Table 3.

Institutional level (school) of a conceptual framework for School-Based Physical Activity Interventions in Children Aged 7–11 Years of program theories (context-mechanism-outcome).

Context	Mechanism	Outcome	Supporting Evidence
If the school leadership implement changes to school level policy to support physical activity.	Then teachers see the high-level support which increases importance of physical activity and enables a whole school approach.	Effective implementation and increased child physical activity.	Gorely et al. [25]
	But, when there are competing academic demands and reduction in high level support.	The Physical activity program loses support and implementation fidelity is low.	Holt et al. [61]
School based resources are stretched, and time is limited. If the physical activity program characteristics require school resources.	Then a low cost and set up that is easy to deliver within the stretched resource base.	Higher implementation of the program and increased child physical activity.	Drummy et al. [40]
	But, if higher costs/time is required the program is viewed as impractical and no time to implement.	Ineffective and/or inconsistent implementation of the physical activity program.	Kang and Brinthaupt [47] Gorely et al. [56] Holt et al. [61]
If the school workforce structure includes a dedicated staff position for physical activity.	Then it increases the chance of program sustainability and continuity	Program implementation, delivery and maintenance are improved.	Burns et al. [54]
If the characteristics include structure and adult supervision of physical activity (e.g., active learning, formal playtime program).	Then the whole class/group engages with the program. But the program will stop when the formal intervention stops.	Children are happy to participate and certain groups, especially girls, increase their physical activity during the intervention. But this is not maintained beyond the formal intervention.	Dzewaltowski et al. [43] Ridgers et al. [49] and [50] Efrat [44]
But if the characteristics of the program is unstructured physical activity (e.g., increased recess time or free play equipment).	Then it stimulates creativity and child autonomy increases with more self-directed physical activity.	More sustained increases in child physical activity and PA maintains challenge.	Hyndman et al. [29] Engelen et al. [52]
If the school playground environment is maximized including staggered lunch times and sectioning areas for specific activities.	Then girls are more likely to occupy play spaces they normally do not and there is an increased choice of physical activity.	Reduced gender differences in physical activity and overall increased child physical activity.	Janssen et al. [46] Ridgers et al. [49,50]
But if the school playground is supervised but otherwise not managed.	Then certain spaces remain occupied by specific groups and there are dominant play characteristics (e.g., football).	Differential intervention outcomes (e.g., of increased play time) by age and gender, older children may reduce physical activity.	Janssen et al. [46] Ridgers et al. [49]
And if training is provided for playground supervisors.	Then supervisors initiate activities and increase use of play equipment.	Sustained stimulus for physical activity and increased child physical activity.	Gorely et al. [25]
But if training is not provided for playground supervisors during an intervention.	The intervention can be seen as interference with a chance to socialize among staff	Intervention program loses support and low implementation fidelity.	Huberty et al. [45]
If the school has approaches related to adverse non controllable factors such as adverse weather.	Then alternative indoor classroom physical activity can take place and disruption is minimized.	Physical activity is sustained and unaffected by adverse weather.	Martin and Murtagh [22]