Faculty of Life Sciences and Health Studies, University of Bradford, Richmond Road, Bradford, UK.
Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, UK.
Int J Behav Nutr Phys Act. 2023 Jul 5;20(1):80. doi: 10.1186/s12966-023-01485-3.
Few whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active Schools (CAS) programme was co-designed and is underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Consolidated Framework for Implementation Research (CFIR). The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay's et al.'s (2019) implementation evaluation roadmap.
Focus groups and interviews were conducted with school staff (n = 30, schools = 25), CAS Champions (n = 9), and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al's implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising.
Identified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided "safe spaces" for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff's self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools.
This study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders' perceived self-efficacy. The combination of McKay's evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity.
很少有整体学校体育活动计划在设计、实施和评估中整合实施科学框架。因此，缺乏支持大规模实施的关键因素的知识。“创建积极学校”（CAS）计划是共同设计的，并以能力、机会、动机和行为（COM-B）模型和实施研究综合框架（CFIR）为基础。该研究旨在使用 McKay 等人（2019 年）的实施评估路线图，在 9 个月内了解布拉德福德的 CAS 的初步影响和实施情况。
对学校工作人员（n=30 人，学校=25 所）、CAS 冠军（n=9 人）和 CAS 战略负责人（n=1 人）进行了焦点小组和访谈。定性数据进行了归纳和演绎分析。演绎分析包括根据 McKay 等人的实施评估路线图，使用主题分析的代码簿方法，将数据编码为先验主题。归纳分析包括在最终确定之前生成初始代码和审查主题。
确定的主题分为三类：（i）成功采用和实施 CAS 的关键因素，（ii）CAS 实施：挑战和解决方案，以及（iv）CAS 在学校层面的感知有效性。这包括当学校认为整体方法高质量且与当前学校价值观一致时，他们愿意采用和实施整体方法。方案实施过程被认为是支持性的；学校确定并重视长期实施 CAS 的阶段性方法。正式和非正式的实践社区为跨校支持提供了“安全空间”。相反，在学校内部和学校之间扩大覆盖面仍然存在挑战，学校工作人员的自我能力和围绕体育活动的学校文化的转变。这导致了学校之间和学校内部的采用率各不相同。
本研究为 CAS 的实施提供了新的见解，结果与采用、覆盖范围和可持续性相一致。CAS 的成功实施是由可接受性、干预复杂性、学校文化和学校利益相关者的感知自我效能等决定因素支撑的。McKay 评估路线图和 CFIR 的结合为行为和实施科学为基础的活动推广计划的评估建立了严格的方法。因此，本研究在理解体育活动的整体学校方法的实施和有效性方面具有新颖性和进展性。
