A mixed-methods exploration of implementation of a comprehensive school healthy eating model one year after scale-up. Naylor, P., McKay, H., A., Valente, M., & Mâsse, L., C. Public health nutrition, 5, 2015.
abstract   bibtex   
OBJECTIVE: To study the implementation of a school-based healthy eating (HE) model one year after scale-up in British Columbia (BC). Specifically, to examine implementation of Action Schools! BC (AS! BC) and its influence on implementation of classroom HE activities, and to explore factors associated with implementation. DESIGN: Diffusion of Innovations, Social Cognitive and Organizational Change theories guided our approach. We used a mixed-methods research design including focus group interviews (seven schools, sixty-two implementers) and a cross-sectional multistage survey to principals (n 36, 92 % response rate) and teachers of grades 4 to 7 (n 168, 70 % response rate). Self-reported implementation of classroom HE activities and reported use of specific AS! BC HE activities were primary implementation measures. Thematic analysis of focus group data and multilevel mixed-effect logistic regression analyses of survey data were conducted. SETTING: Elementary schools across BC, Canada. SUBJECTS: Thirty-nine school districts, thirty-six principals, 168 grade 4 to 7 teachers. RESULTS: Forty-two per cent of teachers in registered schools were implementing AS! BC HE in their classrooms. Users were 6·25 times more likely to have delivered a HE lesson in the past week. Implementation facilitators were school champions, technical support and access to resources; barriers were lack of time, loss of leadership or momentum. Implementation predictors were teacher training, self-efficacy, experience with the physical activity component of AS! BC, supportive school climate and parental post-secondary education. CONCLUSIONS: Our findings reinforce that continued teacher training and support are important public health investments that contribute to successful implementation of school-based HE models after scale-up.
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 title = {A mixed-methods exploration of implementation of a comprehensive school healthy eating model one year after scale-up.},
 type = {article},
 year = {2015},
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 pages = {1-11},
 websites = {http://www.ncbi.nlm.nih.gov/pubmed/25990045},
 month = {5},
 day = {20},
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 accessed = {2015-05-21},
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 abstract = {OBJECTIVE: To study the implementation of a school-based healthy eating (HE) model one year after scale-up in British Columbia (BC). Specifically, to examine implementation of Action Schools! BC (AS! BC) and its influence on implementation of classroom HE activities, and to explore factors associated with implementation.

DESIGN: Diffusion of Innovations, Social Cognitive and Organizational Change theories guided our approach. We used a mixed-methods research design including focus group interviews (seven schools, sixty-two implementers) and a cross-sectional multistage survey to principals (n 36, 92 % response rate) and teachers of grades 4 to 7 (n 168, 70 % response rate). Self-reported implementation of classroom HE activities and reported use of specific AS! BC HE activities were primary implementation measures. Thematic analysis of focus group data and multilevel mixed-effect logistic regression analyses of survey data were conducted.

SETTING: Elementary schools across BC, Canada.

SUBJECTS: Thirty-nine school districts, thirty-six principals, 168 grade 4 to 7 teachers.

RESULTS: Forty-two per cent of teachers in registered schools were implementing AS! BC HE in their classrooms. Users were 6·25 times more likely to have delivered a HE lesson in the past week. Implementation facilitators were school champions, technical support and access to resources; barriers were lack of time, loss of leadership or momentum. Implementation predictors were teacher training, self-efficacy, experience with the physical activity component of AS! BC, supportive school climate and parental post-secondary education.

CONCLUSIONS: Our findings reinforce that continued teacher training and support are important public health investments that contribute to successful implementation of school-based HE models after scale-up.},
 bibtype = {article},
 author = {Naylor, Patti-Jean and McKay, Heather A and Valente, Maria and Mâsse, Louise C},
 journal = {Public health nutrition}
}

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