School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7460 USA.
Department of Planning, Policy and Design, University of California at Irvine, Irvine, CA 92697-7075 USA.
Transl Behav Med. 2014 Jun;4(2):131-40. doi: 10.1007/s13142-013-0226-z.
School-based interventions are essential to prevent pediatric obesity and type 2 diabetes. School environmental factors influence implementation of these interventions. This article examines how school factors acted as barriers to and facilitators of the HEALTHY intervention. The HEALTHY study was a cluster-randomized trial of a multicomponent intervention implemented in 21 schools. Interview data were analyzed to identify barriers and facilitators. Barriers included teacher frustration that intervention activities detracted from tested subjects, student resistance and misbehavior, classroom management problems, communication equipment problems, lack of teacher/staff engagement, high cost and limited availability of nutritious products, inadequate facility space, and large class sizes. Facilitators included teacher/staff engagement, effective classroom management, student engagement, schools with direct control over food service, support from school leaders, and adequate facilities and equipment. Contextual barriers and facilitators must be taken into account in the design and implementation of school-based health interventions.
学校为基础的干预措施对于预防儿童肥胖和 2 型糖尿病至关重要。学校环境因素会影响这些干预措施的实施。本文探讨了学校因素如何成为健康干预的障碍和促进因素。HEALTHY 研究是一项在 21 所学校中实施的多组分干预的集群随机试验。对访谈数据进行了分析，以确定障碍和促进因素。障碍包括教师感到沮丧，因为干预活动会影响考试科目；学生的抵触和不良行为；课堂管理问题；沟通设备问题；缺乏教师/员工的参与；营养产品成本高且供应有限；设施空间不足；以及班级规模过大。促进因素包括教师/员工的参与、有效的课堂管理、学生的参与、对餐饮服务具有直接控制权的学校、学校领导的支持，以及充足的设施和设备。在设计和实施以学校为基础的健康干预措施时，必须考虑到背景障碍和促进因素。
