The complexity of promoting physical activity in English state primary schools: an in-depth qualitative analysis of the role of social context

• Published in: BMC public health Vol. 25; no. 1
• Main Authors: Walker, Robert, House, Danielle, Porter, Alice, Salway, Ruth, Kent-Saisch, Simona, Beets, Michael, Lubans, David Revalds, de Vocht, Frank, Jago, Russell
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 25.08.2025; BioMed Central
• Subjects: Elementary schools; Exercise; Health aspects; Health promotion; Methods; Safety and security measures; United Kingdom; United Kingdom
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-025-23471-z

Primary schools present an opportunity to equitably promote physical activity. To date, school-based interventions have had limited success. Contextual differences between schools could be a key factor that contributes to this lack of impact. However, the elements that constitute a school's social context (i.e. the organisational, political, cultural, and sociodemographic characteristics) and how they might impact on primary school physical activity are unclear. The aims of this study were to conduct an in-depth qualitative analysis of state primary school social context related to physical activity and, using this analysis, provide recommendations for policy and practice. We conducted one-to-one semi-structured interviews with 33 state primary school staff in Southwest England between November 2023 and January 2024. Staff roles included headteachers/principals (n = 5), deputy headteachers/principals (n = 5), class teachers (n = 7), Physical Education (PE) subject leads (n = 8), dedicated PE teachers (n = 4), teaching assistants (n = 2), and one Parent Teacher Association chair. Staff were recruited from 19 purposively-sampled schools with a range of school sizes and sociodemographic characteristics. We used reflexive thematic analysis. Five themes were generated that highlighted: (1) the impact of regulatory systems and curriculum pressures created an environment where physical activity was difficult to prioritise; (2) schools with high pupil needs experienced increased pressure, which sometimes impacted staff motivation and wellbeing; (3) senior leadership priorities were key to promoting pupil physical activity, influenced by their personal interests/background/values, regulatory inspections, curriculum pressures, and pupil needs; (4) limited PE training during teacher training impacted teacher confidence that, when combined with curriculum pressures, led many schools to outsource PE to external enterprise; and (5) "passionate" individual staff members who dedicated their own time were important to drive physical activity in the pressured school environment. Revisions to school regulatory systems and policies are needed to enable schools to prioritise physical activity so it is not dependent on "passionate" individuals. Senior leadership plays a key role in prioritising physical activity in the high pressure state primary school environment. It is important that practitioners and researchers consider these diverse and challenging social contextual factors within English state primary schools in intervention design.