A Comparative Analysis of Fourth-Grade Students’ Satisfaction With Opportunities for Physical Activity in “School in Motion” and Nonnetwork Schools: Findings From National Satisfaction Survey, 2018–2024

BACKGROUND: Comprehensive school-based physical activity (PA) interventions are considered effective for fostering movement-supportive school cultures. This study examined differences in fourth-grade students' satisfaction with PA opportunities between schools participating in the School in Motion (SiM) network and nonnetwork schools in Estonia from 2018 to 2024. METHODS: Data from 77,677 fourth-grade students (participation rate 70%-81%) in the National School Satisfaction Survey were analyzed. Satisfaction was assessed on a 5-point Likert scale and dichotomized into "satisfied" (Ratings 4-5) and "not satisfied" (Ratings 1-3). Proportions of satisfied students were calculated annually, and differences between school types were analyzed using Generalized linear mixed models, with school as a random intercept, adjusting for language of instruction and regional poverty rates. RESULTS: Students in SiM network consistently reported higher satisfaction with PA opportunities in almost all survey years (P < .001). Overall satisfaction with PA opportunities ranged from 36.5% to 41.9% in SiM network and 29.7% to 34.4% in nonnetwork schools. Differences remained significant after adjusting for socioeconomic factors (odds ratios [OR] = 1.21-1.35; P < .001). The strongest difference was observed for student-organized activities (OR 1.29-2.40), while active lessons (OR 1.16-1.39) and teacher encouragement (OR 1.09-1.31) showed modest but consistent effects. For recess-related opportunities, effects were smaller, ranging from OR 0.98 to 1.19 for indoor recess and OR 0.74 to 1.30 for outdoor recess. CONCLUSIONS: Participation in the SiM network was associated with higher student satisfaction with school-based PA opportunities. Whole-of-school approaches may help to promote more equitable access to PA and contribute to movement-supportive school cultures.