Department of Pediatrics, University of British Columbia, L408-4480 Oak Street, Vancouver, BC, Canada.
Am J Prev Med. 2012 Oct;43(4):369-77. doi: 10.1016/j.amepre.2012.06.010.
Action Schools! BC (AS!BC) is a comprehensive school-based model that utilizes a socioecologic approach to provide children with opportunities for physical activity at school in British Columbia.
The hierarchy of factors associated with successful implementation of AS!BC was examined 4 years after it was scaled up.
A cross-sectional multistage survey was administered to principals (n=133; 92% response rate) and Grade 4-7 teachers (n=587; 71% response rate) in 2008-2009. Constructs from the theories of organizational change, social cognitive theory and Rogers's diffusion of innovation model were used to examine characteristics of teachers and schools and attributes of the innovation associated with implementation. Multilevel mixed-effect logistic regression analyses were employed (analyzed in November 2011).
Self-efficacy, outcome expectation, training received, organizational climate/support, level of institutionalization, environmental influence, and attributes of the innovation were associated with implementation. In multivariate analyses, self-efficacy, training, and level of institutionalization remained significant (all p<0.05).
Demonstrating that an intervention "works" is only the first step toward promoting enhanced health at the population level. For wide-scale implementation, teacher-level self-efficacy and ongoing technical support to train teachers were important. At the school level, policies and guidelines provided a necessary, supportive environment for implementation.
行动学校！不列颠哥伦比亚省（AS!BC）是一个综合的基于学校的模式，利用社会生态学方法为不列颠哥伦比亚省的儿童提供在学校进行体育活动的机会。
在扩大规模四年后，检查了与 AS!BC 成功实施相关的因素层次。
2008-2009 年，对校长（n=133；92%的响应率）和 4-7 年级教师（n=587；71%的响应率）进行了横断面多阶段调查。使用组织变革理论、社会认知理论和罗杰斯创新扩散模型的构建来检验教师和学校的特征以及与实施相关的创新属性。采用多级混合效应逻辑回归分析（2011 年 11 月分析）。
自我效能感、结果预期、接受的培训、组织氛围/支持、制度化程度、环境影响以及创新属性与实施相关。在多变量分析中，自我效能感、培训和制度化程度仍然显著（均 p<0.05）。
证明干预措施“有效”只是提高人群健康水平的第一步。为了广泛实施，教师的自我效能感和持续培训教师的技术支持非常重要。在学校层面，政策和准则为实施提供了必要的支持环境。
