Bolton Kristy A, Kremer Peter, Gibbs Lisa, Swinburn Boyd, Waters Elizabeth, de Silva Andrea
WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia.
School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
Obes Res Clin Pract. 2016 Mar-Apr;10(2):197-206. doi: 10.1016/j.orcp.2015.05.017. Epub 2015 Jul 9.
A previously successful community-based obesity prevention intervention with a focus on school settings was expanded into new communities with varying contexts. In order to understand the complexities involved in implementing health promotion activities in schools, this study examined experiences of school staff and project officers including barriers, contextual factors and achievements.
School environment assessments were conducted in schools across four Victorian communities with school staff (n=1-5 staff plus a trained researcher per group in 9 primary and 8 secondary schools) 12-18 months post-intervention. Process reports from project officers were also reviewed and analysed (n=4).
School staff commonly reported time pressures as a barrier to implementation and project officers working within schools reported competing priorities and limited health promotion experience of staff; lack of stakeholder engagement; low participation in some activities and insufficient implementation time. Contextual factors included community socioeconomic status, student ethnicity and living rurally. Achievements included student and staff enjoyment from programme activities, staff capacity building, partnerships, embedding activities into existing infrastructure and programmes, and having consistent health-related messages repeated through a variety of strategies.
Community-based interventions with a focus on school settings need to consider system level, organisational and contextual (i.e. socioeconomic, ethnicity, family and town characteristics) factors when expanding previously effective strategies into new communities. Implementation benefits may have added whole of school benefits in addition to child health. Focussing on overcoming the challenges experienced in this complex initiative is required for future interventions.
ACTRN12609000892213.
一项先前成功的、以学校为重点的社区肥胖预防干预措施扩展到了不同背景的新社区。为了了解在学校开展健康促进活动所涉及的复杂性，本研究调查了学校工作人员和项目官员的经验，包括障碍、背景因素和成就。
在干预后12 - 18个月，对维多利亚州四个社区的学校进行了学校环境评估，参与评估的有学校工作人员（9所小学和8所中学，每组1 - 5名工作人员加一名经过培训的研究人员）。还对项目官员的过程报告进行了审查和分析（共4份）。
学校工作人员普遍报告称时间压力是实施干预的障碍，在学校工作的项目官员则报告了相互竞争的优先事项以及工作人员健康促进经验有限；利益相关者参与不足；一些活动参与度低以及实施时间不足。背景因素包括社区社会经济地位、学生种族和农村居住情况。成就包括学生和工作人员对项目活动的喜爱、工作人员能力建设、伙伴关系、将活动纳入现有基础设施和项目，以及通过各种策略反复传递一致的健康相关信息。
以学校为重点的社区干预措施在将先前有效的策略扩展到新社区时，需要考虑系统层面、组织和背景（即社会经济、种族、家庭和城镇特征）因素。实施干预除了对儿童健康有益外，还可能为整个学校带来额外益处。未来的干预措施需要专注于克服这一复杂举措中遇到的挑战。
ACTRN12609000892213 。
