Centre for Intervention Research in Health Promotion and Disease Prevention, National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455 Copenhagen K, Denmark.
Health Educ Res. 2020 Jun 1;35(3):195-215. doi: 10.1093/her/cyaa003.
Process evaluation of public health interventions is important for understanding intervention results and can help explain why interventions succeed or fail. This study evaluated implementation of a school-based intervention combining educational and environmental strategies to prevent stress among Danish high school students. We investigated dose delivered, dose received, fidelity, appreciation, barriers and facilitators at the 15 intervention schools using mixed methods and multiple data sources: questionnaires among students, teachers and school coordinators; semi-structured interviews with school coordinators; telephone interviews with student counsellors; and focus group interviews with students and teachers. Implementation varied by schools and classes. Half of the intervention schools delivered the environmental strategies. For the educational strategies, dose delivered differed according to intervention provider. Students reported a lower dose received compared with dose delivered reported by school staff. Overall, student counsellors, school coordinators and students-especially those with low perceived stress-were satisfied with the stress preventive initiatives while teacher satisfaction varied. Five main barriers and three facilitators for implementation were identified. The use of multiple data sources and data methods created new knowledge of the implementation process which is important for the interpretation of effect evaluation and development of future interventions.
公共卫生干预措施的过程评估对于理解干预结果非常重要，并且可以帮助解释干预措施为何成功或失败。本研究评估了在丹麦高中实施的一项结合教育和环境策略的基于学校的干预措施，以预防学生的压力。我们使用混合方法和多种数据源，在 15 所干预学校中调查了剂量传递、剂量接受、保真度、认可、障碍和促进因素：学生、教师和学校协调员的问卷调查；与学校协调员的半结构化访谈；与学生辅导员的电话访谈；以及学生和教师的焦点小组访谈。实施情况因学校和班级而异。一半的干预学校提供了环境策略。对于教育策略，剂量传递因干预提供者而异。与学校工作人员报告的剂量传递相比，学生报告的剂量接受较低。总体而言，学生辅导员、学校协调员和学生——尤其是那些感知压力较低的学生——对预防压力的举措感到满意，而教师的满意度则有所不同。确定了五个主要障碍和三个促进因素。使用多种数据源和数据方法为实施过程创造了新知识，这对于解释效果评估和未来干预措施的发展非常重要。
