Using the RE-AIM framework to evaluate a school-based municipal programme tripling time spent on PE

Nielsen, Jonas Vestergaard; Skovgaard, Thomas; Bredahl, Thomas Viskum Gjelstrup; Bugge, Anna; Wedderkopp, Niels; Klakk, Heidi

doi:10.1016/j.evalprogplan.2018.05.005

Cited by 13 publications

(17 citation statements)

References 43 publications

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“…Of the 27 papers included in this review and outlined in Table 1, five employed a qualitative study design [45, 54, 57, 59, 61], nine a quantitative design [42, 44, 48, 50–52, 60, 62, 65], ten utilised mixed-methods [40, 41, 43, 46, 47, 55, 59, 63, 64, 66], and three included summary articles which collated previous findings and discussed lessons learned across multiple publications for a specific intervention [49, 53, 56]. Interventions conducted in the articles were delivered in six high income countries, as categorised by the World Bank [67]: USA [41–44, 48–51, 56, 58, 60, 65, 66], Canada [52, 53, 59], Netherlands [46, 47, 61–64], United Kingdom [45, 57], Australia [40], and Denmark [54, 55]. Further, interventions were conducted in a range of school settings including primary/elementary [40, 42, 44–47, 49, 51, 54–57], middle [43, 48, 66], primary/middle [52, 53, 59], high [58], pre-vocational [61–64], and all ages (primary, middle and high) [41, 50].…”

Section: Resultsmentioning

confidence: 99%

Adoption, implementation and sustainability of school-based physical activity and sedentary behaviour interventions in real-world settings: a systematic review

Cassar

Salmon

Timperio

et al. 2019

Int J Behav Nutr Phys Act

155

190

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BackgroundGlobally, many children fail to meet the World Health Organization’s physical activity and sedentary behaviour guidelines. Schools are an ideal setting to intervene, yet despite many interventions in this setting, success when delivered under real-world conditions or at scale is limited. This systematic review aims to i) identify which implementation models are used in school-based physical activity effectiveness, dissemination, and/or implementation trials, and ii) identify factors associated with the adoption, implementation and sustainability of school-based physical activity interventions in real-world settings.MethodsThe review followed PRISMA guidelines and included a systematic search of seven databases from January 1st, 2000 to July 31st, 2018: MEDLINE, EMBASE, CINAHL, SPORTDiscus, PsycINFO, CENTRAL, and ERIC. A forward citation search of included studies using Google Scholar was performed on the 21st of January 2019 including articles published until the end of 2018. Study inclusion criteria: (i) a primary outcome to increase physical activity and/or decrease sedentary behaviour among school-aged children and/or adolescents; (ii) intervention delivery within school settings, (iii) use of implementation models to plan or interpret study results; and (iv) interventions delivered under real-world conditions. Exclusion criteria: (i) efficacy trials; (ii) studies applying or testing school-based physical activity policies, and; (iii) studies targeting special schools or pre-school and/or kindergarten aged children.Results27 papers comprising 17 unique interventions were included. Fourteen implementation models (e.g., RE-AIM, Rogers’ Diffusion of Innovations, Precede Proceed model), were applied across 27 papers. Implementation models were mostly used to interpret results (n = 9), for planning evaluation and interpreting results (n = 8), for planning evaluation (n = 6), for intervention design (n = 4), or for a combination of designing the intervention and interpreting results (n = 3). We identified 269 factors related to barriers (n = 93) and facilitators (n = 176) for the adoption (n = 7 studies), implementation (n = 14 studies) and sustainability (n = 7 studies) of interventions.ConclusionsImplementation model use was predominately centered on the interpretation of results and analyses, with few examples of use across all study phases as a planning tool and to understand results. This lack of implementation models applied may explain the limited success of interventions when delivered under real-world conditions or at scale.Trial registrationPROSPERO (CRD42018099836).

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Section: Resultsmentioning

confidence: 99%

Adoption, implementation and sustainability of school-based physical activity and sedentary behaviour interventions in real-world settings: a systematic review

Cassar

Salmon

Timperio

et al. 2019

Int J Behav Nutr Phys Act

155

190

View full text Add to dashboard Cite

show abstract

“…Thus, motivated school staff is an important factor for the implementation process and has been iden ed to affect both adoption, implementation, and maintenance [35,51]. This is in line with Nielsen et al (2018), highlighting the importance of training in order to ensure teachers level of skills and self-e cacy, both affecting their motivation and dedication to the innovation.…”

Section: Motivation Of School Staffmentioning

confidence: 64%

“…Results from the interviews revealed that all schools in that municipality were economically supported by the municipality if the schools chose to become part of their municipal PA programme, tripling the amount of weekly PE. This case is a great example of a successful implementation process, with active involvement of both schools and municipalities, developing a shared strategy [43].…”

Section: Municipal Supportmentioning

confidence: 99%

“…The Reach, Effectiveness, Adoption, Implementation, and Maintenance framework (RE-AIM) has been deemed useful to evaluate internal and external validity of PA promotion programs, helping to provide a comprehensive evaluation [21,22]. In particular the RE-AIM framework has been used to evaluate real-world programs focusing on the implementation of PA in a school context [10,43,49].…”

Section: Introductionmentioning

confidence: 99%

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Physical activity in the classroom: Using RE-AIM to evaluate a national school reform – a mixed methods study

Koch

Pawlowski

Skovgaard

et al. 2021

Preprint

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Background In 2014, the Danish Government introduced a wide-ranging school reform that applied to all public schools in Denmark. A distinctive feature of the reform was that it became mandatory to implement an average of 45 minutes of daily physical activity within the curriculum. Using the RE-AIM framework as an evaluation tool, the objective of the current study was to evaluate the reach, effectiveness, adoption, implementation, and maintenance of mandatory physical activity within curriculum at ten Danish schools. Methods A complementary mixed methods approach using accelerometers, questionnaires, and semi-structured interviews was conducted. A total of 11 representative school were invited to participate, including 993 students, 131 teachers, and 11 school managers. Students were invited to wear an accelerometer for seven consecutive days. Teachers were invited to participate in a questionnaire and school managers were encouraged to take part in a semi-structured interview. Results A total of 10 schools were included in the analysis, including 846 students, 76 teachers, and 10 school managers. Results showed that, on average, 45.2% of the students were active at least 45 minutes daily within curriculum. Teacher and school management interest in physical activity, competencies development, and shared decision-making were identified as central factors for adoption of the requirement. Scheduling physical activity within timetables and collaborations with external parties were found to influence the implementation dimension. Finally, internal coordination, motivated school staff, and school management priority were identified as centrals factors for maintenance. Conclusions This study provides an evaluation on a national physical activity requirement in Danish public schools. When introcuding a wide-ranging national requirement on physical activity within curriculum, school managers need to prioritize and support the implementation process. Teachers need to be involved in the decision processes, in order to ensure motivation and local ownership. The study also highlight the benefits of an internal coordinator as well as development of a shared strategy among schools, municipalities, and other stakeholders in order to succeed with the implementation.

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“…The present study explores the Svendborgproject (SP) -a programme proved to triple the amount of physical education (PE), documenting decreased incidence of overweight, obesity and cardiovascular risk factors (Klakk, Andersen, Heidemann, Moller, et al, 2014;Klakk, Chinapaw, Heidemann, Andersen, et al, 2013) and been sustained for 10-years (Nielsen, Skovgaard, Bredahl, Bugge, et al, 2018). Previous process evaluations studies of SP have established that the programme has been implemented and maintained with high fidelity as well as programme managers' perspective on influential implementation factors (Nielsen, Klakk, Bugge, Andreasen, et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Implementation of a successful long-term school based physical education intervention: Exploring provider and programme characteristics

Nielsen

Bredahl

Bugge

et al. 2019

Evaluation and Program Planning

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Using the RE-AIM framework to evaluate a school-based municipal programme tripling time spent on PE

Cited by 13 publications

References 43 publications

Adoption, implementation and sustainability of school-based physical activity and sedentary behaviour interventions in real-world settings: a systematic review

Adoption, implementation and sustainability of school-based physical activity and sedentary behaviour interventions in real-world settings: a systematic review

Physical activity in the classroom: Using RE-AIM to evaluate a national school reform – a mixed methods study

Implementation of a successful long-term school based physical education intervention: Exploring provider and programme characteristics

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