Integration of physical activity throughout the school day – A mixed method study

Despite schools providing an important environment for promoting active behaviors, achieving recommended physical activity (PA) levels among children remains challenging. In Sweden, the national Movement Initiative in Schools (MIS) (2021–2031) aims to increase PA throughout the school day. However, schools face difficulties integrating such initiatives into daily practice. Therefore, this study aimed to investigate the facilitators and barriers to the integration of MIS and explore school staff’s experiences and perceptions of its integration into daily practice. A mixed-method explanatory sequential design was used. This study included 132 schools in central Sweden. Survey findings informed an interview guide based on Normalization Process Theory (NPT) constructs: coherence, cognitive participation, collective action, and reflexive monitoring. A total of 135 participants completed the surveys, of whom 14 participated in focus group interviews. Overall, 80% reported positive agreement or strong agreement across the four NPT constructs. Qualitative content analysis resulted in five categories concerning resources and support, leadership, information transfer, perceived value, and dependency on local champions. In conclusion, while engagement and perceived psychosocial benefits of MIS were high, integrating PA into routine school practice depended largely on school-level capacity and support. Key barriers included limited resources, inconsistent leadership support, and insufficient knowledge transfer.