行动学校！不列颠哥伦比亚省实施情况：从疗效到效果再到扩大规模。
Action Schools! BC implementation: from efficacy to effectiveness to scale-up.
机构信息
Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada.
Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada Child and Family Research Institute, Vancouver, British Columbia, Canada.
出版信息
Br J Sports Med. 2015 Feb;49(4):210-8. doi: 10.1136/bjsports-2013-093361. Epub 2014 Oct 13.
OBJECTIVES
To describe Action Schools! BC (AS! BC) from efficacy to scale-up.
PARTICIPANTS/SETTING: Education and health system stakeholders and children in grades 4-6 from elementary schools in British Columbia, Canada.
INTERVENTION
At the provincial level, the AS! BC model reflected socioecological theory and a partnership approach to social change. Knowledge translation and exchange were embedded as a foundational element. At the school level, AS! BC is a comprehensive school health-based model providing teachers and schools with training and resources to integrate physical activity (PA) and healthy eating (HE) into the school environment. Our research team partnered with key community and government stakeholders to deliver and evaluate AS! BC over efficacy, effectiveness and implementation trials.
RESULTS
On the basis of significant increases in PA, cardiovascular fitness, bone and HE in AS! BC schools during efficacy trials, the BC government supported a provincial scale-up. Since its inception, the AS! BC Support Team and >225 trained regional trainers have delivered 4677 teacher-focused workshops (training approximately 81,000 teachers), reaching approximately 500,000 students. After scale-up, PA delivery was replicated but the magnitude of change appeared less. One (HE) and 4 (PA) years after scale-up, trained AS! BC teachers provided more PA and HE opportunities for students even in the context of supportive provincial policies.
CONCLUSIONS
Whole school models like AS! BC can enhance children's PA and health when implemented in partnership with key stakeholders. At the school level, adequately trained and resourced teachers and supportive school policies promoted successful scale-up and sustained implementation. At the provincial level, multisectoral partnerships and embedded knowledge exchange mechanisms influenced the context for action at the provincial and school level, and were core elements of successful implementation.
TRIAL REGISTRATION NUMBER
Clinical Trials Registry NCT01412203.
目的
从疗效评估到推广实施的角度来描述“行动学校！不列颠哥伦比亚省”（AS! BC）。
参与者/背景：来自加拿大不列颠哥伦比亚省的教育和卫生系统利益相关者，以及小学 4-6 年级的儿童。
干预措施
在省级层面，AS! BC 模式反映了社会生态学理论和社会变革的伙伴关系方法。知识转化和交流被嵌入作为一个基础要素。在学校层面，AS! BC 是一个综合的学校健康模式，为教师和学校提供培训和资源，将体育活动（PA）和健康饮食（HE）融入学校环境。我们的研究团队与关键的社区和政府利益相关者合作，在疗效、效果和实施试验中提供和评估 AS! BC。
结果
在 AS! BC 学校的 PA、心血管健康、骨骼和 HE 在疗效试验中显著增加的基础上，不列颠哥伦比亚省政府支持了省级推广。自成立以来，AS! BC 支持团队和 225 多名经过培训的区域培训师已经举办了 4677 次面向教师的研讨会（培训了大约 81000 名教师），覆盖了大约 50 万名学生。推广后，PA 的实施得到了复制，但变化的幅度似乎较小。在推广后 1 年（HE）和 4 年（PA），经过培训的 AS! BC 教师为学生提供了更多的 PA 和 HE 机会，即使在支持性的省级政策背景下也是如此。
结论
像 AS! BC 这样的整体学校模式，当与关键利益相关者合作实施时，可以提高儿童的 PA 和健康水平。在学校层面，经过充分培训和资源支持的教师和支持性的学校政策促进了成功的推广和持续的实施。在省级层面，多部门伙伴关系和嵌入的知识交流机制影响了省级和学校层面的行动背景，是成功实施的核心要素。
试验注册号
ClinicalTrials.gov NCT01412203。
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