Co-designing policy, practice, and research directions for whole-school physical activity: towards sustainable culture change

BACKGROUND: Whole-school physical activity (WSPA) approaches are recognised globally as a key investment for increasing children's activity levels. Their success depends on translating national policy into effective school practices through systems-level thinking and multi-stakeholder collaboration. This study aimed to use an experience-based co-design process to produce and prioritise future directions for WSPA policy, practice and research by engaging international stakeholders to identify key roles, needs, and actionable recommendations. METHODS: The co-design process took place during a two-day international conference on Whole-School Physical Activity (#WSPA2024). Adopting a design thinking approach, 152 international stakeholders representing 16 countries engaged in two co-design workshops. Participants included professionals representing the policy (n = 64), practice (n = 26), or research (n = 62) sectors. Participants undertook tasks in either same stakeholder or mixed stakeholder groupings to explore and prioritise future needs for policy, practice, and research related to WSPA. All discussions were audio recorded, transcribed verbatim, and analysed using inductive thematic and content analysis. Prioritised actions were synthesised and recommendations to support the future of WSPA were drafted. Stakeholders reviewed the drafted recommendations and proposed modifications using an online questionnaire. RESULTS: Twenty-four recommendations (10 for policymakers, eight for practitioners, and six for researchers) to prioritise and plan for WSPA were developed. These are represented by six interlinked themes reflecting conditions for change: systems thinking, partner engagement and collaboration, equity and inclusion, evidence-based and action orientated, knowledge mobilisation, support and capacity building. CONCLUSIONS: WSPA approaches should be viewed as a long-term systems change agenda requiring aligned policy, adaptable practice, and innovative research. The WSPA recommendations provide a platform for multi-sector collaboration, co-production, and investment in scalable, context-sensitive solutions.