Journal
JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR
Volume 46, Issue 6, Pages 576-582Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jneb.2014.04.293
Keywords
qualitative; school; intervention; obesity prevention
Funding
- Massachusetts Department of Public Health, under International Nutrition Foundation, Inc, Boston, MA
- Leadership Education in Adolescent Health Project, Maternal and Child Health Bureau, HRSA Grant [6t71-MC00009]
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Objective: To explore barriers and facilitators to implementing and sustaining Healthy Choices, a 3-year multicomponent obesity prevention intervention implemented in middle schools in Massachusetts. Methods: Using purposive sampling, 56 in-depth interviews were conducted with middle school employees representing different positions (administrators, teachers, food service personnel, and employees serving as intervention coordinators). Interviews were recorded and transcribed. Emergent themes were identified using thematic analyses. Results: State-mandated testing, budget limitations, and time constraints were viewed as implementation barriers, whereas staff buy-in, external support, and technical assistance were seen as facilitating implementation. Respondents thought that intervention sustainability depended on external funding and expert assistance. Conclusions and Implications: Results confirm the importance of gaining faculty and staff support. Schools implementing large-scale interventions should consider developing sustainable partnerships with organizations that can provide resources and ongoing training. Sustainability of complex interventions may depend on state-level strategies that provide resources for implementation and technical assistance.
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