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Background: The HealthWorks: Fitness for Life project was a multi-year initiative implemented across six Southwestern USA school districts aimed at increasing physical activity, improving physical education quality, and promoting healthy behaviours among students. Objectives: This study examined long-term trends in teacher-led movement integration, evaluated the impact of professional development, and identified factors influencing the sustainability of activity-promoting practices in schools. Methods: Data were collected over 7 years using multiple sources, including teacher self-reports, school records, policy reviews, and classroom observations. Analyses focused on longitudinal trends in movement integration, the implementation of Wellness Weeks, levels of administrative support, and policy enforcement. Results: Teacher-led activity breaks increased from approximately one to seven per week on average. Higher implementation rates were observed in schools that emphasised professional development and leadership support. Structured Wellness Weeks showed strong engagement and sustained participation. However, inconsistencies in policy enforcement and curriculum constraints limited broader adoption. Teachers who received ongoing mentorship and training were more likely to sustain movement-integration practices. Conclusions: Sustaining active school environments over time depends on consistent professional development, strong leadership support, and integrated, school-wide strategies. Addressing policy inconsistencies and structural barriers is critical to enhancing long-term implementation and delivery.
Yu et al. (2026) studied this question.