Real-world evidence of physical activity practices and policies in Greater London primary schools: A cross-sectional survey

Abstract

Background The World Health Organization (WHO) recommends six domains for a whole-school approach to promote physical activity (PA) levels. This approach aims to help children achieve 30 of the recommended 60 minutes of daily moderate-to-vigorous physical activity (MVPA). Evidence on PA practice and policy in school settings is limited, particularly in urban areas with high deprivation, where children’s PA levels are lowest. Methods We developed a 20-item survey based on the WHO domains and distributed it to 1826 state-funded primary schools in all 32 Greater London boroughs between 6 November 2023 and 31 December 2024. We extracted survey items relating to each domain and calculated the percentage of schools reporting each practice. Results Our sample of 185 schools (10.1%) included at least one school from each borough and was broadly representative of school populations in Greater London, except that responding schools were more likely to have fewer pupils eligible for free school meals. Most schools (68.5%) reported implementing at least one practice aligned with each of the six WHO domains. Specifically, 98.4% reported providing curricular physical education (Domain 1), 78.9% had an active travel plan (Domain 2), 98.4% offered PA opportunities before/after school (Domain 3), 92.4% provided opportunities for PA during breaks (Domain 4), 81.7% incorporated PA into lessons (Domain 5), and 81.5% reported supporting the inclusion of pupils with additional needs in PA opportunities (Domain 6). However, implementation within domains varied; for example, only 53.5% met the nationally recommended two hours of physical education per week, with similarly low levels for before‑school PA provision and active travel initiatives. Conclusion Most primary schools in this large, multi-ethnic urban sample reported school policies and practices aligned with WHO domains, suggesting that a whole-school approach to creating an active school environment is feasible to implement. However, we identified areas for improvement within domains, and alignment alone may be insufficient to meaningfully increase children’s PA levels. This study provides a foundation for future research linking active school environments with children’s PA and mental health, thereby informing efforts to increase MVPA and promote equitable outcomes.