Feasibility and acceptability of an implementation strategy to enhance use of classroom-based physical activity approaches in elementary schools: a mixed methods study

Background: Classroom-based approaches are an evidence-based way to improve children’s physical activity; however, they are inconsistently implemented in schools. We developed MAGIC (Movement for Academic Growth In Classrooms), a multifaceted implementation strategy that consists of leadership training, teacher training, and a monthly newsletter to improve use of classroom-based physical activity approaches. The purpose of this study is to examine the feasibility and acceptability of MAGIC among elementary school teachers and leaders. Methods: We used an embedded, convergent mixed methods design. We provided the MAGIC implementation strategy to a partner elementary school. We then administered surveys to teachers to quantitatively examine feasibility and acceptability. The surveys included questions about training attendance, receipt of newsletters, and acceptability based on a theoretical framework of acceptability. We used descriptive statistics to understand feasibility and acceptability trends. We also conducted semi-structured group and individual interviews with teachers and school leaders to understand perspectives about MAGIC components. We used rapid assessment procedures to analyze qualitative data, and multiple integration strategies, including joint displays, to compare quantitative and qualitative findings. Results: A total of 35 teachers (kindergarten-5^th grade) completed study surveys and 27 teachers and school leaders participated in interviews. As an indicator of feasibility, all leaders attended leadership training sessions 1 (n = 13/13), 2 (n = 13/13), and 4 (n = 7/7); and 57% attended session 3 (n = 7/13); 93% (n = 28/30) of teachers attended training session 1, 90% (n = 27/20) attended session 2, and 87.5% (n = 21/24) attended session 3; and 67–75% of teachers received respective newsletters. The trainings and newsletters had high acceptability levels as indicated by survey results and interview data. Trainings included flexible scheduling integrated into existing meetings, which participants reported helped improve feasibility. Participants also highlighted the importance of incorporating classroom-based approaches into trainings and the simplicity of the newsletter, which contributed to their acceptability. Conclusions: This study provides evidence supporting the feasibility and acceptability of the MAGIC implementation strategy among elementary school teachers and leaders. Future research should test MAGIC among more elementary schools to examine its impact on teacher implementation outcomes and students’ physical activity levels. Trial registration: ClinicalTrials.gov, NCT05048433, registered 9/8/2021, https://clinicaltrials.gov/ct2/show/NCT05048433