Using Implementation Mapping to develop and test an implementation strategy for active learning to promote physical activity in children: a feasibility study using a hybrid type 2 design.

Background: Incorporating physical movement in the teaching of academic content (active learning) is a promising approach to improve children's health and academic performance. Despite documented benefits, implementation of active learning remains challenging for schools. The aims of this study are to develop an implementation strategy to support the delivery of active learning in elementary schools and examine the impact of the developed implementation strategy on the implementation and effectiveness of active learning.

Methods: Aim 1 will use Implementation Mapping, which is a multi-step approach that guides the use of theory, stakeholder input, and existing literature to develop a scientifically based implementation strategy for active learning in elementary schools. Aim 2 will feature a feasibility study to examine the impact of the implementation strategy on both implementation and effectiveness outcomes, consistent with a Hybrid Type 2 design. Acceptability and implementation fidelity will be the primary implementation outcomes, and student physical activity levels will be the primary effectiveness outcome. We will recruit two elementary schools within our partner district, and one will be randomly assigned to receive usual support while the other will receive the newly developed implementation strategy. Participants from each school will complete baseline, 6-, and 12-month assessments. Bayesian statistical approaches will quantitatively examine preliminary effectiveness outcomes. We will also use an embedded mixed methods approach to triangulate findings.

Discussion: This study's innovative overarching conceptual framework (centered on Implementation Mapping) will inform the development and testing of the implementation strategy. This study also uses methodological approaches optimal for feasibility studies, including mixed methods and Bayesian statistics. As a result, we will be able to gain a thorough understanding about the feasibility and preliminary effectiveness of the implementation strategy, which will inform subsequent research and practice for implementing active learning in schools.

Trial Registration: ClinicalTrials.gov, NCT05048433 , registered on September 8, 2021.