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.
Highlights
The World Health Organisation (WHO) identifies schools as primary sites for health interventions due to their ability to reach the vast majority of school-aged youth
Implementation has been defined as a “specific set of activities designed to put into practice an activity or programme of known dimensions” [4,11]. This encompasses all aspects of the process of intervention delivery including the extent to which an intervention and its elements are implemented as planned, how much of the intervention is delivered or received, how responsive participants were to the intervention and changes made to the intervention during implementation that enhance its fit within the setting it is being delivered in [10,12]. It has been argued by Durlak and DuPre [12] that in order to bridge the gap between developed and adopted effective physical activity interventions on a scale broad enough to promote large-scale health changes, there is a critical need to understand factors related to intervention implementation
The definitions of the five components of the RE-AIM framework are frequently adapted by researchers so that they are suitable for the context in which they are applying them to; see Table 2
Summary
The World Health Organisation (WHO) identifies schools as primary sites for health interventions due to their ability to reach the vast majority of school-aged youth. This encompasses all aspects of the process of intervention delivery including the extent to which an intervention and its elements are implemented as planned, how much of the intervention is delivered or received, how responsive participants were to the intervention and changes made to the intervention during implementation that enhance its fit within the setting it is being delivered in [10,12] It has been argued by Durlak and DuPre [12] that in order to bridge the gap between developed and adopted effective physical activity interventions on a scale broad enough to promote large-scale health changes, there is a critical need to understand factors related to intervention implementation. Discuss maintenance of the intervention in relation to sustained behaviour change
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