Background: Establishing and maintaining a positive, inclusive social climate in school is essential, especially given the many potential social pressures that make school a toxic environment for vulnerable students. We explored middle school physical education (PE) teachers' perceptions of the factors that influence the implementation of social-oriented approaches to include overweight and obese students.
Methods: We used a qualitative multicase study design guided by the Social Ecological Constraints model to study 9 PE teachers' perspectives and actions.