Naylor Patti-Jean, McKay Heather A, Valente Maria, Mâsse Louise C
1School of Exercise Science,Physical and Health Education,University of Victoria,Box 3015,STN CSC,Victoria,BC V8W 3P1,Canada.
2Department of Family Practice and Department of Orthopedics,Centre for Hip Health and Mobility,University of British Columbia,Vancouver,British Columbia,Canada.
Public Health Nutr. 2016 Apr;19(5):924-34. doi: 10.1017/S1368980015001482. Epub 2015 May 20.
To study the implementation of a school-based healthy eating (HE) model one year after scale-up in British Columbia (BC). Specifically, to examine implementation of Action Schools! BC (AS! BC) and its influence on implementation of classroom HE activities, and to explore factors associated with implementation.
Diffusion of Innovations, Social Cognitive and Organizational Change theories guided our approach. We used a mixed-methods research design including focus group interviews (seven schools, sixty-two implementers) and a cross-sectional multistage survey to principals (n 36, 92 % response rate) and teachers of grades 4 to 7 (n 168, 70 % response rate). Self-reported implementation of classroom HE activities and reported use of specific AS! BC HE activities were primary implementation measures. Thematic analysis of focus group data and multilevel mixed-effect logistic regression analyses of survey data were conducted.
Elementary schools across BC, Canada.
Thirty-nine school districts, thirty-six principals, 168 grade 4 to 7 teachers.
Forty-two per cent of teachers in registered schools were implementing AS! BC HE in their classrooms. Users were 6·25 times more likely to have delivered a HE lesson in the past week. Implementation facilitators were school champions, technical support and access to resources; barriers were lack of time, loss of leadership or momentum. Implementation predictors were teacher training, self-efficacy, experience with the physical activity component of AS! BC, supportive school climate and parental post-secondary education.
Our findings reinforce that continued teacher training and support are important public health investments that contribute to successful implementation of school-based HE models after scale-up.
研究在不列颠哥伦比亚省（BC）扩大规模一年后基于学校的健康饮食（HE）模式的实施情况。具体而言，考察“行动学校！BC”（AS! BC）的实施情况及其对课堂健康饮食活动实施的影响，并探索与实施相关的因素。
创新扩散、社会认知和组织变革理论指导了我们的研究方法。我们采用了混合方法研究设计，包括焦点小组访谈（7所学校，62名实施者）以及对校长（n = 36，回应率92%）和4至7年级教师（n = 168，回应率70%）的横断面多阶段调查。自我报告的课堂健康饮食活动实施情况以及报告的特定AS! BC健康饮食活动的使用情况是主要的实施指标。对焦点小组数据进行了主题分析，并对调查数据进行了多层次混合效应逻辑回归分析。
加拿大BC省的小学。
39个学区、36名校长、168名4至7年级教师。
注册学校中42%的教师在其课堂上实施了AS! BC健康饮食模式。在过去一周内，使用者开展健康饮食课程的可能性是未使用者的6.25倍。实施促进因素包括学校倡导者、技术支持和资源获取；障碍包括时间不足、领导力或动力丧失。实施预测因素包括教师培训、自我效能感、AS! BC体育活动部分的经验、支持性的学校氛围和家长的高等教育程度。
我们的研究结果强化了持续的教师培训和支持是重要的公共卫生投资，有助于在扩大规模后成功实施基于学校的健康饮食模式。
