Posters 1

Background: To explore why and how physical activity programs work, there is a need for high-quality process evaluations. Physical Activity 4 Everyone (PA4E1) is a whole-school physical activity program, with demonstrated efficacy from a randomised controlled trial (2012-2014). PA4E1 was adapted and tested in a scale-up trial (2017-2020).

Purpose: Firstly, to describe the acceptability, appropriateness and feasibility of PA4E1 in the scale-up trial, from the perspective of school staff involved in PA4E1’s management and delivery. Secondly, to generate themes that may explain school staff assessments of acceptability, appropriateness and feasibility.

Methods: Data were collected at various time-points throughout the two-year implementation phase. Online surveys, focus groups and interviews were collected from in-School Champions, Head PE teachers, Principals, and PE teachers involved in the delivery and management of the program in secondary schools (n=24). Published data on website engagement, adaptations, modifications and school PA4E1 practice implementation (primary trial outcome) were triangulated with surveys, interview and focus group data during analysis to generate codes, then refined into themes.

Results: School staff delivering PA4E1 reported it was highly acceptable, appropriate, and feasible. Seven themes were generated relating to: how the program was funded; delivery modes of implementation support; identification of easy-wins; recruitment of the right in-School Champion; facilitating principal buy-in; mitigating the impact of school staff turnover; and, engaging the whole school.

Conclusions: Acceptability, appropriateness, and feasibility of PA4E1 were high. Recommendations based on the generated themes will be made, for example, provide clear guidance to schools when choosing their ideal in-School Champion.

Practical implications: The findings may inform future adaptations to PA4E1 and potentially other school-based physical activity programs more generally, as well as future scalability assessments of the suitability of PA4E1 for dissemination.

Funding: NSW Ministry of Health, Translational Research Grant Scheme; Cancer Council NSW; Hunter Medical Research Institute.

Background: Rising concerns that leisure time physical activity (PA) is being replaced by video gaming, yet there is a lack of evidence that the displacement hypothesis is true among adolescents. Purpose: To examine the associations between video gaming and PA among Finnish 11y –20y olds, and how associations may change by school type. Methods: The self-reported Finnish School-aged Physical Activity (F-SPA) studies for 2020 (high school students) and 2022 (upper general secondary students) were pooled together. Two genres of video games, 1. sport simulations, and 2. esports, were categorized into “a lot” and “not a lot” of gaming. Single item moderate to vigorous PA for at least 60 minutes per day was converted into four categories (0–2; 3–4; 5–6, 7 days). Odds ratios via multinominal logistic regressions with reference = 0-2 days were performed. Results: More of the sample were from high school (n=2406) than upper general secondary School (n=946). Of these, 17% (n =552) of students reported playing a lot of sport simulation games, and 43% (n=1431) reported playing a lot of esports. Playing a lot of esports (5-6 days, OR = .7, CI=.57–.97; 7 days OR=.5, CI=.37–.70) was negatively, and playing a lot of sports simulation games (7 days, OR=1.6, CI=1.11–2.30) was positively associated with PA compared to the reference category. Conclusions: The displacement hypothesis was partly supported, depending on the genre of video games, namely playing esports. Contrary to the hypothesis, playing a lot of sport games was associated with more PA, suggesting the importance of sport simulations as part of a physical activity relationship. Practical implications: Not all gaming is bad for health. Sports simulation gaming is part of a PA culture. Funding: The study was funded by the Finnish Ministry of Education and Culture.

Background: The Out of School Hours Care (OSHC) setting provides opportunities for promoting child physical activity. An mHealth app was co-designed with OSHC stakeholders to promote physical activity and nutrition. Purpose: To test the feasibility, acceptability and potential efficacy of The Eat Smart Play Smart app to support OSHC staff in the promotion of physical activity. Methods: Using a pilot parallel-group cluster RCT, services were recruited from two Local Health Districts in New South Wales, Australia. Feasibility was determined by recruitment and attrition rates. Acceptability was assessed post-intervention via questionnaire and data analytics on app usage were captured. Potential efficacy was determined through validated observational tools of staff physical activity-promoting behaviours. Differences between groups in staff behaviours were analysed using linear mixed models. Results: 15 OSHC services were randomly assigned to intervention (n=8) and control (n=7) groups. App installation instructions were sent to 34 OSHC educators and directors within the intervention group, and 24 participants (71%) downloaded the app. A 65% increase in app usage was noted on days push notifications were sent compared to other days. One-quarter of users accessed the app at least weekly. The acceptability questionnaire was completed by 65% of participants. Ninety-three percent found the app easy to use, trusted the information, and would recommend the app. Staff physical activity-promoting behaviors increased over time in both groups. There were no significant between-group differences. Conclusions: Our evaluation showed high feasibility and acceptability and resulted in increased uptake of physical activity resources. While we did not find statistically significant results, there is a need for a fully powered RCT in future research. Practical implications: An mHealth app for Australian OSHC services was beneficial for staff and can influence physical activity-promoting behaviors. Funding: Supported by the Prevention Research Support Program, funded by the New South Wales Ministry of Health.

Background: Augmented reality (AR), where a computer-generated image is overlaid on the real world viewed through the camera of a smart device, is becoming increasingly available in children’s lives. AR has been shown to increase participation in physical activity and social interactions in an adult population but also induce simulator sickness. However, the potential benefits and risks of AR use by young children is unclear. Purpose: To investigate the potential benefits (physical activity and enjoyment) and risks (simulator sickness and loss of peer connection) of an AR enhanced laboratory playground on young children. Methods: In pairs, thirty-four 5–8-year-old children and their caregivers attended a laboratory set-up as in an indoor playground. They completed four animal search tasks, in either toy or AR (Apple iPhone) play conditions. Thigh-mounted accelerometer (SENS) data was analysed to assess time spent in different postures and movements. Children rated their enjoyment, peer connection and simulator sickness on questionnaires. Caregivers also rated their child’s enjoyment. Results: Children spent longer engaging in the AR conditions (279 vs 235secs). Time spent walking was the same, but more time was spent performing squats in AR (diff=7.3secs) and running in toys (diff=24.3secs). Children rated AR more enjoyable than toy play (84% in favour of AR), with parents reporting the same preference. The same level of connection with their peers was reported during AR and toy play (4.9±2.2 vs 4.7±2.2). Most children reported no simulator sickness symptoms. Conclusions: AR can encourage physical activity and more enjoyment without a negative impact on peer connection or simulator sickness symptoms. Practical implications: AR enhanced playgrounds could motivate young children to be physically active while still engaging with their peers. Funding: The Australian Research Council Centre of Excellence for the Digital Child and a Curtin School of Allied Health 2023 Teaching and Research Grant.

Background: The quantity of physical activity one accrues is associated with many health benefits. The quality of physical activity, often operationalised as children’s fundamental movement skill (FMS) proficiency, is also related to health outcomes including physical fitness, weight status, and perceived competence. Traditionally, assessments of FMS are conducted manually by trained raters, which is time consuming and susceptible to biases. Purpose: To evaluate the performance of an artificial intelligence-based system for FMS assessment. Methods: FMS performances for jump (n=1,327) and hop (n=1,084) of preschool-aged children (4.51 years, SD=0.79; 57% boys) were video-recorded and scored by a trained rater using the Test of Gross Motor Development version 3 (TGMD-3) criteria. Using these ratings as the ground truth, Skinned Multi-Person Linear models of the performances were extracted and trained using the Long-Short Term Memory architecture, a form of recurring neural network. 80% and 20% of inputted data was used for model training and evaluation, respectively. The percentages of accurate ratings with respect to each TGMD criterion was evaluated. Results: The overall agreement between model and expert ratings across all tested criteria (four for each skill) ranged between 57% to 93%, with a mean of 75%. Conclusions: Our results, while only being modest in some criteria, suggest the approach has potential and assessment models for other FMS should be developed and evaluated. Nonetheless, we observed that video resolutions and shooting angles may impact assessment performances. Video-recording protocols would have to be reviewed and modified in order to improve assessment accuracy. Practical implications: If successful, this system, which is currently linked through a mobile application, could be applied to global research and used as an objective, efficient, and uniform approach for motor skill assessment. Funding: The project was supported by the Research Impact Fund, University Grants Committee, Hong Kong.

Background: Smartwatch activity trackers are devices that measure physical activity levels with features that aim to encourage physically active behaviours. These devices have shown promise for increasing physical activity levels among school-aged children, adolescents, and adults. However, it is unclear whether the use of these devices is feasible and effective in young children. Purpose: To explore parental perspectives on the use of smartwatch activity trackers by young children. Methods: Semi-structured interviews were conducted with 22 parents of children aged 3 – 5 years exploring their perspectives on the feasibility, potential implications and roles of smartwatch activity tracker use by young children. Interviews were audio-recorded, transcribed verbatim, and data analysed using thematic analysis. Results: Preliminary analysis indicates that parents perceive that the use of these devices by young children is feasible, and that temperament and developmental stage/abilities are important considerations. Parents reported concerns related to the potential negative impact of the devices providing extrinsic motivation to move (e.g. providing updates on daily activity goals), the guilt parents may feel with low physical activity measures, and the safety and privacy of their child’s information. Most parents believed that young children are inherently active and do not need devices to support physically active behaviours. However, most parents were interested to know how much physical activity their children were doing and that there may be a role for these devices for children who are less physically active. Conclusions: Parents reported temperament and developmental stage/abilities are relevant when considering the feasibility of smartwatch activity tracker use by young children. Parents also believed there is limited role for these devices in young, active children. Practical implications: Further research should explore the role for smartwatch activity trackers to support families of inactive young children. Funding: Curtin School of Allied Health 2023 Teaching and Research Grant.

Background: There is a scarcity of openly-accessible algorithms for classifying children’s physical activity types and postures. The ActiPASS software – based on the open-source Acti4 algorithm – can be used to classify physical activity types in adults using thigh-worn accelerometry. However, the original algorithm has not been validated in children, nor has it been compared to a child-specific set of algorithm thresholds. Purpose: The objective of this study was to evaluate the accuracy of two ActiPASS thresholds for classifying physical activity types and postures in children. Methods: The laboratory condition comprised 41 children (11.0 ± 4.8 years; 46.5% male), while the free-living condition comprised 15 children (10.0 ± 2.6 years; 66.6% male). Children were asked to complete a standardized activity protocol in the laboratory condition and up to 2 hours of self-selected activities during the free-living condition. A single accelerometer (Axivity AX3, 100 Hz and ±8 g) was worn by the participants on the dominant thigh. Annotated video recordings were used as reference across both conditions. Results: Using the original adult thresholds, the mean balanced accuracies (95% CI) for the laboratory condition ranged from 0.62 (0.56 – 0.67) for lying down to 0.97 (0.94 – 0.99) for running. For the free-living condition, the balanced accuracies ranged from 0.65 (0.51 – 0.79) for lying down to 0.96 (0.92 – 0.99) for cycling. No differences between the adult and child-specific algorithm thresholds were observed, except for walking in laboratory conditions. Conclusions: The validation results indicate that ActiPASS can accurately classify the types of physical activity performed by children using a single accelerometer worn on the thigh. Practical implications: Researchers may choose to use ActiPASS with either of the two existing thresholds to identify basic activity types in children. Funding: CL is supported by a fellowship of the German Academic Exchange Service (DAAD).

Background: The use of time-matched Geographic Positioning Systems (GPS) and accelerometry data holds great promise for better understanding the micro-level environmental factors (street-level features) that influence active travel in populations. However, processing and analyzing these data in ways that yield meaningful insights for answering health and place questions, and inform built environment policy and action, remains challenging. Purpose: To develop an open-source code that integrates GPS and accelerometer data for exploring the patterns of active travel to/from schools, and associated geospatial factors. Methods: We developed an open-source, Python-based code integrating QTravel BT-10000 GPS and GT3X-wBT Actigraph device data via temporal matching and used it to process data from the STREETS study, a natural experiment assessing the impact of a Safe Routes to School intervention in Austin, Texas, USA, on active-travel-to-school among elementary school (9-10 years) children living within walking distance of school. Parental surveys and child accelerometer counts were used to calibrate travel mode detection. Routes were geocoded using ArcGIS. Results: GPS and accelerometer data were processed for 326 participants at baseline, of which 28.2% engaged in at least one walking or cycling trip to/from school during the assessment week. GIS analysis is underway. Preliminary findings suggest that most walking and cycling trips to/from school do not happen in the “fastest/nearest route”, and occur more frequently along routes with high tree canopy and sidewalk coverage, and built-up areas. Conclusions: This open-source tool provides a novel and valid approach to comprehensively examine children’s interaction patterns with their neighborhood environment while actively commuting to school, and how these interactions influence physical activity and health outcomes. Practical Implications: This tool and analysis framework can be used to inform urban design standards near school areas to provide all children the opportunity to safely, comfortably, and enjoyably walk or cycle to school. Funding: NIH R01HD097669.

Background: Regular physical activity (PA) is part of GDM management, but most women are not sufficiently active. In Quebec (Canada), qualified exercise professionals are rarely included in medical teams caring for GDM women. It is therefore essential to find a way to support women towards a more active lifestyle, without adding to the burden of patient care by clinicians. Nowadays, more lifestyle interventions are moving from traditional patient–provider encounters to digital platforms. The use of computer-tailoring technology, combined with proven theory-based interventions is of particular interest. Purpose: To develop a m-health application to promote PA and glycemic control in women with GDM. Methods: Co-construction phase: 1) Focus groups were conducted with end-users (i.e., GDM women and clinicians) to gather their needs, expectations, and preferences regarding various aspects of the application and to identify best strategies to ensure users’ engagement. 2) The content of the application was developed. Briefly, the theoretical underpinnings for the intervention’s development were derived from the “multi-process action control model”, which is a framework created as a practical approach to PA promotion based on theoretical and empirical evidence. 3) The content and format of the application were validated by end-users. Proof-of-concept phase: 1) The use of the application will be tested in a clinical setting to assess a) feasibility; b) impact on PA and glycemic control (preliminary analyses). Conclusion and practical implications: This project will respond to a need raised by GDM women and clinicians by offering them a tool to support motivation and empowerment towards PA and glycemic control. This will improve the care and services offered to patients. Funding/Parteners: Diabète Québec, Fondation Santé Trois-Rivières, Université du Québec à Trois-Rivières Research chair in prenatal physical activity and maternal and neonatal health; Ikigai Développement Inc.; Réseau de recherche sur la santé cardiométabolique, le diabète et l’obésité.

Background: The growing popularity of esports (video game competition) is pushing schools to offer programs (Schaeperkoetter et al., 2017). Esports are sometimes considered problematic, due to the lack of physical activity (PA) and its sedentary nature. Conversely, professional esports athletes have better lifestyle habits than the general population (Monteiro Pereira et al., 2022). Purpose: The objective of this research project was to document the effects of participation in an esports program on different lifestyle habits and health. Methods: Students (n = 39) aged 12 to 16 divided into three programs (esports, sports and regular) participated in the project. They wore an accelerometer for seven days, answered questionnaires about their physical and mental health and participated in a focus group on the risks and benefits associated with esports. Results: Esports students are more sedentary and practice less PA than those in other programs. The time spent playing video games during the week and on weekends is not different between the three programs. Most students reported that the time they spend playing video games has a negative effect on their sleep and physical health, but a positive effect on their social relationships and mental health. Conclusions: There is little research on the lifestyle habits of esports players. Examining the phenomenon of esports in school context could lead stakeholders to better define and understand this innovation and thus reduce the impacts that certain students or schools may face (Bányai et al., 2018). References Bányai, F., et al. (2019). The psychology of esports: A systematic literature review. Journal of gambling studies, 35(2), 351-365. Masala, D., and Iona, T. (2018). The Psycho-pedagogic Value of Video Games and E-sports. Senses and Sciences, 5(4), 676-683. Schaeperkoetter, C. C., et al., (2017). The “New” Student-Athlete: An exploratory examination of scholarship eSports players. Journal of Intercollegiate Sport, 10(1), 1-21.

Background: TransformUs program has improved physical activity (PA) and reduced sedentary time (SED) in primary schools through active pedagogy and supportive classroom and school ground environments. Purpose: This pilot study aims to trial TransformUs to determine the effect on PA and SED in secondary schools. Methods: This study involved adolescents (n=129) from three Australian schools. Each school selected a different combination of TransformUs strategies (active classrooms, active recreation, and supportive school environments) to increase PA and reduce SED, which included active academic breaks/lessons, standing desks, teacher’s professional development, sport/fitness equipment, and organised activities. Interventions spanned 12, 11, and 6 weeks for schools 1, 2, and 3, respectively. Garmin Vivosmart 4 heart rate monitoring tracked SED and PA (light [LPA], moderate [MPA], and vigorous [VPA]) at baseline, every 2 weeks during the interventions, and at follow-up. Mixed model analysis separately assessed intervention effects on each school’s SED and PA during school, class, and recess. Results: School 1 showed no significant intervention effect. School 2 exhibited increased MPA during class time in the first 2 weeks, with significant variations during recess. School 3 displayed decreased LPA during the second 2 weeks of intervention compared to baseline, particularly during class time. Secondary analysis revealed significant differences within the intervention period, including increased SED and decreased LPA during recess in the first 2 weeks. Conclusion: Overall, no movement behaviours were significantly changed before and after the intervention in any of the three schools during school time. Significant changes in SED, LPA and MPA within the intervention period indicate variability in the response to the implemented strategies. Practical implications: The variability in response to the implemented strategies among the three schools highlights the importance of carefully tailoring interventions to each school’s specific context and needs. The study was funded through the Victorian Department of Education.

Background: There is an urgent need to tackle low physical activity (PA) levels in Australia and the Pacific Islands. This necessitates innovative solutions to address insufficient daily moderate-to-vigorous PA (MVPA) in adolescents. The iEngage program, co-designed with a digital health industry partner, is a modular and technology-based health educational program that was designed to enhance MVPA among adolescents. It was tested in distinct school contexts, specifically in Australia and New Caledonia. Methods: iEngage was implemented a) in urban area with two Sydney schools over 5 weeks, engaging 10–12-year-olds (n = 57), and b) in remote area with 24 adolescents from New Caledonia aged 12 to 14 years. The program incorporated technology, integrating Misfit Ray© activity trackers and mobile apps, while providing goal-setting guidance, self-monitoring, and experiential learning. Results: In the urban iEngage study, adolescents exhibited a 30% increase in daily steps (+2647 steps/day, P < .001) at completion of the program, with boys outpacing girls in goal attainment. Proportion of days exceeding 11,000 steps increased from 35% to 48%, indicating sustained improvement. In the trial implemented in a remote area, adolescents showed a consistency rate of reaching 11,000 steps per day peaking at 59% toward the end of the program, demonstrating progressive adherence to international recommendations. Daily behaviour clustering indicated a 27% increase in adherence, which was particularly noticeable in less active adolescents. Conclusion: These trials collectively affirm the efficacy of technology-supported educational programs in enhancing adolescents' PA levels in both urban and remote contexts. The iEngage program, with its comprehensive approach, successfully empowered adolescents to set and achieve PA goals. These findings underscore the potential of technology-driven interventions to bridge the gap between global health recommendations and the specific needs of Pacific adolescents, providing valuable insights for future health promotion initiatives. Funding: Pacific Fund, Diabetes Australia.

Purpose Creating safe spaces for vulnerable populations like children is essential for their physical and mental well-being. Outdoor gyms (OGs) create safe spaces for children, by providing opportunities for them to engage in activities improving their physical wellbeing. This observational study aimed to determine the pattern of use for park and recreational facilities, including OGs within these facilities, across the CCT by children from June 2022-September 2023. Methods A cross-sectional, observational study in collaboration with the CCT and the University of Cape Town to investigated the use of OGs across 18 parks and recreational facilities, in low- and middle-high-income areas. Data collection used an adaptation of the SOPARC tool to observe OG use, age, and physical activity intensity. Intercept surveys were completed by individuals 18 years and over (N=248). Statistical analysis was performed determining demographic (gender, location), socioeconomic status, and gym equipment type/number. A heat map was created to identify OG use intensity. Results There were 2,842 visitors observed across 18 parks and recreational facilities with 52.4% observed to be a child. Most experienced moderate physical activity (MPA). Children were most likely to use the “Monkey Horizontal Bars”. Low-income, highly populated areas had the highest proportion of child users. Perceived safety of OGs and related facilities were significantly associated with the number of children using the OGs (P=0.026). However, when facility attributes including access, perceived safety, and equipment were considered; access to the OG was the preferred choice (P=0.056). Conclusion Outdoor gyms associated with recreational public spaces were widely used by children engaging in at least MPA, especially in low-income areas in the CCT. Perceived safety and access facilities were factors associated with OG use by children. It is recommended that OGs have the potential to be safe, equitable spaces for supervised play for children to improve their physical wellbeing.

Context:In order to empower local stakeholders to address the issues of physical activity (PA) and sedentary behavior (SB) by providing them with knowledge, benchmarks, and data specific to their territories, the French National observatory of physical activity and sedentary behavior (Onaps) has developed and implemented a method for local diagnosis. This method aims to provide stakeholders with decision-making elements and to design an action plan tailored to each territory. This approach pursues four objectives: i)Analyze the adequacy between the offer of physical and sports activities, practices, barriers, and population perceptions, ii)Identify existing best practices and resources to mobilize, iii)Raise awareness and break down barriers between stakeholders, iv)Identify levers to integrate these findings into territorial documents and tools. Evaluation:In order to assess the adequacy between the current offer, needs, territorial inequalities, and action levers, the indicators considered in the diagnosis, allowing the monitoring of their evolution, are: planning documents integrating actions in favor of physical activity, data on facilities, sports clubs, licensed sports practice, travel flows and mobility (context and type), associative offer, levels of PA and SB of the population, practices of local stakeholders, health indicators related to PA and SB. Conclusions:24 recommendations were presented: 9 focus on the management of a territorial sports project, active mobilities, reducing territorial and social inequalities, the quality of actions, and territorial coordination. The other 15 recommendations concern every stage of life, from young children to seniors. Practical Implications:Nearly twenty actions have been implemented in the territory following the diagnosis: creation of educational trails, training for professionals assisting elderly people living at home, active design in school playgrounds, creation of a “Maison Sport Santé”, awareness project in middle schools, etc. The diagnostic method is now being deployed by Onaps in other territories and populations. Funding:Ministry of Sports and Olympic and Paralympic Games, Paris 2024.

Background: Improving children’s physical activity is complex due to multiple determinants working together in a complex interplay. Participatory system dynamics approaches have shown promising potential to understand and work with such complex health problems. However, evaluating such approaches through a systems lens is still an emerging academic field. Purpose: To present how a systems lens is applied in the evaluation of the Child-COOP Denmark trial. Methods: The Child-COOP Denmark trial is a 3-year system dynamics trial promoting healthy physical activity behaviour in ~2000 children aged 6-12 years across ten communities and five municipalities in Denmark. The Child-COOP Denmark trial is based on a participatory Group Model Building (GMB) approach. The comprehensive system evaluation design combines qualitative and quantitative data using a) a new practice-oriented tool combining Ripple Effect Mapping and Action Scales Model, b) qualitative Community Readiness assessment, c) Stakeholder-driven Community Diffusion survey, d) Social Network Analysis and e) Participatory Mapping. Results and practical implications: We will present the design and methods of the system evaluation as well as baseline results from the Participatory Mapping and Community Readiness assessment (data collected spring 2024). While we also discuss implications and potential of our overall evaluation approach within participatory system dynamics approaches. System Level Evaluations generates data that on how practice work and navigate complex health problems and once returned to practice may give directions on how to improve their work in the applied area of work. Conclusion: System level evaluations are still an emerging field within public health. Thus, it is important to share design and methods to stimulate knowledge sharing and collaboration across the academic field to ensure standardization. Funding: This study received funding from Novo Nordisk Foundation.

Background: Research indicates 21% of primary schoolchildren and 16% of post-primary schoolchildren in Northern Ireland (NI) currently meet the daily recommended minimum of 60 minutes of moderate-to-vigorous PA. Whole-of-school approaches have been identified as one of 7 key investments for PA promotion, including active classrooms and high-quality physical education. Purpose: This research involves adapting and feasibility testing two successful interventions: TransformUs (primary schools, Australia) and the Youth – Physical Activity Towards Health (Y-PATH) intervention (post-primary schools, Ireland) for the NI context. Methods: As part of the adaptability, the interventions were rebranded as Children – Sit Less, Move More (C-SLAMM) intervention (formerly TransformUs) and Y-PATH NI. Within both studies, we conducted focus groups with pupils, and interviews with stakeholders (ranging from parents to school senior leadership), to understand current views and perceptions of opportunities for PA within the classroom and wider school environment. In addition, we conducted an online survey with n1500 post-primary schoolchildren to better understand their preferences for PA provision. Results: Findings from the Y-PATH NI study have highlighted a preference for PA to be provided with friends, during schooltime. Findings from our qualitive work highlighted several important factors that should be closely considered within school-based PA promotion, including incorporating an element of choice, adaptability, and flexibility within approaches. Based on findings from the qualitative work, we feasibility tested the C-SLAMM intervention in 8 primary schools in Northern Ireland, over an 8-week period. Conclusions and practical implications: Evaluation of the C-SLAMM intervention highlighted the importance of stakeholder buy-in from teachers, parents, and pupils if school-based PA promotion is to be successful. This feasibility work developed methods to assess implementation and adherence, which will be utilised within our feasibility testing of the Y-PATH NI intervention, commencing in early 2024. Funding: Northern Ireland Chest Heart and Stroke.