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Hanna L, Burns C, O'Neill C, Coughlan E. Evaluating the Perceived Health-Related Effectiveness of 'The Daily Mile' Initiative in Irish Primary Schools. Healthcare (Basel) 2024; 12:1284. [PMID: 38998819 PMCID: PMC11240888 DOI: 10.3390/healthcare12131284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Many Irish primary school children do not meet recommended physical activity (PA) guidelines. The Daily Mile (TDM) is a primary school initiative designed to increase children's PA output. This study evaluates TDM's perceived effect on Irish primary school children's health-related metrics. A mixed-methods study, comprising two data collection phases, used the RE-AIM framework to evaluate TDM. Phase One involved teachers, principals and classroom assistants (n = 191) from TDM-registered schools completing a questionnaire. Two TDM-registered schools participated in Phase Two, where (i) interviews were conducted with each principal, (ii) a teacher sub-sample (n = 4) participated in a focus group, and (iii) a child sub-sample (n = 14) participated in separate focus groups. TDM was perceived to positively impact the markers of children's health, including their PA behaviour, physical fitness and social well-being. Inclement weather (66.5%) and a lack of time (56.5%) were reported as the top-ranked implementation barriers. Moreover, TDM's repetitive nature often left children feeling disinterested and resulted in some teachers modifying the initiative to maintain engagement levels. Maintaining the long-term implementation of TDM and its health benefits in primary schools may require bespoke amendments to the original format to preserve children's engagement.
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Affiliation(s)
- Luke Hanna
- Department of Sport, Leisure and Childhood Studies, Munster Technological University, Bishopstown, T12P928 Cork, Ireland
| | - Con Burns
- Department of Sport, Leisure and Childhood Studies, Munster Technological University, Bishopstown, T12P928 Cork, Ireland
| | - Cian O'Neill
- Department of Sport, Leisure and Childhood Studies, Munster Technological University, Bishopstown, T12P928 Cork, Ireland
| | - Edward Coughlan
- Department of Sport, Leisure and Childhood Studies, Munster Technological University, Bishopstown, T12P928 Cork, Ireland
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Cline A, Knox G, De Martin Silva L, Draper S. A Process Evaluation of A UK Classroom-Based Physical Activity Intervention-'Busy Brain Breaks'. CHILDREN (BASEL, SWITZERLAND) 2021; 8:63. [PMID: 33498371 PMCID: PMC7909392 DOI: 10.3390/children8020063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 12/22/2022]
Abstract
The gap between development of effective physical activity interventions and the wide-scale adoption of these interventions in real-world settings has been reported since the early 2000s. Evaluations have been criticised for failing to report details of context, implementation, adoption and maintenance. 'Busy Brain Breaks' was an intervention designed to improve fundamental movement patterns whilst increasing physical activity within the classroom. This evaluation study used a mixed-methods approach including questionnaires, observations, semi-structured interviews and quantification of class-level dose. Findings suggest that giving teachers flexibility and autonomy over the way in which they implement physical activity interventions may increase the likelihood of adoption. Time was frequently perceived as a significant barrier to the intervention, giving the teachers flexibility to implement the intervention when they thought most suitable allowed teaching staff to retain their autonomy and make the intervention work with their schedule. Children's behaviour appeared to be both a facilitator and barrier to implementing physical activity interventions within the classroom. Whilst misbehaviour can pose as a barrier, children's enjoyment acts as a key facilitator to implementation for teaching practitioners. Teachers interviewed (n = 17) observed that movement ability had developed as a result of the intervention and recognised co-ordination, balance and stability as areas that had noticeably improved. Conducting an in-depth process evaluation has allowed for greater insight and understanding as to how, and to what extent, the intervention was implemented within the school-based setting.
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Affiliation(s)
- Alice Cline
- Department of Sport, Hartpury University, Gloucestershire, Gloucester GL19 3BE, UK; (G.K.); (L.D.M.S.); (S.D.)
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Smedegaard S, Brondeel R, Christiansen LB, Skovgaard T. What happened in the 'Move for Well-being in School': a process evaluation of a cluster randomized physical activity intervention using the RE-AIM framework. Int J Behav Nutr Phys Act 2017; 14:159. [PMID: 29145868 PMCID: PMC5689205 DOI: 10.1186/s12966-017-0614-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 11/07/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The aim of this study was to address the gap in the translation of research into practice through an extensive process evaluation of the Move for Well-being in School programme using the RE-AIM framework. The purpose was to gain insight into the extent by which the intervention was adopted and implemented as intended and to understand how educators observed its effectiveness and maintenance. METHODS Public schools located in seven municipalities in Denmark were invited to enroll their 4th to 6th grade classes in the project. Of these, 24 school decided to participate in the project in the school-year 2015-16 and were randomly (cluster) allocated to either intervention or control group. A process survey was completed online by school personnel at the start, at midterm, and at the end of the school year. Additionally, informal interviews and observations were conducted throughout the year. RESULTS At the 12 intervention schools, a total of 148 educators were involved in the implementation of the programme over the school-year. More than nine out of ten educators integrated brain breaks in their lessons and practically all the physical education teachers used the physical education lesson plans. The educators delivered on average 4.5 brain breaks per week and up to 90% of the physical education teachers used the project lesson plans for at least half of their classes. Half of the educators initiated new recess activities. A total of 78%, 85% and 90% of the educators believed that the implemented recess, brain break and physical education components 'to a high degree' or 'to some degree' promoted the pupils' well-being, respectively. CONCLUSIONS This study shows that it is possible to design a school-based PA intervention that educators largely adopt and implement. Implementation of the PA elements was stable throughout the school year and data demonstrate that educators believed in the ability of the intervention to promote well-being among the pupils. Finally, the study show that a structured intervention consisting of competence development, set goals for new practices combined with specific materials, and ongoing support, effectively reached a vast majority of all teachers in the enrolled schools with a substantial impact. TRIAL REGISTRATION Date of registration: retrospectively registered on 24 April 2015 at Current Controlled Trials (DOI 0.1186/ ISRCTN12496336 - named: "The role of physical activity in improving the well-being of children and youth").
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Affiliation(s)
- Søren Smedegaard
- FIIBL, Research and Innovation Centre for Human Movement and Learning, Odense M, Denmark
- SDU, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- IOB, Department of Sports Science and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
- UCL, University College Lillebaelt, UCL Campus Odense, Niels Bohrs Allé 1, 5230 Odense M, Denmark
| | - Ruben Brondeel
- Centre de recherche du CHUM, 900 St Denis St, Montréal, QC H2X 0A9 Canada
| | - Lars Breum Christiansen
- SDU, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- IOB, Department of Sports Science and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
| | - Thomas Skovgaard
- FIIBL, Research and Innovation Centre for Human Movement and Learning, Odense M, Denmark
- SDU, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
- IOB, Department of Sports Science and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
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Johnson SB, Harden SM, Estabrooks PA. Uptake of evidence-based physical activity programs: comparing perceptions of adopters and nonadopters. Transl Behav Med 2016; 6:629-637. [PMID: 27848209 PMCID: PMC5110488 DOI: 10.1007/s13142-015-0371-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Translating evidence-based physical activity interventions into practice have been problematic. Limited research exists on the adoption decision-making process. This study explored health educator perceptions of two evidence-based, physical activity programs-one was developed through an integrated research-practice partnership approach (FitEx) and the other was research-developed, Active Living Every Day (ALED). Semi-structured interviews were conducted with 12 health educators who were trained on either ALED (n = 6) or FitEx (n = 6) and had either delivered (n = 6) or did not deliver (n = 6) the intervention. Program adopters identified with program characteristics, materials, processes, implementation, fit within system, and collaborations as more positive factors in decision-making when compared to those that did not deliver. FitEx health educators were more likely to deliver the program and found it to be a better fit and easier to use. An integrated research-practice partnership may improve adoption of physical activity programs in typical practice settings.
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Affiliation(s)
- Sallie Beth Johnson
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, 1981 Kraft Dr, Blacksburg, VA, 24060, USA
- Fralin Translational Obesity Research Center, Blacksburg, VA, USA
| | - Samantha M Harden
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, 1981 Kraft Dr, Blacksburg, VA, 24060, USA
- Fralin Translational Obesity Research Center, Blacksburg, VA, USA
- Department of Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Paul A Estabrooks
- Department of Human Nutrition, Foods and Exercise, Virginia Tech, 1981 Kraft Dr, Blacksburg, VA, 24060, USA.
- Fralin Translational Obesity Research Center, Blacksburg, VA, USA.
- Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA.
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Casey MM, Telford A, Mooney A, Harvey JT, Eime RM, Payne WR. Linking secondary school physical education with community sport and recreation for girls: a process evaluation. BMC Public Health 2014; 14:1039. [PMID: 25283157 PMCID: PMC4196094 DOI: 10.1186/1471-2458-14-1039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 10/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to undertake a process evaluation to examine the reach, adoption and implementation of a school-community linked physical activity (PA) program for girls aged 12 - 15 years (School Years 7 - 9) using the RE-AIM framework. METHODS Various approaches were used to assess 'reach', 'adoption' and implementation: (a) a school environment survey of intervention schools (n = 6); (b) teacher feedback regarding the professional development component (91.1% response rate) and lesson implementation (60.8% response rate); and (c) post-intervention focus group interviews with physical education (PE) teachers (n = 29), students (n = 125), coaches (n = 13) and instructors (n = 8) regarding program experiences. RESULTS Reach and Adoption: Seven schools (n = 1491 Year 7-9 female student enrolment; 70% adoption rate), five tennis clubs, eight football clubs and five leisure centres participated in the program during 2011. IMPLEMENTATION Program design and professional development opportunities (training, resource manual and opportunities to work with coaches and instructors during PE classes) supported implementation and student engagement in PA. However, there was a lack of individual and organisational readiness to adopt program principles. For some deliverers there were deeply embedded ideologies that were not aligned with the Game Sense teaching approach upon which the program was based. Further, cognitive components of the program such as self-management were not widely adopted as other components of the program tended to be prioritised. CONCLUSION The program design and resources supported the success of the program, however, some aspects were not implemented as intended, which may have affected the likelihood of achieving further positive outcomes. Barriers to program implementation were identified and should be considered when designing school-community linked interventions. In particular, future programs should seek to assess and adjust for organizational readiness within the study design. For example, shared commitment and abilities of program deliverers to implement the program needs to be determined to support program implementation. TRIAL REGISTRATION ACTRN12614000446662. April 30th 2014.
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Affiliation(s)
- Meghan M Casey
- />School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia
| | - Amanda Telford
- />School of Medical Sciences, Discipline of Exercise Sciences, RMIT University, Melbourne, Australia
| | - Amanda Mooney
- />School of Education, Faculty of Arts & Education, Deakin University, Melbourne, Australia
| | - Jack T Harvey
- />School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia
| | - Rochelle M Eime
- />School of Health Sciences and Psychology, Federation University Australia, Ballarat, Australia
- />Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
| | - Warren R Payne
- />Institute of Sport, Exercise and Active Living (ISEAL), Victoria University, Melbourne, Australia
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Janssen M, Toussaint HM, van Mechelen W, Verhagen EALM. Translating the PLAYgrounds program into practice: a process evaluation using the RE-AIM framework. J Sci Med Sport 2012; 16:211-6. [PMID: 22824311 DOI: 10.1016/j.jsams.2012.06.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 05/31/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To present the results of the process evaluation of the PLAYgrounds program, using the RE-AIM framework. DESIGN This study provides information regarding Reach, Adoption, Implementation and Maintenance. METHODS The PLAYgrounds program promotes increasing levels of physical activity in 6-12 years old children and was evaluated using the RE-AIM framework in 4 intervention schools. Data collection consisted of a physical activity questionnaire with children (n=765, Reach), SOPLAY observations (Implementation and Maintenance), questionnaires on the satisfaction of the implemented elements with teachers (n=59) and children (n=730, Implementation) and interviews for increased depth of information. In addition a simple counting of participating schools, describing of non-participating reasons and characteristics of the schools were documented (Adoption). RESULTS Reach of the target population (i.e. inactive children) was 60.7% (n=464) and the target population was representative for populations in low-SES neighbourhoods. The PLAYgrounds program was adopted by 4 schools (80%), at which 5 (from 7) program elements were successfully implemented. At 18 months follow-up, 3 of those 5 elements were completely maintained. CONCLUSIONS Adoption, Implementation, and Maintenance proved to be very high. Most likely due to the PLAYgrounds program being a complete intervention package that included financial, material, and staff support. Therefore, it is recommended to retain this high level of support when introducing the PLAYgrounds (or any other intervention) program in schools. In the future it would be recommended to evaluate the PLAYgrounds program on maintenance in schools where the key-person is employed at the school and funding is not available.
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Affiliation(s)
- Mirka Janssen
- Academy for Physical Education, Technical University of Applied Sciences of Amsterdam, The Netherlands
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Glasgow RE, Chambers D. Developing robust, sustainable, implementation systems using rigorous, rapid and relevant science. Clin Transl Sci 2012; 5:48-55. [PMID: 22376257 PMCID: PMC5439908 DOI: 10.1111/j.1752-8062.2011.00383.x] [Citation(s) in RCA: 168] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Current approaches to medical science generally have not resulted in rapid, robust integration into feasible, sustainable real world healthcare programs and policies. Implementation science risks falling short of expectations if it aligns with historical norms. Fundamentally different scientific approaches are needed to accelerate such integration. METHODS We propose that the key goal of implementation science should be to study the development, spread and sustainability of broadly applicable and practical programs, treatments, guidelines, and policies that are contextually relevant and robust across diverse settings, delivery staff, and subgroups. We recommend key conceptual and methodological characteristics needed to accomplish these goals. RESULTS The methods to produce such advances should be rapid, rigorous, transparent, and contextually relevant. We recommend approaches that incorporate a systems perspective, investigate generalizability, are transparent, and employ practical measures and participatory approaches. CONCLUSIONS To produce different outcomes, we need to think and act differently. Implications of such an implementation science approach include fundamental changes that should be relevant to Clinical Translational Science Award investigators, comparative effectiveness researchers, those interested in pragmatic trials, grant funders, and community partners.
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Affiliation(s)
- Russell E Glasgow
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland, USA.
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Van Haitsma KS, Williamson JB, Pruchno R. Practice Concepts and Policy Studies: The New Divide. THE GERONTOLOGIST 2011; 51:731-3. [DOI: 10.1093/geront/gnr105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Scheirer MA, Dearing JW. An agenda for research on the sustainability of public health programs. Am J Public Health 2011; 101:2059-67. [PMID: 21940916 DOI: 10.2105/ajph.2011.300193] [Citation(s) in RCA: 416] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Funders of programs in public health and community health are increasingly concerned about the sustainability of changes they initiate. Despite a recent increase in sustainability research and evaluation, this literature has not developed a widely used paradigm for conducting research that can accumulate into generalizable findings. We provide guidance for research and evaluation of health program sustainability, including definitions and types of sustainability, specifications and measurements of dependent variables, definitions of independent variables or factors that influence sustainability, and suggestions for designs for research and data collection. We suggest viewing sustainability research as a further stage in the translation or dissemination of research-based interventions into practice. This perspective emphasizes ongoing relationships with earlier stages of a broader diffusion framework, including adoption and implementation processes.
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Austin G, Bell T, Caperchione C, Mummery WK. Translating research to practice: using the RE-AIM framework to examine an evidence-based physical activity intervention in primary school settings. Health Promot Pract 2011; 12:932-41. [PMID: 21421774 DOI: 10.1177/1524839910366101] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although there has been an increase in the availability of effective, evidence-based physical activity interventions in school settings during the past decade, there is a paucity of published research focusing on the translation of these effective interventions into real-world practice. The purpose of this research was to examine the translatability of an existing school-based physical activity intervention. More specifically, this research sought to identify the barriers and facilitators in adopting, implementing, and maintaining a school-based physical activity intervention using RE-AIM as a theoretical evaluation framework. It was concluded that interventions that consider issues around complexity and compatibility with the school setting are more likely to be adopted, implemented, and maintained. It was recommended that future evaluations of physical activity interventions should not be limited to testing internal validity, but should consider external validity and ecological aspects, relevant to increasing dissemination in real-world settings.
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Affiliation(s)
- Glenn Austin
- Wide Bay Public Health Unit, Bundaberg, Queensland 4670, Australia.
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Glasgow RE, King DK. Implications of Active Living by Design for broad adoption, successful implementation, and long-term sustainability. Am J Prev Med 2009; 37:S450-2. [PMID: 19944948 PMCID: PMC2800952 DOI: 10.1016/j.amepre.2009.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2009] [Revised: 08/15/2009] [Accepted: 09/07/2009] [Indexed: 11/29/2022]
Affiliation(s)
- Russell E Glasgow
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado 80237-8066, USA.
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Stathi A, Gillison FB, Riddoch CJ. Opportunities and challenges in physical activity research in young people. J Sci Med Sport 2008; 12:515-7. [PMID: 19056314 DOI: 10.1016/j.jsams.2008.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2008] [Revised: 09/24/2008] [Accepted: 09/26/2008] [Indexed: 11/18/2022]
Abstract
The purpose of this opinion piece is to discuss opportunities and challenges to physical activity [PA] research in young people. Two key limitations were identified; (i) the lack of specificity of the types of PA measured and standards in reporting this, and (ii) lack of attention given to ecological frameworks. First, it is argued that a greater specificity of measurement is needed as PA undertaken for different purposes and/or at different levels of intensity is predicted by different determinants, and its uptake mediated by different factors. As such, researchers should carefully define the types and dimensions of physical activity they want to target and choose the appropriate physical activity measure accordingly. Second, given the relatively modest success rates of intensive PA interventions based solely on an individual approach, consideration of ecological research frameworks is advocated, as such approaches that consider multiple levels of influence on individual behaviour have the potential to facilitate far greater understanding of the full range of determinants of PA. Ultimately, it is suggested that low levels of PA among young people might be better addressed through the application of solutions at the local level, and that by tailoring PA programmes to the characteristics of the local environment and population rather than viewing contextual differences as a problem, the efficacy of promising means of intervention could be increased.
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