Table 1.

Adaptations to each specific component of PA4E1 efficacy trial made for the scale-up trial, including adaptations to individual school physical activity practices and implementation support strategies offered to schools.

Name of efficacy trial program component	Following adaptation, name of scale-up trial program component	Descriptive summary of main adaptations from efficacy trial to scale-up trial	Fidelity consistent?*	Systematic?*	Proposed positive (+), negative (-) or null (0) impact on the project
Practice 1: teaching strategies to maximize students' physical activity in health and physical education (PE) lessons	Practice 1: quality PE lessons	• Change of focus from focusing on “Active” (which is a single principle within “SAAFE” PE lesson guidelines) to all “SAAFE” principles PE Lessons (i.e., supportive, active, autonomous, fair and enjoyable) (40). • Though pedometers were made available to schools, this became less of a focus and was not a mandatory part of the practice. • The PE Department used documented principles or guidelines. • PE teacher should participate in peer observation of a practical PE lesson at least once per year.	X	✓	+
Practice 2: development and monitoring of student physical activity plans within PE lessons	Practice 2: student PA plans	• As well as Grade 8's in year two, Grade 7's should also develop a physical activity plan in year two. • Goals were to be reviewed yearly, not termly.	✓	✓	+
Practice 3: enhanced school sport program	Practice 3: enhanced school sport program	• Changed from “Program X” (41) to the “Resistance Training 4 Teens (RT4T)” program (42). • RT4T was offered as accredited training by the NSW Department of Education.	✓	✓	+
Practice 4: development/ modification of school policies	Practice 5: school PA policy or procedure	• The policy must include the provision of at least 150 min of moderate to vigorous-intensity physical activity during school time for all students in Grade 7–10.	✓	✓	+
Practice 5: physical activity programs during school breaks	Practice 4: recess and lunchtime PA	• Changed to 3 days per week (from two), ideally with at least one activity targeting girls specifically. • Schools were also asked to provide access to physical activity equipment to students at least 3 days per week.	✓	✓	+
Practice 6: promotion of community physical activity providers (community links)	Practice 6: links with community PA providers	• Specification that schools form three links with community physical activity providers that go beyond the promotion of the provider. • It was desirable that at least one of the community links made were to promote free or low-cost options in the community. • Schools were asked to use multiple modes to promote (e.g., newsletter, parent app). • This replaced a 1-day community physical activity provider expo (as more feasible and sustained)	✓	✓	+
Practice 7: parent engagement	Practice 7: communicating PA messages to all parents	• Schools were asked to use multiple modes to communicate the messages (e.g., newsletter, parent app).	✓	✓	+
Strategy 1: in-school physical activity consultant	Strategy 2 and 3: embedded school staff: in-School Champion and External implementation support	• External physical activity consultant replaced by an in-School Champion (an existing PE teacher within the school) who was supported by a health promotion support officer employed by the respective local health district. • In-School Champions were funded $400 a fortnight. • Support Officer and in-School Champion maintained contact through face-to-face meetings, email and phone according to the schedule documented within the support strategy. • Support Officer was co-located in the same local health district with in-School Champions.	X	✓	+
Strategy 2: establishing leadership and support	Strategy 1: executive and leadership support	• Less total committee members in the scale-up trial (i.e., no requirement for student, parent, Head PE teacher and community representative) and include both the in-School Champion and school executive.	✓	✓	+
Strategy 3: teacher training	Strategy 4: teacher professional learning	• PE Teacher training via a website (six modules) rather than three face-to-face sessions. • NESA (New South Wales Education Standards Authority) accreditation attached to online training. • Specific training for writing a physical activity policy for in-school champions. • Three days training for in-school champion.	✓	✓	+
Strategy 4: resources	Strategy 5: resources	• Paper-based resources were replaced by a website housing documentation and resources, except for printed posters outlining the SAAFE principles (for practice 1). • Less total equipment provided, five gymsticks and an equipment voucher were provided to schools rather than providing all the $6,000 equipment. • Promotional materials were not issued as part of the support strategy but instead for the completion of evaluation measures.	✓	✓	-
Strategy 5: prompts	Strategy 6: provision of prompts and reminders	• Support officers reminded in-school champions to implement the program rather than the in-school consultant reminding teachers. • Automated prompts to in-School Champions and PE teachers delivered via the program website.	✓	✓	+
Strategy 6: intervention implementation performance	Strategy 7: implementation performance monitoring and feedback	• Feedback was automated via the program website and was directly against the physical activity practice milestones (as practice implementation builds over two school years and is designed to be ongoing). • Feedback was automatically sent to (website registered) in-School Champions and Principals. • No direct observations were undertaken by the Support Officer.	✓	✓	0

A total of 20 adaptations were made to scale-up PA4E1, including seven to individual physical activity practices and six to implementation support strategies. A further six adaptations were made to the evaluation methods and one adaptation to all physical activity practices, not included in this table. For a description of each coding category, see the methods and FRAME (13). See Additional File 3 for a complete dataset of the types and reasons for each modification according to the FRAME (13).

^*Tick (✓) indicates agreement with the question (i.e., yes). Cross (X) indicates disagreement with the question (i.e., no).

PE, Physical Education; SAAFE, Supportive Active Autonomous Fair Enjoyable; RT4T, Resistance Training 4 Teens; NSW, New South Wales.; NESA, NSW Education Standards Authority.