BACKGROUND Globally, many children fail to meet the World Health Organization's physical activity and sedentary behaviour guidelines. Schools are an ideal setting to intervene, yet despite many interventions in this setting, success when delivered under real-world conditions or at scale is limited. This systematic review aims to i) identify which implementation models are used in school-based physical activity effectiveness, dissemination, and/or implementation trials, and ii) identify factors associated with the adoption, implementation and sustainability of school-based physical activity interventions in real-world settings. METHODS The review followed PRISMA guidelines and included a systematic search of seven databases from January 1st, 2000 to July 31st, 2018: MEDLINE, EMBASE, CINAHL, SPORTDiscus, PsycINFO, CENTRAL, and ERIC. A forward citation search of included studies using Google Scholar was performed on the 21st of January 2019 including articles published until the end of 2018. Study inclusion criteria: (i) a primary outcome to increase physical activity and/or decrease sedentary behaviour among school-aged children and/or adolescents; (ii) intervention delivery within school settings, (iii) use of implementation models to plan or interpret study results; and (iv) interventions delivered under real-world conditions. EXCLUSION CRITERIA (i) efficacy trials; (ii) studies applying or testing school-based physical activity policies, and; (iii) studies targeting special schools or pre-school and/or kindergarten aged children. RESULTS 27 papers comprising 17 unique interventions were included. Fourteen implementation models (e.g., RE-AIM, Rogers' Diffusion of Innovations, Precede Proceed model), were applied across 27 papers. Implementation models were mostly used to interpret results (n = 9), for planning evaluation and interpreting results (n = 8), for planning evaluation (n = 6), for intervention design (n = 4), or for a combination of designing the intervention and interpreting results (n = 3). We identified 269 factors related to barriers (n = 93) and facilitators (n = 176) for the adoption (n = 7 studies), implementation (n = 14 studies) and sustainability (n = 7 studies) of interventions. CONCLUSIONS Implementation model use was predominately centered on the interpretation of results and analyses, with few examples of use across all study phases as a planning tool and to understand results. This lack of implementation models applied may explain the limited success of interventions when delivered under real-world conditions or at scale. TRIAL REGISTRATION PROSPERO (CRD42018099836).

中文翻译：

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在现实环境中采用、实施和可持续性基于学校的体育活动和久坐行为干预措施：系统评价。


背景技术在全球范围内，许多儿童未能达到世界卫生组织的身体活动和久坐行为指南。学校是进行干预的理想环境，但尽管在这种环境下进行了许多干预措施，但在现实条件下或大规模实施时取得的成功是有限的。本系统审查的目的是 i) 确定哪些实施模式用于校本体育活动的有效性、传播和/或实施试验，以及 ii) 确定与学校体育活动干预措施的采用、实施和可持续性相关的因素现实世界的设置。方法 该评价遵循 PRISMA 指南，包括对 2000 年 1 月 1 日至 2018 年 7 月 31 日期间七个数据库的系统检索：MEDLINE、EMBASE、CINAHL、SPORTDiscus、PsycINFO、CENTRAL 和 ERIC。 2019 年 1 月 21 日使用 Google Scholar 对纳入的研究进行了前向引文检索，其中包括截至 2018 年底发表的文章。研究纳入标准：(i) 主要结果是增加学校中的身体活动和/或减少久坐行为老年儿童和/或青少年； (ii) 在学校环境中实施干预，(iii) 使用实施模型来计划或解释研究结果； (iv) 在现实条件下实施的干预措施。排除标准 (i) 功效试验； (ii) 研究应用或测试学校体育活动政策，以及； (iii) 针对特殊学校或学前和/或幼儿园适龄儿童的研究。结果 包含 17 项独特干预措施的 27 篇论文被纳入。 27 篇论文中应用了 14 种实施模型（例如 RE-AIM、罗杰斯创新扩散、Precede Proceed 模型）。 实施模型主要用于解释结果（n = 9）、规划评估和解释结果（n = 8）、规划评估（n = 6）、干预设计（n = 4）或设计的组合干预和解释结果（n = 3）。我们确定了与干预措施的采用（n = 7 项研究）、实施（n = 14 项研究）和可持续性（n = 7 项研究）的障碍（n = 93）和促进因素（n = 176）相关的 269 个因素。结论 实施模型的使用主要集中在结果和分析的解释上，几乎没有在所有研究阶段作为规划工具和理解结果的例子。缺乏应用的实施模型可能解释了在现实条件下或大规模实施干预措施时效果有限的原因。试用注册普洛斯彼罗 (CRD42018099836)。