Using the R = MC2 heuristic to assess whole-of-school physical activity implementation in elementary schools: a cross-sectional study.

Background: Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readin...

Full description

Bibliographic Details
Published in:International Journal of Behavioral Nutrition & Physical Activity Vol. 22; no. 1; pp. 1 - 9
Main Authors: Craig, Derek W., Lanza, Kevin, Pfledderer, Christopher D., Pavlovic, Andjelka, Onadeko, Kempson, Heredia, Natalia I., Injil, Jizyah, DeFina, Laura F., Walker, Timothy J.
Format: research tables/charts Journal Article
Published: BioMed Central 8/23/2025
Online Access:View this record in EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187496673&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 187496673
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        14795868
        1CR7
      jtl: International Journal of Behavioral Nutrition & Physical Activity
      issn: 14795868
      maglogo: N
    pubinfo:
      dt: 8/23/2025
      vid: 22
      iid: 1
      pid: 24147
      pub: BioMed Central
    artinfo:
      ui:
        187496673
        187496673
        187496673
        10.1186/s12966-025-01815-7
        187496673
      ppf: 1
      ppct: 8
      formats:
      tig:
        atl: Using the R = MC2 heuristic to assess whole-of-school physical activity implementation in elementary schools: a cross-sectional study.
      aug:
        au:
          Craig, Derek W.
          Lanza, Kevin
          Pfledderer, Christopher D.
          Pavlovic, Andjelka
          Onadeko, Kempson
          Heredia, Natalia I.
          Injil, Jizyah
          DeFina, Laura F.
          Walker, Timothy J.
        affil: https://ror.org/03gds6c39 Department of Health Promotion and Behavioral Sciences, UTHealth Houston School of Public Health, Houston, Texas, USA
      sug:
        subj:
          Physical Activity
          Schools, Elementary
          Health Promotion
          Exercise Education
          Implementation Science
          School Health Services
          Human
          United States
          Secondary Analysis
          Cross Sectional Studies
          Physical Education and Training
          Learning Environment
          Models, Theoretical
          Linear Regression
          Race Factors
          Ethnic Groups
          Leadership
          Organizational Culture
          Confidence Intervals
          Statistical Significance
          Data Analysis Software
          Descriptive Statistics
          Funding Source
      ab: Background: Schools are recommended to use a whole-of-school (WOS) approach to promote physical activity opportunities before, during, and after school. Yet, the barriers and facilitators to implementing a WOS approach successfully are not well understood. The R = MC2 heuristic, which defines readiness for implementation as a combination of an organization's motivation and capacity to implement, can enhance our understanding of implementation in the school setting. This study examines associations between constructs from the R = MC2 heuristic and schools' implementation of a WOS approach. Methods: We conducted a secondary analysis of cross-sectional data from U.S. elementary schools participating in the NFL PLAY60 FitnessGram Project during the 2022–23 school year. From surveys administered to school staff, we created a WOS index (range = 0–12) comprising six physical activity practices: physical education, recess, before and after-school programs, classroom-based approaches, and active transport. We also assessed how six constructs from the R = MC2 heuristic (i.e., culture, implementation climate, leadership, priority, resources utilization, resource availability) impact physical activity implementation using a series of questions measured on a 5-point Likert scale. We used linear regression models to determine associations between R = MC2 constructs (independent variables) and WOS index scores (dependent variable), controlling for school-level characteristics (student enrollment, percentage of race/ethnicity and economically disadvantaged students served) and state-level clustering. Results: The analytic sample consisted of 132 schools across 18 states. On average, school staff rated leadership (mean = 4.1, range = 1.5–5) and organizational culture (mean = 4.0, range = 2.25–5) the highest. The mean WOS index score was 6.1. Partially adjusted models indicated significant positive associations between each R = MC2 construct and WOS index scores. Fully adjusted regression models revealed priority (b = 0.88; p = 0.010; 95% CI = 0.19–1.56) and implementation climate (b = 0.69; p = 0.047; 95% CI = 0.07–1.32) were positively and significantly associated with WOS index scores. Conclusions: Our study provides insights into key implementation constructs associated with providing school-based physical activity opportunities. These findings can support the development of resources and implementation strategies which, in turn, can help schools address implementation-related disparities. This will help schools improve the quality and accessibility of opportunities for physical activity provided to students across the United States.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N