Poole Mary Kathryn, Lee Rebekka M, Kinderknecht Kelsey L, Kenney Erica L
Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
Implement Sci Commun. 2023 Jun 9;4(1):63. doi: 10.1186/s43058-023-00443-1.
This study explored reasons for the adoption of a policy to distribute report cards to parents about children's weight status ("BMI report cards") in Massachusetts (MA) public schools in 2009 and the contextual factors influencing the policy removal in 2013.
We conducted semi-structured, qualitative interviews with 15 key decision-makers and practitioners involved with implementing and de-implementing the MA BMI report card policy. We analyzed interview data using a thematic analytic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0.
Primary themes were that (1) factors other than scientific evidence mattered more for policy adoption, (2) societal pressure spurred policy adoption, (3) problems with the policy design contributed to inconsistent implementation and dissatisfaction, and (4) media coverage, societal pressure, and organizational politics and pressure largely prompted de-implementation.
Numerous factors contributed to the de-implementation of the policy. An orderly process for the de-implementation of a policy in public health practice that manages drivers of de-implementation may not yet exist. Public health research should further focus on how to de-implement policy interventions when evidence is lacking or there is potential for harm.
本研究探讨了2009年马萨诸塞州（MA）公立学校采用向家长发放儿童体重状况报告卡（“BMI报告卡”）政策的原因，以及2013年影响该政策取消的背景因素。
我们对15名参与实施和取消MA BMI报告卡政策的关键决策者和从业者进行了半结构化的定性访谈。我们使用由实施研究综合框架（CFIR）2.0指导的主题分析方法对访谈数据进行了分析。
主要主题包括：（1）政策采用中科学证据以外的因素更为重要；（2）社会压力促使政策采用；（3）政策设计问题导致实施不一致和不满；（4）媒体报道、社会压力以及组织政治和压力在很大程度上促使了政策的取消。
众多因素导致了该政策的取消。在公共卫生实践中，可能尚不存在一个有序的政策取消过程来管理取消的驱动因素。公共卫生研究应进一步关注在缺乏证据或存在潜在危害时如何取消政策干预措施。
