The process evaluation of a school-based physical activity intervention: influencing factors and potential consequences of implementation

Andreas Åvitsland,Stein Erik Ohna,Øystein Lerum,Sindre Mikal Dyrstad,Eva Leibinger,Hege Eikeland Tjomsland

doi:10.1108/he-01-2020-0004

Abstract

PurposeThis paper evaluates the implementation of a school-based physical activity intervention and discusses how the intervention outcomes can be influenced by the implementation.Design/methodology/approachIn four of the nine lower secondary schools in which the intervention was conducted, the authors examined implementation fidelity, adaptation, quality, responsiveness and dose received. The authors conducted focus group interviews with teachers (n = 8) and students (n = 46) and made observations. Dose delivered was examined quantitatively, with weekly registrations.FindingsResults showed that two out of four schools made few and positive adaptations, implemented the intervention with high fidelity and quality and responded positively. Four main factors were found to influence implementation: frame factors, intervention characteristics, participant characteristics and provider characteristics.Research limitations/implicationsA cross-sectional design was used and may not represent implementation throughout the whole school year.Practical implicationsIn terms of large-scale implementation, the intervention may be generalizable. However, intervention criteria such as adequate facilities and a flexible timetable may be unattainable for some schools. The intervention can be adapted without compromising its purpose, but adaptations should be a result of cooperation between students and teachers.Originality/valueProcess evaluations on this topic are rare. This study adds to a limited knowledge base concerning what factors may influence implementation of school-based physical activity interventions for adolescents.

Highlights

Schools are considered viable settings for intervention, reaching children and adolescents irrespective of sex, socioeconomic status and ethnicity
The authors of this paper were stakeholders in the cluster randomized controlled trial (RCT) evaluating DWBH and may have an interest in portraying it positively. This may have influenced how we conducted the process evaluation, interpreted and reported the results. This process evaluation showed that two out of four qualitatively examined schools delivered the intervention with high fidelity, quality, dose delivered and dose received, while obtaining positive responsiveness from participants and providers
Positive adaptations were made in schools that were likely to succeed anyway, based on their preconditions, while negative adaptations were made in schools that, based on their preconditions, were less likely to succeed

Summary

Introduction

Schools are considered viable settings for intervention, reaching children and adolescents irrespective of sex, socioeconomic status and ethnicity. Studies evaluating school-based physical activity (PA) interventions have largely examined whether the interventions affect. Stein Erik Ohna, Sindre Mikal Dyrstad, Hege Eikeland Tjomsland, Øystein Lerum, Eva Leibinger. The full terms of this licence may be seen at http:// creativecommons.org/licences/by/4.0/legalcode

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