Appreciation and implementation of the Krachtvoer healthy diet promotion programme for 12- to 14- year-old students of prevocational schools

Abstract

BackgroundKrachtvoer is a school-based healthy diet programme, developed in 2001 and revised in 2007 to meet the needs of particular segments of the target population as well as a wider target group. The main aims of the present process evaluation of the revised programme were to examine student and teacher appreciation of the programme, completeness of and adherence to its implementation, and relations between appreciation and completeness of implementation.MethodsData were collected among 22 teachers and 1117 students of 13 schools, using student evaluation forms, teacher logbooks, telephone interviews, and classroom observations.ResultsResults indicate favourable levels of teacher and student appreciation for the programme in general and the revised elements. Girls, first-year students and students with more favourable dietary intakes particularly appreciated individual programme elements. Levels of completeness of implementation were high, but several teachers did not adhere to the intended implementation period. Some moderately strong relations were found between teacher appreciation and completeness of implementation scores.ConclusionWe conclude that the revisions have resulted in a programme that was appreciated well, also by the extended target group, and was implemented with a high degree of completeness. Teacher appreciation proved potentially important for completeness of implementation. We identified several aspects requiring improvement, indicating the importance of continued programme updates and repeated evaluation.

Examining the relationship between completeness of teachers’ implementation of the Krachtvoer healthy diet programme and changes in students’ dietary intakes

“…Additional optional programme elements within lesson 4 (second part) and lesson 7 (first part) are participating in a nationwide recipe contest (as homework), reading and discussing the Krachtvoer magazine, knowledge tests on the programme website, and additional food exposure activities as proposed in lesson 5. The programme builds on the three phases of selfmanagement theory (13) , successively aiming at raising awareness of personal dietary intakes, proposing solutions in order to meet the Dutch dietary guidelines and setting personal goals for dietary improvement (10,14) . A programme overview is presented in Box 1.…”

“…A programme overview is presented in Box 1. A more extensive programme description is published elsewhere (10) .…”

Setting goal and implementation intentions in consultations between practice nurses and patients with overweight or obesity in general practice

“…Implementation intentions specify the when, where and how of responses leading to goal attainment. Several studies have focused on implementation intentions and changing people's existing eating behaviour (8)(9)(10)(11)(12)(13)(14) , physical activity behaviour (15)(16)(17)(18) and weight-loss behaviour (19) . Furthermore, some clinical studies have been conducted on implementation intentions regarding eating behaviour or physical activity behaviour among cardiac patients (20,21) and hypertensive patients (22) .…”

Implementation strategy for the school-based sex education program Long Live Love

“…This is due to the increased awareness that if health promotion programs are not implemented systematically, their impact on public health will remain low (Durlak & DuPre, 2008;Glasgow et al, 2012;Steckler & Linnan, 2002). It has been established that programs are more likely to be successful if implemented completely and as prescribed by program developers (Bessems et al, 2011;Durlak & Dupre, 2008;Payne, 2009;Payne, Gottfredson, & Gottfredson, 2006). Variability in implementation is related to variability in achieving expected program outcomes (Lendrum & Humphrey, 2012;Little, Riggs, Shin, Tate, & Pentz, 2015).…”

“…Moreover, a limited number of studies have been reported, describing a systematically developed theory-and evidence-based implementation strategy, targeting each stage of the implementation process and considering the broader environment in which the behavior takes place. Effective implementation strategies nonetheless, are worth looking into as they often lead to maximum effect by ensuring that effective programs are adopted on a large scale, implemented with high levels of fidelity and completeness and continued in the long term (Glasgow, Vogt, & Boles, 1999;Bessems et al, 2011). Designing interventions based on theory and evidence can protect against Type 3 error: failure to produce effective results due to poor design or implementation (Dobson & Cook, 1980).…”