1
|
Takens FE, Indyk I, Chinapaw MJM, Ujčič-Voortman JK, van Nassau F, Busch V. Qualitative multi-stakeholder evaluation of the adoption, implementation and sustainment of the school-based dietary intervention "Jump-in". BMC Public Health 2024; 24:1337. [PMID: 38760727 PMCID: PMC11102190 DOI: 10.1186/s12889-024-18814-1] [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] [Received: 10/12/2023] [Accepted: 05/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Comprehensive school-based programs applying the WHO Health Promoting School Model have the potential to initiate and sustain behavior change and impact health. However, since they often include intervention efforts on a school's policies, physical environment, curriculum, health care and involving parents and communities, they significantly 'intrude' on a complex system that is aimed primarily at education, not health promotion. More insights into and concrete strategies are therefore needed regarding their adoption, implementation, and sustainment processes to address the challenge to sustainable implementation of HPS initiatives in a primarily educational setting. This study consequently evaluates adoption, implementation and sustainment processes of Amsterdam's Jump-in healthy nutrition HPS intervention from a multi-stakeholder perspective. METHODS We conducted semi-structured interviews and focus groups with all involved stakeholders (n = 131), i.e., Jump-in health promotion professionals (n = 5), school principals (n = 7), at-school Jump-in coordinators (n = 7), teachers (n = 20), parents (n = 50, 9 groups) and children (n = 42, 7 groups) from 10 primary schools that enrolled in Jump-in in the school year 2016-2017. Included schools had a higher prevalence of overweight and/or obesity than the Dutch average and they were all located in Amsterdam's low-SEP neighborhoods. Data were analyzed using a directed content analysis, in which the Determinants of Innovation Model was used for obtaining theory-based predetermined codes, supplemented with new codes emerging from the data. RESULTS During intervention adoption, all stakeholders emphasized the importance of parental support, and accompanying workshops and promotional materials. Additionally, parents and teachers indicated that a shared responsibility for children's health and nuanced framing of health messages were important. During implementation, all stakeholders needed clear guidelines and support structures. Teachers and children highlighted the importance of peer influence, social norms, and uniform application of guidelines. School staff also found further tailoring of the intervention and dealing with financial constraints important. For long-term intervention sustainment, incorporating the intervention policies into the school statutes was crucial according to health promotion professionals. CONCLUSIONS This qualitative evaluation provides valuable insights into factors influencing the adoption, implementation, and sustainment processes of dietary interventions, such as the importance of transparent and consistent intervention guidelines, clear communication regarding the rationale behind intervention guidelines, and, stakeholders' involvement in decision-making.
Collapse
Affiliation(s)
- Froukje E Takens
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands.
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Indira Indyk
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands.
| | - Mai J M Chinapaw
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Joanne K Ujčič-Voortman
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Health Behaviour and Chronic Diseases, Amsterdam, The Netherlands
| | - Vincent Busch
- Department Gezond Leven, Public Health Service of Amsterdam, Team Sarphati Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| |
Collapse
|
2
|
McGinty EE, Alegria M, Beidas RS, Braithwaite J, Kola L, Leslie DL, Moise N, Mueller B, Pincus HA, Shidhaye R, Simon K, Singer SJ, Stuart EA, Eisenberg MD. The Lancet Psychiatry Commission: transforming mental health implementation research. Lancet Psychiatry 2024; 11:368-396. [PMID: 38552663 DOI: 10.1016/s2215-0366(24)00040-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 04/19/2024]
Affiliation(s)
| | - Margarita Alegria
- Massachusetts General Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Rinad S Beidas
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Lola Kola
- College of Medicine, University of Ibadan, Ibadan, Nigeria; Kings College London, London, UK
| | | | | | | | | | - Rahul Shidhaye
- Pravara Institute of Medical Sciences University, Loni, India; Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | | | - Sara J Singer
- Stanford University School of Medicine, Stanford, CA, USA
| | | | | |
Collapse
|
3
|
Busch V, Steenkamer I, van Nassau F, van Opdorp P, van Houtum L, Verhoeff A, Twisk J. The Effects of the Jump-In Whole-School Intervention on the Weight Development of Children in Amsterdam, the Netherlands. THE JOURNAL OF SCHOOL HEALTH 2024; 94:37-46. [PMID: 37518834 DOI: 10.1111/josh.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 06/13/2023] [Accepted: 06/22/2023] [Indexed: 08/01/2023]
Abstract
BACKGROUND This study assessed the effects of the "Jump-in" whole-school intervention in Amsterdam, the Netherlands, on children's weight development by comparing children exposed to the intervention and controls from 3 other large Dutch cities. Jump-in is a comprehensive intervention that aims to stimulate healthy nutrition and physical activity in children at primary schools in Amsterdam. In addition, the relationship between the intervention's implementation degree and its effectiveness was studied. METHODS Demographic and anthropometric data, collected by youth health care professionals via routine health checks at T0 (2014) and T1 (2019), were used to analyze possible intervention effects by comparing the weight development of children exposed to the Jump-in intervention versus unexposed controls. Implementation logs from health promotion professionals were used to determine intervention effects per implementation degree. Multilevel regression analyses were used for all analyses. RESULTS In total, 4299 children were included mean age ± 5.5 years (T0), 10.6 years (T1), and ≈50% boys/girls at both times. Receiving the fully implemented intervention resulted in a decline in standardized body-mass index (zBMI) compared to the controls (-0.23, confidence interval [CI] -0.33, -0.13). It also led to higher odds to move into a healthier weight category over time (odds ratio [OR] 1.36, CI 1.06, 1.74), yet no statistically significant shift towards a healthy weight was found. CONCLUSIONS Relative to the controls, children exposed to the intervention showed positive zBMI developments, with stronger effects when the implementation degree was higher. Despite positive results, creating more impact might require the further integration of school-based programs into whole-systems approaches that include other energy-balance behaviors.
Collapse
Affiliation(s)
- Vincent Busch
- Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Ilona Steenkamer
- Department of Healthy Living, Public Health Service (GGD), Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centre, Vrije Universiteit, De Boelelaan 1089a, 1081 HV Amsterdam, Amsterdam, The Netherlands
| | - Paul van Opdorp
- Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Lieke van Houtum
- Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, The Netherlands
| | - Arnoud Verhoeff
- Department of Sociology, University of Amsterdam, Nieuwe Achtergracht 166, 1018WV, Amsterdam, the Netherlands; Director, Sarphati Amsterdam, Department of Healthy Living, Public Health Service (GGD) Amsterdam, City of Amsterdam, Nieuwe Achtergracht 100, 1018WT, Amsterdam, The Netherlands
- Department of Sociology, University of Amsterdam. Nieuwe Achtergracht 166, 1018 WV, Amsterdam, The Netherlands
| | - Jos Twisk
- Department of Epidemiology and Data Science, Amsterdam UMC, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands
| |
Collapse
|
4
|
Sharfstein JM, Leighton J, Sommer A, MacKenzie EJ. Public Health Rising to the Challenge: The Bloomberg American Health Initiative. Public Health Rep 2018; 133:3S-4S. [PMID: 30426869 DOI: 10.1177/0033354918799744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Joshua M Sharfstein
- 1 Bloomberg American Health Initiative, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,2 Public Health Practice and Community Engagement, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Alfred Sommer
- 4 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ellen J MacKenzie
- 4 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
5
|
Affiliation(s)
- Ellen J MacKenzie
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael J Klag
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alfred Sommer
- 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|