Standing desks have the potential to improve educational and health outcomes in elementary schools, yet limited intervention studies have been undertaken using mixed methods approaches or in Asian countries. The aim of this research was to elucidate the subjective experiences and objective effects of standing desk use in a Japanese elementary school. Respondents in the intervention included a class of 22 year six students and their teacher at a public elementary school in Nagano, Japan. Standing desks were implemented in the classroom for nine months. Subjective focus group and interview data were generated on two occasions during the intervention period to facilitate data saturation. Objective accelerometery data were used to record active and sedentary behaviour before and during the intervention. Focus group and interview data highlighted positive physical and educational effects, including perceived improvements in endurance and posture, self-expression, peer interaction, and reduced state anxiety. These data also revealed concerns about age-appropriateness and practicality of implementation in a conservative education system. Accelerometery findings showed significant changes in moderate- to vigorous-intensity physical activity during both school and non-school hours. Standing desks provide a practical approach for modernizing Japanese elementary education, which may hold benefits across both health and education. Follow-up multi-site randomized controlled interventions and comparisons of teacher style and philosophy in standing desk classrooms are recommended to confirm and expand the present findings.
