Background School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. Methods As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). Results Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed non-significant associations between implementation group and gains in school capacity (F [2, 24] = 1.63; p = .21), class capacity (F [2, 24]=0.20 p = .82), lunchroom capacity (F [2, 24]=0.29; p = .78), and physical education (F [2, 24]=1.45; p = .25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. Conclusions The results from this implementation study document the importance of allowing schools to adapt programming to meet their local needs, and highlight the strengths of measuring multiple implementation outcomes. Increased support is needed for schools regarding the formation and improvement of wellness policies as a means to enhance sustainability over time.

Authentic youth engagement was a central component of the Food & Fitness (F&F) Initiative, a 9-year community-based intervention, whose goal was to ensure that all children have equitable access to healthy food and built environments that promote safe physical activity. The youth engagement component focused on strategies and structures that would support a model framework for youth involved in F&F community partnerships. These strategies empowered youth by providing the leadership and technical skills needed in collaborative efforts to sustain change in communities with inequities, where structural racism and inequities result in poor health outcomes for children. This article describes the models that the diverse urban and rural communities across the United States employed to successfully engage youth in the vision and work of F&F and discusses overall lessons learned, challenges, and best practices/recommendations for effectively engaging youth in community-determined change.

Background Schools provide an ideal setting for promoting healthy lifestyles in youth, but it has proven difficult to promote the adoption and implementation of evidence-based programming by school leaders. The SWITCH® (School Wellness Integration Targeting Child Health) intervention is a capacity-building process designed to help school leaders learn how to plan, implement, and sustain school wellness programs on their own. Objective The present study evaluates the transdisciplinary approaches used in establishing an integrated research-practice partnership with the statewide 4-H/Extension network to support broader dissemination. Method The study used a mixed methods approach to evaluate the degree of engagement and motivation of 4-H leaders (N = 30) for providing ancillary support for local school wellness programming. Engagement from 4-H Staff was logged over a year-long period through tracking completion of training and ongoing engagement with aspects of SWITCH. They completed checkpoint surveys and an interview to provide perceptions of supporting school implementation of SWITCH programming. Data were analysed through Pearson bivariate correlations and constant comparative analysis. Results County-level 4-H staff demonstrated high engagement in SWITCH by attending training sessions and hosting structured checkpoint sessions with schools. Interview data revealed that 4-H Staff valued connections with schools and emphasized that training on SWITCH was consistent with their existing roles related to youth programming. Conclusions The results demonstrate the value of the sequential capacity-building process used to train 4-H Staff to facilitate school wellness programming. The transdisciplinary approaches built transferable skills and fostered relationships that directly support the broader goals of 4-H.

Background: School wellness programming is important for promoting healthy lifestyles and academic achievement in youth; however, research is needed on methods that can help schools implement and sustain such programs on their own. The purpose of this study was to investigate factors within and outside the school environment that influenced school capacity for implementation and potential sustainability of wellness programming. Methods: As part of the School Wellness Integration Targeting Child Health (SWITCH®) intervention, elementary school wellness teams (N = 30) were guided through a capacity-building process focused on promoting the adoption of healthy lifestyle behaviors in students. Data on implementation were collected through three standardized surveys and interviews (pre-mid-post) and a post-implementation interview. Indicators of organizational capacity were assessed using the School Wellness Readiness Assessment (SWRA). Paired t-tests were run to assess changes in implementation (classroom, physical education, and lunchroom settings), capacity, and stakeholder engagement over time. One-way analysis of variance (ANOVA) tests were run to examine how implementation of best practices (low, moderate, high) explained differences in capacity gains. Qualitative data were analyzed through inductive and deductive analysis, following the Consolidated Framework for Implementation Research (CFIR). Results: Paired t-tests showed non-significant increases in school and setting-specific capacity and implementation of SWITCH best practices over time, in addition to a consistent level of engagement from key stakeholders. ANOVA results revealed positive, non-significant variances between implementation group and gains in school capacity (F[2,24] = 1.63; p = .21), class capacity (F[2,24]=0.20 p=.82), lunchroom capacity (F[2,24]=0.29; p=.78), and physical education (F[2,24]=1.45; p=.25). Qualitative data demonstrated that factors within the outer setting (i.e., engaging community partners) facilitated programming. Inner-setting factors (i.e., relationships with administration and staff) influenced implementation. Implementation process themes (e.g., planning, adaptation of resources to meet school capacity/needs, and engaging students as leaders) were cited as key facilitators. Schools discussed factors affecting sustainability, such as school culture and knowledge of school wellness policy. Conclusions: The results from this implementation study document the importance of allowing schools to adapt programming to meet their local needs, and highlight the strengths of measuring multiple implementation outcomes. Increased support is needed for schools regarding the formation and improvement of wellness policies as a means to enhance sustainability over time.