Using implementation mapping to design an implementation strategy for classroom-based physical activity approaches in elementary schools.

Background: Physically active breaks and lessons are evidence-based approaches to improving student's physical activity. Yet, schools and teachers face implementation challenges, requiring the need for effective implementation strategies.

Purpose: Use Implementation Mapping to develop an implementation strategy for physically active breaks and lessons in elementary schools.

Methods: With our partner school district, we assembled a planning group with expertise in education, public health, and implementation science. The group completed five Implementation Mapping tasks: (i) conduct needs and assets assessment and identify adopters and implementers, (ii) identify implementation outcomes, performance objectives, and determinants, and create matrices of change objectives, (iii) choose theoretical change methods and select and create implementation strategies, (iv) produce implementation protocols and materials, and (v) evaluate implementation outcomes. We also developed an Implementation Mapping (IMap) Logic Model illustrating proposed mechanisms of action.

Results: The implementation strategy focused on the principal/assistant principal, instructional coaches, and teachers. The implementation outcome was teacher implementation fidelity (implementation ≥2 physically active breaks/lessons per day). The developed strategy consisted of leadership training, teacher training, a newsletter, resources for teachers, and a parent flyer. The strategy operationalized change methods (theoretical techniques influencing implementation determinants) and practical applications (operationalization of change methods) to address implementation determinants and outcomes.

Conclusions: Implementation Mapping provided a systematic process for developing an implementation strategy for physically active breaks and lessons in elementary schools. The IMap Logic Model identifies the proposed mechanisms of action for further testing. The strategy has the potential to benefit schools, teachers/staff, and students by enhancing physical activity.