Using the R=MC2 Heuristic to Assess Whole-of-School Physical Activity Implementation in Elementary Schools: A Cross-Sectional Study

Details

• Journal Article:
  The International Journal of Behavioral Nutrition and Physical Activity
• Personal Author:
  Craig, Derek W. ; Lanza, Kevin ; Pfledderer, Christopher D. ; Pavlovic, Andjelka ; Onadeko, Kempson ; Heredia, Natalia I. ; Injil, Jizyah ; DeFina, Laura F. ; Walker, Timothy J.
• Description:
  Background: Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readiness for implementation as a combination of an organization's motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC2 heuristic and schools' implementation of a WOS approach. Methods: We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in the NFL PLAY60 FitnessGram Project during the 2022-23 school year. From surveys administered to school staff, we created a WOS index (range = 0-12) comprising six physical activity practices: physical education, recess, before and after-school programs, classroom-based approaches, and active transport. We also assessed how six constructs from the R = MC2 heuristic (i.e., culture, implementation climate, leadership, priority, resources utilization, resource availability) impact physical activity implementation using a series of questions measured on a 5-point Likert scale. We used linear regression models to determine associations between R = MC2 constructs (independent variables) and WOS index scores (dependent variable), controlling for school-level characteristics (student enrollment, percentage of race/ethnicity and economically disadvantaged students served) and state-level clustering. Results: The analytic sample consisted of 132 schools across 18 states. On average, school staff rated leadership (mean = 4.1, range = 1.5-5) and organizational culture (mean = 4.0, range = 2.25-5) the highest. The mean WOS index score was 6.1. Partially adjusted models indicated significant positive associations between each R = MC2 construct and WOS index scores. Fully adjusted regression models revealed priority (b = 0.88; p = 0.010; 95% CI = 0.19-1.56) and implementation climate (b = 0.69; p = 0.047; 95% CI = 0.07-1.32) were positively and significantly associated with WOS index scores. Conclusions: Our study provides insights into key implementation constructs associated with providing school-based physical activity opportunities. These findings can support the development of resources and implementation strategies which, in turn, can help schools address implementation-related disparities. This will help schools improve the quality and accessibility of opportunities for physical activity provided to students across the United States. Description provided by NIOSH
• Subjects:
  • Exercise
  • Occupational Health
  • Safety
  • Schools
• Keywords:
  • Children
  • Education
  • Physical exercise
  • Physical fitness
  • Activity levels
  • Cross sectional studies
  • Author Keywords: Schools
  • Physical activity
  • Implementation
  • Organizational readiness
• ISSN:
  1479-5868
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Dallas Region OSHA ; Texas
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  8 pdf pages
• Volume:
  22
• NIOSHTIC Number:
  nn:20071748
• Citation:
  Int J Behav Nutr Phys Act 2025 Aug; 22:114
• Contact Point Address:
  Derek W. Craig, Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Houston, Texas, USA
• Email:
  Derek.W.Craig@uth.tmc.edu
• Federal Fiscal Year:
  2025
• Performing Organization:
  University of Texas Health Science Center, Houston
• Peer Reviewed:
  True
• Start Date:
  2005/07/01
• End Date:
  2026/06/30
• Download URL:
  https://stacks.cdc.gov/view/cdc/259973/cdc_259973_DS1.pdf
• File Type:
  [PDF - 1014.22 KB]
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1578147dbe9a200cfa087acbf699ed3b448eb8ed107f54909a3542b8d97ae8721b377c9f121eac6aeaafb187c1e1428f501569981193f2fb5ecd86579698f7d0