Social–Ecological Considerations in Sustaining Comprehensive School Physical Activity Programs: A Follow-Up Study

Purpose: The purpose of this study was to investigate the perspective of school personnel regarding the impact of social–ecological factors and to identify salient ways to support school personnel in sustaining Comprehensive School Physical Activity Programs. Methods: In this mixed-methods longitudinal study, stakeholders were surveyed at two points in time (n = 67) and interviewed in semistructured interviews (n = 41) using card sorting to understand the influence of social–ecological factors on Comprehensive School Physical Activity Programs sustainability. Results: Across time, the perceived influence of social–ecological levels varied considerably: individual, t(78.86) = −4.22, p < .001, d = 0.52, interpersonal, t(88.20) = −2.32, p = .023, d = 0.09, organizational, t(80.56) = −2.38, p = .02, d = 0.29, and the community factor, t(83.24) = −3.05, p = .003, d = 0.30. Stakeholders rated ecological levels from greatest to least influential as individual, organizational, interpersonal, community, and policy. Themes within levels provided a deeper understanding of these influences. Conclusion: To successfully sustain Comprehensive School Physical Activity Programs in schools, balanced support from all social–ecological levels may be needed.