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Koch, Sofie ORCID: https://orcid.org/0000-0002-9404-5001, Tarantino, Giampiero ORCID: https://orcid.org/0000-0001-9627-883X, Ntoumanis, Nikos ORCID: https://orcid.org/0000-0001-7122-3795, Thøgersen-Ntoumani, Cecilie ORCID: https://orcid.org/0000-0003-0255-1263, Larsen, Malte Nejst ORCID: https://orcid.org/0000-0002-2600-7126, Krustrup, Peter ORCID: https://orcid.org/0000-0002-1461-9838 and Christiansen, Lars Breum Skov ORCID: https://orcid.org/0000-0002-5142-3623 (2026) Maintaining conceptual fidelity through teacher-led adaptation: an implementation-focused mixed methods study of a school-based physical activity program. BMC Public Health, 26 (1).