, defining and naming meaningful and important themes were inductively developed. The inductively developed themes were then fitted in relation to PHE eight promising principles. Results: There was evidence of practice across all eight promising principles although this varied in depth and scale. There was one set of data that did not fit appropriately within the PHE eight promising principles and warranted its own category broadly termed ‘rewards to recognise physical activity’. There was widespread evidence of PESP funding providing increased provision, variety and quality of sport opportunities but limited evidence of physical activity practice or programmes targeting the least active. Two different approaches in relation to ensuring a skilled workforce materialised continuing professional development which reflected in impact statements linked to increased confidence to deliver and quality of physical education versus outsourcing to specialists with little impact cited other than offering specialist or diverse sports. Conclusions: The study demonstrated that the PHE eight promising principles of practice was a useful framework in relation to current practice, although a ninth promising principle of rewarding physically active behaviour should be considered. The two key themes that need to be addressed for the ambitions established in the new school sport and activity action plan to be deliverable, with PESP funding as a driver, are skilled workforce and development of a wider understanding of what physical activity is

A realist case study inquiry of English primary school physical activity initiatives

Concern that children are not engaging in enough physical activity (PA) to bring about health benefits is a crisis globally. This paper aims to examine primary school-based PA initiatives from within an English context. A qualitative inquiry was adopted and underpinned by the socio-ecological model. The study was presented through a realist case study of three selected primary schools to reveal a collection of context-mechanism-outcome statements across five levels of the socio-ecological model (individual, interpersonal, institutional, community and policy). The findings highlighted a multi-layered interaction of PA within the school setting as well as the school’s own relationships with external influences. Three key components emerged from the research findings; these included the 1) teacher’s unintentional facilitation of simple PA in classroom settings, 2) innovative uses of community networks as an additional resource to schools and 3) the uncovering of a complexity of external influences from home, community and policies on school-based initiatives

The use of standardised data collection in private physiotherapy practice to provide information for clinicians, clinics and private practice organisations

Clinicians are becoming increasingly aware of the need to be able to demonstrate and account for the delivery and quality of their clinical services. Online standardised data collection systems can be used by clinicians to gather this information in a robust and accessible way. Physio First (the Organisation for Chartered Physiotherapists in Private Practice) have commissioned several data collection projects in the UK