叶戈计划：提高美国印第安小学生健康饮食和园艺参与度的过程评价
Process evaluation of the Yéego! Program to increase healthy eating and gardening among American Indian elementary school children.
机构信息
University of Washington, Box 351621, Seattle, WA, 98195, USA.
Fred Hutchinson Cancer Research Center, Seattle, USA.
出版信息
BMC Public Health. 2024 Jan 19;24(1):232. doi: 10.1186/s12889-024-17689-6.
BACKGROUND
American Indian children are at increased risk for obesity and diabetes. School-based health promotion interventions are one approach to promoting healthy behaviors to reduce this risk, yet few studies have described their implementation and fidelity. We conducted a qualitative process evaluation of the Yéego! Healthy Eating and Gardening Program, a school-based intervention to promote healthy eating among Navajo elementary school children. The intervention included a yearlong integrated curriculum, as well as the construction and maintenance of a school-based garden.
METHODS
Our process evaluation included fidelity checklists completed by program staff and qualitative interviews with program staff and classroom teachers after the intervention was implemented. We used content analysis to identify themes.
RESULTS
We identified several themes related to evidence of delivery adherence, program satisfaction, and lessons learned about delivery. Intervention staff followed similar procedures to prepare for and deliver lessons, but timing, teaching styles, and school-level factors also impacted overall implementation fidelity. Teachers and students had positive perceptions of the program, especially lessons that were highly visual, experiential, and connected to Navajo culture and the surrounding community. Teachers and program staff identified ways to enhance the usability of the curriculum by narrowing the scope, relating content to student experiences, and aligning content with school curriculum standards.
CONCLUSIONS
The program was implemented with moderately high fidelity across contexts. We identified areas where modifications could improve engagement, acceptability, efficacy, and sustainability of the program. Our results have implications for the evaluation and dissemination of school-based health interventions to promote healthy eating among children, especially in American Indian communities.
背景
美国印第安儿童肥胖和糖尿病的风险增加。基于学校的健康促进干预措施是促进健康行为以降低这种风险的一种方法，但很少有研究描述其实施和保真度。我们对 Yéego！健康饮食和园艺计划进行了定性的过程评估，这是一项针对纳瓦霍小学生促进健康饮食的基于学校的干预措施。该干预措施包括一整年的综合课程，以及建立和维护一个基于学校的花园。
方法
我们的过程评估包括计划工作人员完成的保真度检查表，以及在干预实施后对计划工作人员和课堂教师进行的定性访谈。我们使用内容分析来确定主题。
结果
我们确定了几个与证据交付坚持性、计划满意度和交付经验教训有关的主题。干预工作人员遵循类似的程序来准备和交付课程，但时间安排、教学风格和学校层面的因素也会影响整体实施保真度。教师和学生对该计划有积极的看法，特别是那些高度直观、体验式的、与纳瓦霍文化和周边社区相关的课程。教师和计划工作人员确定了通过缩小范围、将内容与学生的经验联系起来以及使内容与学校课程标准保持一致来提高课程可用性的方法。
结论
该计划在不同背景下以中等高度的保真度实施。我们确定了可以提高参与度、可接受性、疗效和可持续性的改进领域。我们的结果对评估和传播促进儿童健康饮食的基于学校的健康干预措施具有启示意义，特别是在美洲印第安人社区。
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