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Nielsen JV, Smedegaard S, Klakk H, Skovgaard T. Same, Same but Different: Comparing Program Fidelity at Early Versus Late Adopters of a Successful Long-Term School-Based Physical Activity Intervention. Health Promot Pract 2023; 24:1237-1245. [PMID: 36146950 DOI: 10.1177/15248399221100786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Schools have been identified as a promising setting for promoting physical activity (PA). Yet, to realize changes at the population level, successful school-based PA programs need to go to scale. The Svendborgproject is an effective school-based program promoting additional physical education (PE) lessons. The aim of this study is to determine program fidelity across different school groups, representing early and late adopters of the Svendborgproject, and how these are adapting the intervention. Three different school groups were identified, covering the original intervention schools and two groups of late adopters consisting of four former control schools, and five normal schools without any previous connection to the program. A PE teacher questionnaire (n = 122) was used to determine school fidelity. The results show that, while the original intervention schools have implemented the program with the highest fidelity, all schools have implemented the program with medium to high fidelity. It is suggested that having front-runner schools achieving early success with the program both strengthens political project support and provides strategies to back late adopters' implementation of the program. Furthermore, results from the current study suggest that continual promotion of the program by school heads is less important if support is established at the structural and organizational macro level. Finally, we highlight the importance of scaling up organizational capacity when scaling up program reach to assure a workable balance between fidelity and improving the fit to specific contexts.
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Affiliation(s)
- Jonas Vestergaard Nielsen
- Research and Implementation Center for Human Movement and Learning, Odense M, Denmark
- University of Southern Denmark, Odense M, Denmark
| | - Søren Smedegaard
- Research and Implementation Center for Human Movement and Learning, Odense M, Denmark
- University College Lillebaelt, Odense M, Denmark
| | - Heidi Klakk
- University of Southern Denmark, Odense M, Denmark
- University College South Denmark, Haderslev, Denmark
| | - Thomas Skovgaard
- Research and Implementation Center for Human Movement and Learning, Odense M, Denmark
- University of Southern Denmark, Odense M, Denmark
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Teasdale RM, Strasser M, Moore C, Graham KE. Evaluative criteria in practice: Findings from an analysis of evaluations published in Evaluation and Program Planning. EVALUATION AND PROGRAM PLANNING 2023; 97:102226. [PMID: 36645955 DOI: 10.1016/j.evalprogplan.2023.102226] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/22/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Evaluative criteria represent values about characteristics that define a successful evaluand. Criteria direct evaluators' lines of inquiry, including how aims are framed, which questions are asked, and what conclusions are reached. Yet, criteria often remain unstated, and little is known about criteria employed in practice. METHODS We analyzed 141 evaluations published in Evaluation and Program Planning over four years (2016-2019). Applying a model of criteria domains, we utilized collaborative, interpretive coding to surface and examine the criteria embedded in evaluation aims, questions, and conclusions. We also identified methods used to gather evaluation data. FINDINGS Analysis illuminated eight criteria domains evident in the sample and revealed how multiple domains were combined within individual evaluations. We found overlap among data collection methods used to investigate different domains. CONCLUSIONS Findings reveal the variety of criteria employed in practice and how evaluators combine criteria to examine multifaceted evaluands. Findings also highlight the need for evaluators to understand how to adapt methods to investigate different criteria domains. This article contributes to the empirical knowledge base about evaluative criteria and identifies revisions to the criteria model.
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Affiliation(s)
- Rebecca M Teasdale
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
| | - Mikayla Strasser
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
| | - Ceily Moore
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
| | - Kara E Graham
- Department of Educational Psychology, University of Illinois at Chicago, 1040 W. Harrison St, Chicago, IL 60607, USA.
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Koch S, Pawlowski CS, Skovgaard T, Pedersen NH, Troelsen J. Exploring implementation of a nationwide requirement to increase physical activity in the curriculum in Danish public schools: a mixed methods study. BMC Public Health 2021; 21:2073. [PMID: 34763700 PMCID: PMC8588597 DOI: 10.1186/s12889-021-12152-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2014, the Danish Government introduced a wide-ranging school reform that applied to all public schools in Denmark. A distinctive feature of the reform was that it became mandatory to implement an average of 45 min of daily physical activity within the curriculum. Using the RE-AIM framework as an evaluation tool, the objective of the current study was to evaluate the reach, effectiveness, adoption, implementation, and maintenance of mandatory physical activity within the curriculum at ten Danish schools. METHODS A complementary mixed-methods approach using accelerometers, questionnaires, and semi-structured interviews was conducted. A total of 10 schools were invited to participate, including 846 students, 76 teachers, and 10 school managers on various levels. Students were invited to wear an accelerometer for seven consecutive days. Teachers were invited to participate in a questionnaire, and school managers were encouraged to take part in a semi-structured interview. RESULTS Results showed that, on average, 45.2% of the students were active at least 45 min daily within the curriculum. Teacher and school management interest in physical activity, competencies development, and shared decision-making were identified as central factors for adoption of the requirement. Scheduling physical activity within scheduels and collaborations with external parties were found to influence implementation. Finally, internal coordination, motivated school staff, and school management priority were identified as central factors for maintenance. CONCLUSIONS This study provides an evaluation on a nationwide physical activity requirement in Danish public schools. When introducing a wide-ranging nation-wide requirement on physical activity within the curriculum, school managers need to prioritize and support the implementation process. Teachers need to be involved in the decision processes in order to ensure motivation and local ownership. The study also highlights the benefits of an internal coordinator as well as development of a shared strategy among schools, municipalities, and other stakeholders in order to succeed with the implementation.
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Affiliation(s)
- Sofie Koch
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Charlotte Skau Pawlowski
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Thomas Skovgaard
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Research and Implementation Centre for Human Movement and Learning, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Natascha Holbæk Pedersen
- Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej, 55, Odense M, Denmark.,Research Unit for Exercise Epidemiology, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej, 55, Odense M, Denmark
| | - Jens Troelsen
- Research Unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Tarp J, Gejl AK, Hillman CH, Wedderkopp N, Bugge A. Does Additional Physical Education Improve Exam Performance at the End of Compulsory Education? A Secondary Analysis from a Natural Experiment: The CHAMPS-Study DK. CHILDREN-BASEL 2021; 8:children8010057. [PMID: 33477570 PMCID: PMC7831119 DOI: 10.3390/children8010057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 12/28/2022]
Abstract
It remains unclear whether the provision of additional physical activity in school improves academic outcomes. We conducted a secondary analysis of the Childhood Health, Activity, and Motor Performance School Study Denmark (CHAMPS-study DK), a natural experiment based on a trebling of curricular physical education, to investigate whether children receiving additional physical education performed better on their academic exams at the conclusion of compulsory education (i.e., 9th grade). Children from six intervention schools received 3–7 years of exposure to 270 weekly minutes of physical education (sports schools), while children from four control schools received the 90-min national standard (normal schools). Academic performance was based on the standard Danish 7-point scale (ranging from −03 to 12) and retrieved from national registries. The primary outcome was calculated as the average exam grade. Comparisons of participants at sports and normal schools were adjusted for individual socioeconomic factors and school-level academic environment. There were no differences in the pooled exam performance among 691 sports- and 510 normal-school participants (0.20 (95% confidence interval: −0.12 to 0.52)). Results for subject-specific exams indicated similar results. This analysis from a non-randomized natural experiment did not provide evidence that simply adding additional physical education is sufficient to affect academic performance relative to the national standard.
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Affiliation(s)
- Jakob Tarp
- Department of Sports Medicine, Norwegian School of Sports Sciences, 0863 Oslo, Norway
- Correspondence: ; Tel.: +47-2-326-2322
| | - Anne Kær Gejl
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, 1799 Copenhagen, Denmark; (A.K.G.); (A.B.)
| | - Charles H. Hillman
- Department of Psychology, Department of Physical Therapy, Movement, & Rehabilitation Sciences, Northeastern University, Boston, MA 02115, USA;
| | - Niels Wedderkopp
- Department of Regional Health, University of Southern Denmark, 5000 Odense, Denmark;
- Department of Orthopedics, University Hospital of South West Jutland, 6700 Esbjerg, Denmark
| | - Anna Bugge
- Department of Midwifery, Physiotherapy, Occupational Therapy and Psychomotor Therapy, Faculty of Health, University College Copenhagen, 1799 Copenhagen, Denmark; (A.K.G.); (A.B.)
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Belton S, Britton Ú, Murtagh E, Meegan S, Duff C, McGann J. Ten Years of 'Flying the Flag': An Overview and Retrospective Consideration of the Active School Flag Physical Activity Initiative for Children-Design, Development & Evaluation. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E300. [PMID: 33339383 PMCID: PMC7766853 DOI: 10.3390/children7120300] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 11/16/2022]
Abstract
Whole-school physical activity (PA) promotion programmes are recommended to increase youth PA. Evaluation of programmes is essential to ensure practice is guided by evidence. This paper evaluates the Active School Flag (ASF), a whole-school PA promotion programme in Ireland, using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ASF was evaluated across three levels-(1) administration, (2) application, (3) outcomes-using a mi✗ed-methods case study design. E✗isting data sources were reviewed, the programme coordinator was interviewed, and a pilot study was conducted to investigate impact on 3rd and 5th class students (3 schools, n = 126 students, age range 8-12 years). In-school Moderate to Vigorous Physical Activity (MVPA; by accelerometery), motivation for PA (BREQ), PA self-efficacy (PASES), school affect and peer social support (Kidscreen27) were measured pre-programme (0 months), post-programme (8 months), and at retention (12 months). Teacher perceptions of classroom behaviour (CBAST) were also measured pre- and post-programme. ASF has been successful in engaging 46% of primary schools nationally. Students' in-school moderate-vigorous PA increased in all pilot-study schools from pre-programme to retention (η2 = 0.68-0.84). ASF programme design facilitates implementation fidelity, adoption and maintenance through buy in from schools and government stakeholders. ASF presents as an effective PA promotion programme in the short-to-medium term for primary schools. This RE-AIM evaluation provides evidence of ASF effectiveness, alongside valuable findings that could support programme improvement, and inform future similar programmes.
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Affiliation(s)
- Sarahjane Belton
- School of Health & Human Performance, Dublin City University, D09 V209 Dublin, Ireland; (Ú.B.); (S.M.); (C.D.); (J.M.)
| | - Úna Britton
- School of Health & Human Performance, Dublin City University, D09 V209 Dublin, Ireland; (Ú.B.); (S.M.); (C.D.); (J.M.)
| | - Elaine Murtagh
- Department of Physical Education & Sport Sciences, University of Limerick, V94 T9PX Limerick, Ireland;
- Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Sarah Meegan
- School of Health & Human Performance, Dublin City University, D09 V209 Dublin, Ireland; (Ú.B.); (S.M.); (C.D.); (J.M.)
| | - Christina Duff
- School of Health & Human Performance, Dublin City University, D09 V209 Dublin, Ireland; (Ú.B.); (S.M.); (C.D.); (J.M.)
| | - Jamie McGann
- School of Health & Human Performance, Dublin City University, D09 V209 Dublin, Ireland; (Ú.B.); (S.M.); (C.D.); (J.M.)
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Smith-Turchyn J, Mukherjee S, Richardson J, Ball E, Bordeleau L, Neil-Sztramko S, Levine O, Thabane L, Sathiyapalan A, Sabiston C. Evaluation of a novel strategy to implement exercise evidence into clinical practice in breast cancer care: protocol for the NEXT-BRCA randomised controlled trial. BMJ Open Sport Exerc Med 2020; 6:e000922. [PMID: 33178447 PMCID: PMC7642584 DOI: 10.1136/bmjsem-2020-000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/13/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The burden of breast cancer in Canada is steadily growing. More women are surviving breast cancer, yet, survivors live with side effects for years after treatments have ended. The benefits of exercise for women with breast cancer are well established and include improvement in treatment-related physical and emotional side effects. Despite these benefits, few survivors meet exercise guidelines. Exercise programmes are needed within the cancer institution in Canada to bridge the current knowledge to practice gap. The purpose of this study is to test the effects of a novel implementation strategy that includes institution-based exercise plus self-management (SM) or SM alone versus usual care in improving exercise level, quality of life, aerobic capacity, muscle strength and use of healthcare services over 12 months for women with breast cancer receiving chemotherapy. METHODS AND ANALYSIS Participants: Women with stages I-III breast cancer undergoing chemotherapy. Intervention: Group 1: institution-based exercise and SM (8 exercise sessions plus 8 SM modules); Group 2: SM alone; Group 3: usual care. Outcomes: The primary effectiveness outcome is minutes per week of moderate to vigorous physical activity. Secondary outcomes include quality of life, aerobic capacity, muscle strength, and use of healthcare services. Randomisation: Participants will be randomised (1:1:1) to one of the three groups by a blinded statistician and will be stratified based on age of participant (<40, 40-60, and >60 years). Statistical analysis: Outcomes will be measured at baseline, post-intervention, 6-month and 12-month follow-up using an analysis of covariance to test changes between groups over time adjusted for age. ETHICS AND DISSEMINATION This study addresses a long-standing need to help women with breast cancer undergoing chemotherapy become and stay more active by implementing novel rehabilitation strategies into real-world practice. This is vital in order for this population to minimise the lingering side effects of treatment, improve function and quality of life and prevent cancer recurrence. TRIAL REGISTRATION NUMBER The study protocol (v1: July 2020) has been registered on ClinicalTrials.gov (NCT04109274).
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Affiliation(s)
| | - Som Mukherjee
- Department of Oncology, McMaster University, Hamilton, Canada
- Juravinski Cancer Centre, Hamilton, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | | | - Louise Bordeleau
- Department of Oncology, McMaster University, Hamilton, Canada
- Juravinski Cancer Centre, Hamilton, Canada
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | | | - Oren Levine
- Department of Oncology, McMaster University, Hamilton, Canada
- Juravinski Cancer Centre, Hamilton, Canada
| | - Lehana Thabane
- Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada
| | - Arani Sathiyapalan
- Department of Oncology, McMaster University, Hamilton, Canada
- Juravinski Cancer Centre, Hamilton, Canada
| | - Catherine Sabiston
- Kinesiology and Physical Education, University of Toronto, Toronto, Canada
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Cassar S, Salmon J, Timperio A, Naylor PJ, van Nassau F, Contardo Ayala AM, Koorts H. Adoption, implementation and sustainability of school-based physical activity and sedentary behaviour interventions in real-world settings: a systematic review. Int J Behav Nutr Phys Act 2019; 16:120. [PMID: 31791341 PMCID: PMC6889569 DOI: 10.1186/s12966-019-0876-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/04/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Globally, many children fail to meet the World Health Organization's physical activity and sedentary behaviour guidelines. Schools are an ideal setting to intervene, yet despite many interventions in this setting, success when delivered under real-world conditions or at scale is limited. This systematic review aims to i) identify which implementation models are used in school-based physical activity effectiveness, dissemination, and/or implementation trials, and ii) identify factors associated with the adoption, implementation and sustainability of school-based physical activity interventions in real-world settings. METHODS The review followed PRISMA guidelines and included a systematic search of seven databases from January 1st, 2000 to July 31st, 2018: MEDLINE, EMBASE, CINAHL, SPORTDiscus, PsycINFO, CENTRAL, and ERIC. A forward citation search of included studies using Google Scholar was performed on the 21st of January 2019 including articles published until the end of 2018. Study inclusion criteria: (i) a primary outcome to increase physical activity and/or decrease sedentary behaviour among school-aged children and/or adolescents; (ii) intervention delivery within school settings, (iii) use of implementation models to plan or interpret study results; and (iv) interventions delivered under real-world conditions. EXCLUSION CRITERIA (i) efficacy trials; (ii) studies applying or testing school-based physical activity policies, and; (iii) studies targeting special schools or pre-school and/or kindergarten aged children. RESULTS 27 papers comprising 17 unique interventions were included. Fourteen implementation models (e.g., RE-AIM, Rogers' Diffusion of Innovations, Precede Proceed model), were applied across 27 papers. Implementation models were mostly used to interpret results (n = 9), for planning evaluation and interpreting results (n = 8), for planning evaluation (n = 6), for intervention design (n = 4), or for a combination of designing the intervention and interpreting results (n = 3). We identified 269 factors related to barriers (n = 93) and facilitators (n = 176) for the adoption (n = 7 studies), implementation (n = 14 studies) and sustainability (n = 7 studies) of interventions. CONCLUSIONS Implementation model use was predominately centered on the interpretation of results and analyses, with few examples of use across all study phases as a planning tool and to understand results. This lack of implementation models applied may explain the limited success of interventions when delivered under real-world conditions or at scale. TRIAL REGISTRATION PROSPERO (CRD42018099836).
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Affiliation(s)
- Samuel Cassar
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jo Salmon
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Patti-Jean Naylor
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
| | - Femke van Nassau
- Department of Public and Occupational Health and Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ana María Contardo Ayala
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Harriet Koorts
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
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Nielsen JV, Bredahl TVG, Bugge A, Klakk H, Skovgaard T. Implementation of a successful long-term school based physical education intervention: Exploring provider and programme characteristics. EVALUATION AND PROGRAM PLANNING 2019; 76:101674. [PMID: 31252373 DOI: 10.1016/j.evalprogplan.2019.101674] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 05/27/2019] [Accepted: 06/12/2019] [Indexed: 06/09/2023]
Abstract
There is an ongoing need for research focusing on how to implement physical activity programmes into a school setting. This includes documentation of the extent to which programmes are compatible with the basic views of providers and their local practices. The present study explores the Svendborgproject - a programme tripling the amount of physical education in six public schools, sustaining it for 10-years and documenting a decreased incidence of overweight, obesity and cardiovascular risk factors. The aim was to analyse provider and programme characteristics of the Svendborgproject to gain insights into providers motives for adopting, implementing, and maintaining the programme. Six school heads and six teachers were interviewed to explore how they perceived programme compatibility to their school's practice and their own role as providers. Both teachers and school heads found the additional lessons a valuable asset that fitted existing school values and priorities. Additionally, physical education teachers participated in a course providing new perspectives and teaching methods that aided the implementation of the programme. Lastly, school heads stressed that implementation fidelity was heavily dependent on the dedication of physical education teachers and on having simple programme requirements that made it clear what could be expected of the programme.
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Affiliation(s)
- Jonas Vestergaard Nielsen
- Research and Innovation Centre for Human Movement and Learning, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | | | - Anna Bugge
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Heidi Klakk
- Research in Childhood Health, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; University College Lillebaelt, Denmark
| | - Thomas Skovgaard
- Research and Innovation Centre for Human Movement and Learning, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Active Living, Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
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