Sustainability Requires Many Faces of Support.

Purpose: This study focused on the sustainability of a school-wide health behavior intervention in rural schools in the Southwestern US. Informed by the seven premises of Theories of Action with Merit, the purpose of this study was to investigate which portion(s) of a five-year, school-wide health behavior intervention were still in practice (i.e. sustainable), and why they were maintained following the removal of funding and resources for the program. Method: Teachers (N = 41) participated in individual, semi-structured interviews during which they shared what aspects of the original intervention were retained as part of personal classroom practices or of the school culture. Teachers reflected on facilitators and barriers to the sustainability of these practices. Data also included field notes from campus visits. To establish trustworthiness, data triangulation (interview transcripts, survey results, and field notes) provided multiple angles of analysis, and two researchers negotiated all themes. Results: Using the premises of the Theories of Action with Merit, teachers' comments often circulated around themes of administrative support and personal investment/interest in healthy behaviors. Additional themes of sustainability included feeling capable and physical activity being the "norm" at their school. Conclusions: Teachers' personal beliefs and self-efficacy in physical literacy held the highest importance in sustaining classroom healthy behavior practices as opposed to the district or state expectations for healthy behaviors. Administrator support was key to whole-school integration and sustainability of practices, however, teachers described evidence of support differently suggesting administrators need awareness of how messages of support are being translated.

A gap in perceived accessibility to play spaces for physical activity in Arizona elementary schools.

BACKGROUND: The Physical Activity Guidelines for Americans states all children should be provided with various physical activity opportunities; however, school play spaces are often unaccommodating to students with disabilities and this limitation may be exacerbated in lower-income schools. OBJECTIVE: The purpose of the study was to compare elementary school play space accessibility among children with and without disabilities at lower- and higher-income schools. METHODS: This cross-sectional study utilized an online survey assessing the perceived accessibility of play spaces for students with and without disabilities in low- and high-income schools administered to 178 physical education teachers across Arizona. Chi-square analyses were conducted to assess reported play space adequacy among students with and without disabilities, and associations by school-level income. RESULTS: There was a significant association between disability status and reported playground and play field inadequacy (p < 0.05). Without considering school income, reported inadequacy was 3x greater for students with disabilities compared to those without for both playgrounds and play fields. Among low-income schools, reported inadequacy was 3x greater for playgrounds and 7x greater for play fields for students with disabilities compared to those without. CONCLUSIONS: These results suggest a gap in access to school play spaces for students with disabilities and highlight the lack of inclusive play areas specifically among schools serving low-income populations. Our findings underscore the need for students with disabilities to be considered in the development of play spaces to ensure this at-risk population receives maximum opportunities for accessible movement and social engagement during the school day.

Comparing the impact of the Sport Education model on student motivation in Kuwaiti and American students.

Background: Sport Education (SE) stands as the most researched pedagogical model in physical education. While researchers have consistently underscored its capacity to improve student motivation in physical education, a gap remains concerning its implications in Arab nations. Moreover, no studies have been identified comparing the outcomes of SE between the U.S., where the model originated, and other countries. Purpose: This study was conducted to (1) determine the impact of SE on Kuwaiti students' motivation, (2) determine any differential effects of SE on Kuwaiti and American students' motivation, and (3) explore students' perceptions of SE in both countries. Methods: A replicated mixed methods quasi-experimental pre-test and post-test design was used. Participants were 33 secondary school students (nine girls and 24 boys; ages 11-12) from two classes in southwestern US, and 37 secondary school students (12 girls and 25 boys; ages 10-11) from two classes in Kuwait. Both sets of classes across the two countries were instructed by the same teacher who was trained in teaching SE. Student interest/enjoyment, perceived competence, effort/importance, and pressure/tension were measured using the Intrinsic Motivation Inventory instrument (IMI). Student perceptions of SE were assessed using a group Semi-structured interview. Quantitative data were analyzed using repeated measures and mixed ANOVAs followed by t-tests. Qualitative data were analyzed using a thematic analysis technique. Results: Kuwaiti students' perceived interest/enjoyment, perceived competence, effort/importance, and pressure/tension scores significantly improved in the group that taught using SE only. Comparing the impact of the SE on students' motivation between the two countries showed no significant differences. The interview data reflected further support for the IMI results. Conclusion: SE can be effective in increasing Kuwaiti students' motivation in physical education. This motivating effect of SE was observed consistently across both Kuwaiti and American students.

A natural experiment to assess recess frequency on children's physical activity in Arizona (U.S.) elementary schools.

BACKGROUND: In the United States, the number of state policies mandating recess in schools has rapidly increased over the past decade; however, few policies specify recess frequency. Informed by an ecological model of physical activity (PA) policy, this study examined and compared total amounts and intensity of PA expended during recess among children attending schools in compliance with Arizona recess policy ARS§ 15-118 mandating 2 + daily recess periods versus not. METHODS: PA during recess was measured among grade three children (ages 8-10) in four randomly selected elementary schools (two complying averaging 30 daily recess minutes; two non-complying averaging 15 daily recess minutes) in Maricopa County, Arizona. Group-level PA was assessed by direct observation using the System for Observing Play and Leisure (137 observations). A subset of students (N = 134) from all schools wore ActiGraph GT3X + devices during recess to measure individual PA. General linear mixed effects models were used to analyze the impact of recess frequency on group and individual PA during recess. RESULTS: Students attending complying schools spent significantly greater proportions of time in moderate-to-vigorous PA (MVPA) based on direct observation (5%) and accelerometry (15%) and less time being sedentary based on accelerometry (14%) during recess. Across the school day, this would equate to 5.1 more MVPA minutes based on systematic direct observation and 9.5 more MVPA minutes based on accelerometry, and 4.1 less minutes being sedentary based on accelerometry if students received two daily 15-minute recess periods compared to one. CONCLUSIONS: Students attending elementary schools implementing 2 + recesses, in accordance with state policy, demonstrated greater MVPA and less sedentary time, providing preliminary evidence that recess frequency is associated with greater PA intensity among children during recess. Schools that adhere to state-level PA policies may provide a more supportive environment for PA, resulting in increased movement among students. Specifying recess frequency should be considered in statewide recess policy.

High School Athletes' Use and Knowledge of (Safe) Nutritional Supplement Use: An Exploratory Study.

The use of nutritional supplements can lead to doping risk and no data exist on high school athletes' use of certified third-party tested supplements. A cross-sectional cohort design was developed using an anonymous survey. Descriptive data for supplement use, use of third-party tested supplements, and knowledge in high school athletes were reported. A total of 225 high school athletes, ranging from 14-19 years of age, from a private high school in the western US, were included in the analysis of the results. A total of 94% (n=211) of athletes reported nutritional supplement use within the past year with an average of six (interquartile range: 3-9) individual supplements, ranging from 0-20 supplements per person. Most frequently reported were sports drinks (72%), vitamins (65%), sports bars (60%), protein powder (58%), caffeine (37%, as part of normal beverages, or 13% as a supplement), followed by creatine (23%). A total of 24% claimed to know for sure that all their supplements were third-party tested. In addition, the recognition of third-party testing organization icons was low (46% in supplement users vs. 14% in nonusers). Athletes also scored low in reporting how to find (22%) and how to order (25%) third-party tested supplements. In conclusion, almost all athletes in this study reported the use of multiple nutritional supplements annually. Only one-fourth of the athletes reported consistently using third-party tested supplements. Knowledge of where and how tested supplements could be purchased was limited in this high school athlete population.

The Development and Efficacy of a High School Athlete Education Program for Safe Nutritional Supplement Use.

Many high school athletes report using nutritional supplements. Due to a lack of education at the high school level, the use of safe for sports third-party tested nutritional supplements may be limited. To determine the impact of a short online nutritional supplement education program on safe dietary supplement behavior a cross-sectional repeated measures design was used. Therefore, a convenience sample of 106 high school athletes (14-19 years old) was recruited to measure pre-post education difference for nutritional supplement use and third-party tested (TPT) supplements. Additionally, it was analyzed if nutritional supplement related Theory of Planned Behavior (TPB) constructs were associated with athlete choices. The most popular supplements included protein powder (65%), caffeine from beverages (45%), and different types of vitamins (ranging from 38-44%). Consistent use of (safe) third-party tested individual supplements was low, ranging from 35-77% for the most frequently reported supplements. The combined TPB determinants explained 26% of the variance of the intention to use safe supplements (F3, 102 = 13.03, p < 0.001, Adj R2 = 0.26). The self-reported intention to use third-party tested supplements increased significantly (+7%-36% per individual supplement) after following the education program (Z = -3.288, p = 0.001) resulting in an intentional use of 54-94% TPT supplements. In conclusion, education resulted in more high school athletes reporting future third-party tested supplements use, and TPB construct scores did not change over time but could explain a substantial part of the variance of safe supplement use intentions.

Classroom Teachers' Perceived Barriers to Implementing Comprehensive School Physical Activity Programs (TPB- CSPAP): Instrument Development.

Although physical education teachers generally act as the physical activity champion and promote adherence to whole-school physical activity programs, classroom teachers manage the majority of students' access to movement throughout the school day. Purpose: To support the adoption of a whole-school physical activity program, this study developed an instrument that identifies barriers perceived by classroom teachers related to adopting this type of program in their school. Method: A four-step process provided the conceptual framework for this instrument development (literature review, expert review, quantitative evaluation, and validation). The final validation phase (N = 520 teachers) included two individual analyses to separately evaluate respondents from elementary (K-5) and secondary levels (6-12). Each group was randomly split to run exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the models. Results: CFA results support models with adequate fit to the data for barriers for elementary, e.g., (SRMR = 0.0726; Bentler CFI = 0.92.79) and secondary (SRMR = 0.0813; Bentler CFI = 0.9374) teachers for whole-school programming. Conclusion: This instrument can be used by school personnel and researchers to understand perceived barriers for classroom teachers to implement a whole-school physical activity program in their context and then follow up to remove or reduce the barriers.

System for Observing Play and Leisure Activity in Youth: A Systematic Review of US and Canadian Studies.

BACKGROUND: The System of Observing Play and Leisure Activity in Youth (SOPLAY) has assisted in providing valid and reliable data of youth physical activity and characteristics specific to environmental contexts. The review aimed to examine empirical research that employed the SOPLAY instrument to measure physical activity in leisure-based activity environments in North American countries. METHODS: The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A systematic search was conducted with an exhaustive process using 10 electronic databases to locate peer-reviewed studies implementing SOPLAY that were published between 2000 and 2021. RESULTS: A total of 60 studies were included in the review. Most studies (n = 35) reported physical activity findings related to contextual characteristics measured using SOPLAY. Interestingly, a few of the studies (n = 8) found the provision of equipment and supervision, particularly adult supervision, significantly increased child physical activity observed. CONCLUSIONS: This review provides information relative to the group-level physical activity observed across multiple contexts (ie, playgrounds, parks, recreation centers) using a validated direct observation instrument.

The Relationship Between Policy Strength and Physical Activity Practices in Arizona Public Elementary Schools.

BACKGROUND: Many school-based physical activity statutes and regulations have been enacted, with the expectation that schools will comply. However, policy alone does not equate to implementation, and many policies fail for a variety of reasons. The purpose of the study was to determine whether the strength of reported state, district, and school-level physical activity policies were associated with reported recess, physical education, and other school-based physical activity practices at elementary schools in Arizona. METHODS: A modified Comprehensive School Physical Activity Program (CSPAP) Questionnaire was administered to staff at elementary schools across Arizona (N = 171). Summative indices of the number of school physical activity policies and best practices at the state, district, and school levels were created. Relationships between policy strength and best practices were examined using linear regression analyses stratified by recess, physical education, and other school-based physical activity practices. RESULTS: Stronger physical activity-related policies were associated with a greater number of recess (F1,142 = 9.87, P < .05), physical education (F4,148 = 4.58, P < .05, Adj. R2 = .09), and other school-based physical activity (F4,148 = 4.04, P < .05, Adj. R2 = .07) best practices at all levels while controlling for school-level demographic factors. CONCLUSIONS: The strength of policies may improve opportunities for comprehensive physical activity for children in schools. Strengthening policy language (eg, specifying duration and frequency) may contribute to better physical activity practices in schools, improving children's health at the population level.

"He's a little skinny and he's a little wide.": a mixed design investigation of American Indian student perceptions of healthy bodies.

BACKGROUND: Childhood is a critical developmental time of wellness patterns, yet little is known about what children know and believe. Even less is known about non-majority cultures like American Indian youth. The purpose of this study was to explore American Indian students' understandings of nutrition and physical activity. METHODS: This mixed methods study took place in 10 schools in an American Indian community in the Southwestern U.S. Ninety American Indian students in grades 3-12 (8-19 years old) were interviewed. The interview included an 8-point body size chart. Numerical data were analyzed via t-test statistics while a constant comparison process and analysis was used for the interview data. RESULTS: Students rated approximately 85% of students in Category 5 or smaller on the scale while placing 60% of adults at or above that size. There was a general trend of a larger body type for boys seen as healthy compared to that for girls. Students generally believed that their classmates were larger than the healthy body size. For students, a healthy body was the result of compliance with "eat right and exercise" rules. They exhibited little understanding of nutrition or physical activity and there were few developmental differences in understanding. Health was a corporeal concept and violators of the eat right and exercise rules were seen as lazy. CONCLUSIONS: Students held narrow and corporeal focused notions of health focused on simple rules. People who violated the rules were "lazy", a concept that seemed to underlie multiple constructs and a finding that holds true in other investigations. Students also reported few adult role models, a topic that should be explored with expanded family groups to better represent the multi-generational (e.g. grandparents, uncles, aunts) family housing common in the community. The findings are limited to a single American Indian community and a mixed design of relatively small numbers. This addition to the literature from a non-majority cultural group expands our knowledge of student perspectives on health. These findings can be used to create more effective curricula and interventions. Schools need more effective, but also alternately framed approaches that promote broader views of health.

School and Home Contributions to Dietary Behaviors of Rural Youth.

PURPOSE: This study examined dietary behaviors of rural youth at school and at home and sociodemographic differences. DESIGN: A cross-sectional design was used. SETTING: The study took place in five rural schools in the Southwestern US. SAMPLE: Student participants (N = 751) were in 3rd-8th grades. MEASURES: Consumption of fruits, vegetables, dairy, and soda/pop, at school and at home, were measured using a modified 7-day recall Youth Risk Behavior survey for nutrition instrument (CDC, 2011); Sociodemographic data. ANALYSIS: Descriptive statistics, frequency tables and MANCOVA were used. RESULTS: Following a natural log transformation of the dependent variables, there were significant multivariate effects in dietary behaviors across schools (Wilks' λ = 0.962, F(16, 2539.4) = 2.05, P = 0.0082) and location (school v. home; Wilks' λ = 0.849, F(4, 831) = 36.94, P < 0.0001). Follow-up tests showed students in some schools reported higher consumption of fruit, vegetable, and soda at home than school, although most reported consuming less than one serving per day of fruit, vegetables, and dairy across settings. There were no significant main effects for gender/grade/ethnicity across behaviors. CONCLUSIONS: Findings highlight poor dietary behaviors of rural youth as well as school/home differences that can help inform efforts to support optimal dietary behaviors of this population. Results should be interpreted considering limitations of the self-report nature of collected data and missing data.

Fishing Downstream: Does CSPAP Promotion During PETE Transfer to Teaching Practice by K-12 Physical Educators?

Physical Education Teacher Education (PETE) training has the potential to influence graduates' decisions as physical educators. Utilizing themes from Rogers' Diffusion of Innovations and Lawson's Occupational Socialization theories, we focused on graduates from a single PETE program which, beginning in 2007, began integrating content, expectations, and experiences relating to an expanded role of the physical educator such as in comprehensive school physical activity programs (CSPAPs). Purpose: The purpose of this study was to examine transfer in terms of university training leading to teaching practices in expanded physical activity programming. Method: An electronic questionnaire was sent to 335 graduates from May 2000 through May 2019. Sixty-seven graduates' questionnaires were investigated looking at perceptions of CSPAP as an innovation, current expanded physical activity (PA) offerings, and memories of PETE. Additionally, 13 participants participated in a school visit and interview which acted as a fidelity check for self-reported levels of expanded PA programming reported in the questionnaire. Results: All 67 graduates included some amount of expanded PA programming. Positive correlations were found with perception of CSPAP as an innovation, for both year of graduation and memory of PETE programming, thus students exposed to CSPAP programming during PETE were implementing components at their schools at higher levels. Conclusion: There is positive potential for professional socialization to influence graduates' practices. Perceptions of CSPAP as an innovation were positive and support the promotion of triability and starting small when PETE programs encourage expanded PA programming.

A cluster randomized controlled trial of an after-school playground curriculum intervention to improve children's physical, social, and emotional health: study protocol for the PLAYground project.

BACKGROUND: The public health benefits of physical activity for children are well known including contributions to metabolic and cardiorespiratory health. Along with physical benefits, engaging in physical activity can support the social and emotional health of youth and promote health and well-being into adulthood. This cluster-randomized controlled trial assesses the impact of an after-school curriculum aimed at improving physically active and inclusive play to promote physical, social, and emotional health. A secondary focus is on the implementation (appropriateness, feasibility, fidelity, sustainability) of the curriculum. METHODS: The PLAYground (Play and Learning Activities for Youth) project utilizes a social-ecological approach, targeting personal, behavioral, and environmental conditions, and Social Cognitive Theory (SCT) to study how a playground curriculum impacts children's health. All elementary schools with an existing after-school program in a large, public school district in Mesa, Arizona will be eligible to participate. Seven schools will be allocated to the intervention arm in year one using random sampling stratified by school-income. In year two, the seven control schools will receive the intervention. Intervention schools will implement the research-based PlayOn!® playground curriculum to promote active and inclusive play. After-school staff will be trained to teach activities that address social and emotional skills (e.g., conflict resolution) through physical activity. Participating students will be trained as peer leaders to extend the playground activities to the recess setting. This trial will assess between-group differences in physical activity, social and emotional health indicators, and number of health and behavior incidents among students attending intervention schools and control schools. Implementation outcomes will also be assessed among program facilitators at each school site. DISCUSSION: Enhancement of physical activity opportunities at schools has the potential for high impact and reach due to practicality. Enhancements can also improve quality pedagogy and curricula in after-school settings. Results of this project can inform practical strategies to improve existing after-school programs to prepare leaders (adults and children) to facilitate physical activity, positive social interactions, and emotional well-being. TRIAL REGISTRATION: ClinicalTrials.gov, NCT ID NCT05470621 , Registered July 22, 2022.

Off-Hours Facility Use in Public High Schools: Physical Activity Potential vs. Reality.

Purpose: Public high school campuses in the United States are generally built with multiple dedicated physical activity facilities from soccer fields to swimming pools. When viewed from a community health standpoint, these campuses hold great potential (if accessible) in providing community members spaces where they can engage in physical activity during non-school hours. Guided by the Social-Ecological Model (SEM) the purpose of this study was to assess access to and use of all physical activity areas on public high school campuses during non-school hours on weekdays and weekend days. Method: Direct observation using the SOPARC instrument was used to assess 19 public high schools across four districts in the Western U.S., by completing 3959 physical activity area sweeps. Results: Facilities were accessible about half of the time (53.4%), but empty 91% of the time. Public high school campuses are an underused resource for community physical activity during non-school hours. Discussion: Increased use of joint-use agreements would enable school districts to increase both the use of campus-based physical activity facilities and physical activity levels of community members who themselves fund the construction and maintenance of schools and school grounds through local taxes. This would help increase the schools' caloric footprint and contribute to improving public health.

The Effectiveness of Equipment Provisions on Rural Middle School Students' Physical Activity During Lunch Recess.

BACKGROUND: Environmental provisions can boost students' discretionary participation in physical activity (PA) during lunchtime at school. This study investigated the effectiveness of providing PA equipment as an environmental intervention on middle school students' PA levels and stakeholders' perceptions of the effectiveness of equipment provisions during school lunch recess. METHODS: A baseline-intervention research design was used in this study with a first baseline phase followed by an intervention phase (ie, equipment provision phase). A total of 514 students at 2 middle schools (school 1 and school 2) in a rural area of the western United States were observed directly using the System for Observing Play and Leisure Activity in Youth instrument. Interviews were conducted with stakeholders. Paired-sample t tests and visual analysis were conducted to explore differences in PA levels by gender, and common comparison (with trustworthiness measures) was used with the interview data. RESULTS: The overall percentage of moderate to vigorous PA levels was increased in both schools (ranging from 8.0% to 24.0%). In school 2, there was a significant difference in seventh- and eighth-grade students' moderate to vigorous PA levels from the baseline. Three major themes were identified: (1) unmotivated, (2) unequipped, and (3) unquestionable changes (with students becoming more active). CONCLUSIONS: Environmental supports (access, equipment, and supervision) significantly and positively influenced middle school students' lunchtime PA levels.

My Turn to Make a Difference: Efficacy Trends among Induction Physical Educators.

Purpose: This study provides a longitudinal examination of the influences enhancing or constraining the development of efficacy in ten induction physical educators. Method: Over a span of three years, data from structured interviews and responses to the Physical Education Teaching Efficacy Scale were collected at seven time points. Utilizing a mixed-methods approach, data were analyzed for qualitative themes and quantitative trends through the lens of various factors known to influence the career cycle. Results: In the personal environment, the presence of positive individual dispositions, the ability to balance competing demands, and high levels of perceived support emerged as constructive enhancers of efficacy. In the organizational environment, positive influences included the ability to meet the expectations of stakeholders and perceived confidence related to the tasks of teaching. Over time, significant differences existed for the survey categories measuring efficacy in content knowledge, accommodating skill level differences, teaching students with special needs, and instruction. Furthermore, significant differences also occurred related to gender, geographical location/setting, and school classification. Conclusion: Efficacy levels in beginning physical educators are highly dynamic and context-specific, but the presence of high levels of perceived support, both personally and organizationally, can positively enhance the efficacy of induction teachers related to balancing demands both inside and outside the classroom. Implications include the necessity for authentic and thorough preservice training and upon employment, access to adequate resources.

Active Transportation: The Role of Parent Attitude, The Physical Environment, and Social Capital.

BACKGROUND: Despite recommendation and confirmed physical activity benefits, participation in active transportation to school (ATS) has continued to decline. This study's purpose was to create and test a model of ATS that is directly explained by the constructs of parent attitude, the physical environment, and social capital controlling for age and gender. METHODS: Participants were parents (N = 248) of children at 6 elementary and 2 middle schools in 1 district in the Southwestern United States. The survey included previously validated behavior, environmental, attitude, and social items (eg, Safe Routes to School Parent Survey/U.S. General Social Survey). Structural equation modeling was used to test the fit of the model and whether parent attitude, the physical environment, and social capital were associated with active transportation. RESULTS: An adjusted measurement model was a good fit for the data. The physical environment (ß = 0.391; P < .01) as well as parent attitude (ß = 0.535; P < .001) were positively associated with ATS. CONCLUSION: This study supports a model of ATS, affirming that parent attitude, the physical environment, and social capital are effective constructs from which to conceptualize associations with walking and biking to school.

Effectiveness of Secondary School Conceptual Physical Education: A 20-Year Longitudinal Study.

BACKGROUND: Previous research findings from Project Active Teen demonstrated the effectiveness of high school conceptual physical education (CPE) in promoting active lifestyles. METHOD: This study followed Project Active Teen participants 20 years after graduation from high school and 24 years after taking a CPE class. Physical activity behaviors were assessed using the same procedures as previous Project Active Teen studies. Activity patterns were compared with patterns while in high school and shortly after high school graduation. Activity patterns were also compared with a national sample of age-equivalent adults. RESULTS: Twenty years after high school graduation, former CPE students were less likely to be inactive and more likely to be moderately active than when in high school and were less likely to be inactive and more likely to be moderately active than national sample age-equivalent peers. They were typically not more vigorously physically active than comparison groups. CONCLUSION: Results support the long-term effectiveness of CPE in reducing inactive behavior and promoting moderate physical activity later in life.

Physical Education Preservice Teachers' Perceptions About Preparation for Comprehensive School Physical Activity Programs.

PURPOSE: Physical educators may be the responsible people for implementing comprehensive school physical activity programs (CSPAPs) in schools. However, it is unclear whether physical education teacher education (PETE) programs provide the relevant learning opportunities to preservice teachers for CSPAP implementation. The purpose of this study was to understand preservice teachers' perspectives and experiences of CSPAP preparation in their PETE programs. METHOD: Fourteen PETE students from 6 different universities participated and shared their experiences in PETE programs. Data were collected through a short survey, 1 formal interview, field images, document gathering, and an additional survey to follow up the interview. Descriptive statistics, constant comparison, and analytic induction techniques were used to analyze the data. RESULTS: Participants' familiarity with CSPAPs was related to positive opinions about the role of physical educators in CSPAPs. Three common themes were revealed: (a) introducing CSPAP via courses, (b) the lack of programwide hands-on experiences for CSPAP, and (c) limited preparation for social skills with stakeholders. Participants' perceptions of the role of physical educators as physical activity leaders had been expanded during their training. CONCLUSION: The participating PETE programs integrated CSPAP components in the existing courses to introduce CSPAP, while there was a lack of sufficient practical opportunities to learn how to implement (aspects of) a CSPAP. Participants felt they were insufficiently prepared to promote and implement expanded physical activity programming beyond physical education classes in schools. The majority of the PETE preservice teachers wanted more practical CSPAP experiences in their programs.