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

Hayes, C. B.; O'Shea, M. P.; Foley-Nolan, C.; McCarthy, M.; Harrington, Janas M.

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

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.contributor.funder	Health Research Board	en
dc.contributor.funder	European Commission	en
dc.date.accessioned	2019-11-26T04:58:36Z
dc.date.available	2019-11-26T04:58:36Z
dc.date.issued	2019-02-15
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.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	198	en
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.doi	10.1186/s12889-018-6368-7	en
dc.identifier.eissn	1471-2458
dc.identifier.endpage	13	en
dc.identifier.issued	1	en
dc.identifier.journaltitle	BMC Public Health	en
dc.identifier.startpage	1	en
dc.identifier.uri	https://hdl.handle.net/10468/9222
dc.identifier.volume	19	en
dc.language.iso	en	en
dc.publisher	BioMed Central Ltd	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.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