Effective implementation of primary school-based healthy lifestyle programmes: a qualitative study of views of school staff
Effective implementation of primary school-based healthy lifestyle programmes: a qualitative study of views of school staff
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DOI：
10.1186/s12889-019-7550-2
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发表时间：
2019-09-09
影响因子：
4.5
通讯作者：
Christian, Meaghan Sarah
中科院分区：
文献类型：
--
作者：
Day, Rhiannon Eleanor;Sahota, Pinki;Christian, Meaghan Sarah
背景：小学是实施健康生活方式（健康饮食和身体活动）干预措施的宝贵环境，旨在解决儿童肥胖问题。本研究探讨了学校工作人员对阻碍和促进健康生活方式干预措施在小学成功实施和可持续发展的因素的看法。对在英格兰北部小学进行的两项评估的定性数据进行了汇总和分析：营养和体育活动教育方案的可行性研究（PhunkyFoods可行性研究）和健康饮食方案的评估（食品人评估）。方法在参与两项评估的14所学校，对校长、教师、餐饮管理人员、指定的校本项目协调员和支持学校实施项目的项目工作人员进行了65次定性半结构化访谈。Durlak和Dupre（2008）使用成功实施的框架进行了主题分析，并对新兴主题进行了分类。结果总体而言，所有学校都提供了一系列健康生活方式课程，通常内容重叠。执行个别方案所面临的挑战包括：时间有限、执行时间有限、培训和支助有限、资源、能力和设施不足、工作人员对干预的看法和对技能熟练程度（烹饪和体育活动）的认识。短期资金、缺乏外部和内部支助被认为阻碍了可持续性。工作人员对成功执行未来方案的建议包括：延长培训和规划时间、充足的能力、外部支助、良好的资源（互动、实用和适应性）以及烹饪、健康饮食、园艺和体育活动设施。校长需要在过度拥挤的课程中优先提供一些关键的健康生活方式方案。学校需要采取策略，长期吸引教职员工、学生和家长的参与。结论：有效实施以学校为基础的健康生活方式方案被认为需要灵活和适应性强的方案，从而实现良好的环境契合、资源充足的方案、多层次的有效领导、学生（学生支持交付）和家长参与。为了促进可持续性，人们认为方案需要在校长和工作人员的持续支持下长期纳入课程和学校政策。这些发现与方案制定人员、政策制定者和参与提供干预措施的人员有关。
Background Primary schools are valuable settings to implement healthy lifestyle (healthy eating and physical activity) interventions, aimed at targeting childhood obesity. This study explored school staff perceptions of factors that hinder and enable successful implementation and sustainability of healthy lifestyle interventions in primary schools. Qualitative data was pooled and analysed from two evaluations carried out in primary schools in North England: a feasibility study of a nutrition and physical activity educational programme (PhunkyFoods Feasibility Study), and an evaluation of a healthy eating programme (The Food Dudes Evaluation). Methods Sixty-five qualitative semi-structured interviews were conducted with head teachers, teachers, catering managers, designated school-based programme coordinators and programme staff supporting schools with programme delivery, at 14 schools involved in both evaluations. Thematic analysis was undertaken and emergent themes categorised using a framework for successful implementation by Durlak and Dupre (2008). Results Overall, all schools were delivering a range of healthy lifestyle programmes, often with overlapping content. Perceived challenges to implementation of individual programmes included: limited time, timing of implementation, limited training and support, insufficient resources, capacity and facilities, staff perceptions of intervention and perceived skill-proficiency (for cooking and physical activities). Short-term funding, lack of external and internal support were perceived to hinder sustainability. Staff recommendations for successful implementation of future programmes included: extended training and planning time, sufficient capacity, external support for delivery, good resources (interactive, practical and adaptable), and facilities for cooking, healthy eating, gardening and physical activities. Head teachers need to prioritise delivery of a few key healthy lifestyle programmes, in an overcrowded curriculum. Schools need to employ strategies to engage participation of staff, pupils and parents long term. Conclusions Effective implementation of school-based healthy lifestyle programmes was thought to be aided by flexible and adaptable programmes, enabling good contextual fit, well-resourced programmes and effective leadership at multiple levels, pupil (pupils support delivery) and parent involvement. To facilitate sustainability, it was perceived that programmes need to be integrated within the curriculum and school policies long term, with sustained support from head teachers and staff. These findings are relevant to programme developers, policy makers and those involved in delivering interventions.