Whole-of-School Physical Activity Promotion: Findings From Elementary Schools in the United States.

Introduction: Schools can support students' participation in physical activity by offering opportunities consistent with a Whole-of-School (WOS) approach; however, the extent to which physical activity opportunities are provided and how school-level characteristics associate with their use remains unclear. This study examined how elementary schools' use a WOS approach to promote physical activity, as well as associations between school-level characteristics and physical activity opportunities provided.

Methods: Survey data was collected from 162 elementary schools participating in the NFL PLAY 60 FitnessGram Project during the 2022-2023 school year. A WOS index (ranging from 0 to 12) was created from responses by school staff on questions about 6 physical activity practices (physical education, recess, before- and after-school programs, classroom-based approaches, active transport). Multivariable regression models examined associations between school characteristics and WOS index scores. Analyses were completed in Spring 2024.

Results: Fully adjusted models indicated a statistically significant difference between the percentage of economically disadvantaged students served and WOS index score. Schools serving between 20% and 39% (p<0.001), 40%-59% (p<0.01), 60%-79% (p<0.01) and ≥80% (p<0.001) economically disadvantaged students scored significantly lower on the WOS index compared to schools with 0%-19% economically disadvantaged students.

Conclusions: Studies are needed to examine disparities in physical activity practices consistent with a WOS approach to understand the implications on health, academic performance, and other key outcomes. This information can inform the development of strategies to address disparities and ensure youth have equitable access to school-based physical activity opportunities.