Barriers and facilitators to adoption, implementation and sustainment of obesity prevention interventions in schoolchildren– a DEDIPAC case study

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dc.contributor.author Hayes, C. B.
dc.contributor.author O'Shea, M. P.
dc.contributor.author Foley-Nolan, C.
dc.contributor.author McCarthy, M.
dc.contributor.author Harrington, Janas M.
dc.date.accessioned 2019-11-26T04:58:36Z
dc.date.available 2019-11-26T04:58:36Z
dc.date.issued 2019-02-15
dc.identifier.citation Hayes, C.B., O’Shea, M.P., Foley-Nolan, C., McCarthy, M. and Harrington, J.M. (2019) 'Barriers and facilitators to adoption, implementation and sustainment of obesity prevention interventions in schoolchildren–a DEDIPAC case study'. BMC Public health, 19(1), 198. (13 pp.) doi: 10.1186/s12889-018-6368-7 en
dc.identifier.volume 19 en
dc.identifier.issued 1 en
dc.identifier.startpage 1 en
dc.identifier.endpage 13 en
dc.identifier.uri http://hdl.handle.net/10468/9222
dc.identifier.doi 10.1186/s12889-018-6368-7 en
dc.description.abstract Background: The aim of the study was to explore the implementation of school based diet and physical activity interventions with respect to the barriers and facilitators to adoption, implementation and sustainability; supportive actions required for implementation and recommendations to overcome identified barriers. Two interventions rolled out nationally in Ireland were chosen; Food Dudes, a programme to encourage primary school children to consume more fruit and vegetables and Green Schools Travel (GST), an active travel to school programme in primary and secondary schools. Trained school coordinators (teachers) cascade the programmes to other teaching staff. Methods: Multiple case study design using qualitative semi-structured interviews with key stakeholders: primary and secondary school teachers, school coordinators, project coordinators/managers, funders and intermediaries. Fifteen interviews were conducted. Data were coded using a common categorization matrix. Thematic analysis was undertaken using the Adoption, Implementation and Maintenance elements of the RE-AIM implementation framework. Results: Good working relationships within and across government departments, intermediaries and schools were critical for intervention adoption, successful implementation and sustainability. Organisational and leadership ability of coordinators were essential. Provision of participation incentives acted as motivators to engage children’s interest. A deep understanding of the lives of the target children was an important contextual factor. The importance of adaptation without compromising core components in enhancing intervention sustainability emerged. Successful implementation was hindered by: funding insecurity, school timetable constraints, broad rather than specific intervention core components, and lack of agreement on conduct of programme evaluation. Supportive actions for maintenance included ongoing political support, secure funding and pre-existing healthy lifestyle policies. Conclusions: Successful implementation and scale up of public health anti-obesity interventions in schools is dependent on good contextual fit, engagement and leadership at multiple levels and secure funding. Recommendations to overcome barriers include: capacity to deliver within an already overcrowded curriculum and clear specification of intervention components within a conceptual framework to facilitate evaluation. Our findings are generalisable across different contexts and are highly relevant to those involved in the development or adaptation, organisation or execution of national public health interventions: policy makers, guidelines developers, and staff involved in local organisation and delivery. en
dc.description.sponsorship Health Research Board (DEDIPAC/2013/1. Award Number 12648) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BioMed Central Ltd en
dc.relation.uri https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-6368-7
dc.rights © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. en
dc.rights.uri https://creativecommons.org/licenses/by/4.0/ en
dc.subject Implementation barriers en
dc.subject Facilitators en
dc.subject School-based en
dc.subject Obesity prevention en
dc.title Barriers and facilitators to adoption, implementation and sustainment of obesity prevention interventions in schoolchildren– a DEDIPAC case study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Janas Harrington, School of Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: j.harrington@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Research Board en
dc.contributor.funder European Commission en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMC Public Health en
dc.internal.IRISemailaddress j.harrington@ucc.ie en
dc.identifier.articleid 198 en
dc.relation.project info:eu-repo/grantAgreement/EC/H2020::CSA/696300/EU/The second coordination and support action for the JPI Healthy Diet for a Healthy Life/CSA JPI HDHL 2.0 en
dc.identifier.eissn 1471-2458


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© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Except where otherwise noted, this item's license is described as © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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