Vaccine hesitancy among Saudi parents of children in Abha City, Saudi Arabia: a cross-sectional study.

Physically Active Learning (PAL), defined as integrating movement within the delivery of academic content (), has garnered global interest, as evidence suggests that physical activity can positively impact pupils’ academic performance (, ), cognitive processes (, ), and time on task (). PAL has been positioned as a cost-effective approach to addressing core educational goals and increasing pupils’ physical activity levels during their most sedentary period of the day (–). Despite growing interest, challenges remain in sustaining PAL beyond formal researcher-led programs (–). Existing programs are often predefined and lack flexibility for local adaptation, which can limit alignment with teachers’ professional practice and reduce long-term uptake (, ). Additionally, many programs are short-term, often consisting of brief training sessions, which may not sufficiently support sustained changes in teaching practice or help teachers overcome risk aversion (, ). As a result, PAL implementation remains confined to early adopters, limiting broader, scalable uptake across schools (, –). In response, research has increasingly focused on identifying barriers and facilitators to PAL implementation (, ) and on developing more comprehensive approaches to teacher training in both pre-service and in-service contexts (, –). There has also been a growing emphasis on involving stakeholders in the design of such programs (, ). However, empirical knowledge on how to structure teacher training to support sustained PAL implementation remains limited (, , ).