Abstract
BackgroundThe uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. We aimed to gain a better understanding of what health promotion professionals and policy makers think are important factors facilitating adoption, implementation, and maintenance of multi-level interventions and policies promoting healthy eating and PA in Belgium, Germany, Ireland, Norway, and Poland.MethodsSix interventions and six policies were identified based on pre-defined criteria. Forty semi-structured interviews were conducted with stakeholders from various sectors to elicit information on factors impacting adoption, implementation, and maintenance of these interventions and policies. All interview transcripts were coded in NVivo, using a common categorization matrix. Coding in the respective countries was done by one researcher and validated by a second researcher.ResultsActive involvement of relevant stakeholders and good communication between coordinating organizations were described as important factors contributing to successful adoption and implementation of both interventions and policies. Additional facilitating factors included sufficient training of staff and tailoring of materials to match needs of various target groups. The respondents indicated that maintenance of implemented interventions/policies depended on whether they were embedded in existing or newly created organizational structures in different settings and whether continued funding was secured.ConclusionsDespite considerable heterogeneity of interventions and health policies in the five countries, stakeholders across these countries identify similar factors facilitating adoption, implementation, and maintenance of these interventions and policies.
Highlights
The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood
Results of the intervention case studies Facilitating factors concerning the adoption of interventions The expertise of the implementation staff, stemming from previous experiences in and knowledge of the school environment, contributed to a successful implementation of interventions implemented in schools
Training of the implementation staff in aims, sequence, and delivery of intervention activities at the beginning and during the implementation of the intervention was revealed as a facilitating factor during the adoption phase
Summary
The uptake, implementation, and maintenance of effective interventions promoting physical activity (PA) and a healthy diet and the implementation of policies targeting these behaviors are processes not well understood. The World Health Organization (WHO) launched a global action plan in 2013 comprising six steps to increase the levels of these protective behaviors at the population-level and to further reduce additional behaviors known to increase NCD risk [3] One of these steps addresses the underlying social determinants of modifiable risk factors for NCDs by suggesting the creation of health promoting environments. In the ‘Determinants of Diet and Physical Activity’ (DEDIPAC) Knowledge Hub [8], one of the aims was to gain a better insight into factors that facilitate adoption, implementation, and maintenance of multi-level interventions and policies to promote healthy eating, PA (and reduce SB). The aim of the second umbrella review was to identify evidence-based conditions for successfully implementing interventions and policies promoting a healthy diet, PA, and a reduction in SB [9]. Results of these two umbrella reviews suggest that the number of research papers on implementation conditions has grown rapidly in recent years
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