Can data-driven insights and co-design be used to develop bespoke strategies to support physical activity in primary schools?

Background The aim of this study was to examine whether wearable-derived physical activity data can feasibly support the co-design of context-specific strategies aimed at enhancing pupils’ physical activity in primary schools. There is enormous variability in physical activity within-and-between schools, and advances in wearable technologies provide new opportunities to generate objective, school-specific insights into pupils’ physical activity, which could be used to inform tailored strategies to address inactivity. Methods A mixed-method study was conducted with 549 pupils aged 6–12 years, from 38 classes across seven primary schools in the South West of England. Baseline physical activity was measured over three weeks using a commercially available accelerometer designed for schools. Physical activity data were summarised and visualised to support workshops with teachers, where school-specific strategies were co-designed using the Creating Active Schools Framework. The strategies were implemented over a three-week period whilst physical activity continued to be monitored. Quantitative analysis assessed changes in device-measured physical activity, and qualitative data explored the feasibility and acceptability of the approach among teachers. Results Teachers implemented a range of strategies across the Creating Active School Framework, including classroom movement breaks, modifications to playground environments, and approaches to facilitate equitable pupil engagement. Overall, increases in device-measured physical activity were observed during the implementation period, with the largest improvements among the least active pupils, and greater increases among boys than girls. Teachers reported that wearable-derived data were useful for identifying opportunities to promote physical activity and to inform school-based strategies. Variability in teachers’ engagement may have influenced the extent of strategy implementation and associated physical activity changes. Conclusion Integrating wearable-derived physical activity data alongside co-design may be a feasible and promising approach for developing tailored, context specific strategies to increase pupils’ physical activity in primary schoolS. Clinical Trial Registration https://www.clinicaltrials.gov , Clinical Trial Registry NCT07050797.