Policy-influencer perspectives on the development, adoption, and implementation of provincial school-based daily physical activity policies across Canada: A national case study

Campbell, Elizabeth J.; Olstad, Dana Lee; Spence, John C.; Storey, Kate; Nykiforuk, Candace I. J.

doi:10.1016/j.ssmph.2020.100612

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…Despite recognition of the importance and relevance of policy diffusion research by Canadian researchers (Place Research Lab, n.d.;Politis et al, 2014), we found few examples of public health policy diffusion scholarship in the Canadian context, consistent with findings elsewhere (Olive & Boyd, 2021). Our findings build on existing public health policy diffusion scholarship in Canada (Campbell et al, 2020;Nykiforuk et al, 2008Nykiforuk et al, , 2018Olstad et al, 2015;Place Research Lab, n.d.), which primarily adapts Roger's diffusion of innovations theory to explain adoption patterns (Rogers, 2003). Although Roger's theory is widespread in health sciences and healthcare innovation research, our review captures contemporary policy diffusion scholarship to include (for example) Berry and Berry (1990), Maggetti and Gilardi (2016), Volden (2008), andVolden (2006).…”

Section: Discussionsupporting

confidence: 72%

Policy diffusion theory, evidence-informed public health, and public health political science: a scoping review

Fundytus

Santamaria-Plaza

McLaren

2023

Can J Public Health

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Objectives Our aim was to synthesize published scholarship that applies policy diffusion—a theory of the policy process that considers the interdependence of government-level public health policy choices. We paid particular attention to the role of scientific evidence in the diffusion process, and to identifying challenges and gaps towards strengthening the intersection of public health, public policy, and political science. Methods We systematically searched 17 electronic academic databases. We included English-language, peer-reviewed articles published between 2000 and 2021. For each article, we extracted the following information: public health policy domain, geographic setting, diffusion directions and mechanisms, the role of scientific evidence in the diffusion process, and author research discipline. Synthesis We identified 39 peer-reviewed, primary research articles. Anti-smoking and tobacco control policies in the United States (n = 9/39) were the most common policy domain and geographic context examined; comparatively fewer studies examined policy diffusion in the Canadian context (n = 4/39). In terms of how policies diffuse, we found evidence of five diffusion mechanisms (learning, emulation, competition, coercion, and social contagion), which could moreover be conditional on internal government characteristics. The role of scientific evidence in the diffusion process was unclear, as only five articles discussed this. Policy diffusion theory was primarily used by public policy and political science scholars (n = 19/39), with comparatively fewer interdisciplinary authorship teams (n = 6/39). Conclusion Policy diffusion theory provides important insights into the intergovernmental factors that influence public health policy decisions, thus helping to expand our conceptualization of evidence-informed public health. Despite this, policy diffusion research in the Canadian public health context is limited.

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Section: Discussionsupporting

confidence: 72%

Policy diffusion theory, evidence-informed public health, and public health political science: a scoping review

Fundytus

Santamaria-Plaza

McLaren

2023

Can J Public Health

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“…Although a detailed situational analysis is often skipped due to lack of time, developing detailed planning based on an understanding of needs and the resources available also appeared to be a critical factor for success in urban settings. As bottom-up implementation is a prevalent approach for DPA policies in Canada ( Campbell et al , 2020 ), and given that this type of implementation might favour the development of policies that are more acceptable to stakeholders ( Bambra et al , 2005 ) in other countries as well, these factors should be considered by decision-makers and school administrators to facilitate adherence to school-based PA policies.…”

Section: Discussionmentioning

confidence: 99%

“…Since 2005, five Canadian provincial governments (Ontario, Alberta, Manitoba, British Columbia and Saskatchewan) have adopted policies for schools to promote initiatives aimed at providing a minimum amount of DPA to children ( Olstad et al , 2015 ). A recent study of key stakeholder perspectives on the development, adoption and implementation of the five Canadian DPA policies revealed that each of the policies was developed and adopted using a top-down approach by the province’s Ministry of Education and implemented using a bottom-up approach by the schools, meaning that the policies allow schools flexibility in meeting the needs of local educators and students ( Campbell et al , 2020 ). The study concluded that, according to the stakeholders, despite the mandatory nature of the policies and the flexibility in implementation, they were poorly implemented.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of the ‘bottom-up’ implementation of the Active at school! programme in Quebec, Canada

Gosselin

Robitaille

Laberge

2022

Health Promotion International

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Summary The lack of physical activity (PA) amongst children is a public health concern in many industrialized countries. School-based daily physical activity (DPA) policies are a promising intervention for increasing PA levels amongst children. Informed by a logic model framework, this study examines the factors associated with meeting a ‘top-down’ DPA objective in the context of a ‘bottom-up’ implementation of a school-based DPA initiative in Quebec, Canada. An online survey assessing school-level inputs, outputs and outcomes was sent to all participating schools (415). Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression to evaluate potential associations between factors (inputs and outputs) and the school’s adherence to providing at least 60 minutes of DPA (outcome). Adjusted ORs (AORs) and 95% CIs were calculated using a multivariate logistic regression to identify the best set of factors to predict adherence to the DPA objective. A total of 404 schools completed the questionnaire, amongst which 71% reported meeting the DPA target by implementing school-tailored activities. Three factors were identified as the best set of school inputs and outputs to predict meeting the objective: financial resources (per student) (AOR = 1.02; 95% CI 1.01–1.03), a shared vision amongst the school-team members that PA benefits learning outcomes (AOR = 1.94; 95% CI 1.04–3.19) and having conducted a detailed situational analysis (AOR = 1.89; 95% CI 1.00–3.58). Given that ‘bottom-up’ implementation might favour the development of policies that are more acceptable to stakeholders, our results should be considered by decision-makers and school administrators when implementing DPA initiatives.

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“…The identified factors were categorized according to Durlak and DuPre's determinant framework (15), whereby most of the facilitators (n = 15) and barriers (n = 9) related to adoption (e.g., characteristics of the school) could be assigned to the domain "prevention delivery system" (24), which is a domain reflecting organizational capacity. However, research on this topic in relation to policies is rather scarce (11,29,33,34). Furthermore, the research team is not aware of any cross-national, Germany-wide, or south-west Germany-wide studies on barriers and facilitators to the adoption of physical activity policies in elementary schools.…”

mentioning

confidence: 99%

Barriers and facilitators to the adoption of physical activity policies in elementary schools from the perspective of principals: An application of the consolidated framework for implementation research–A cross-sectional study

Wendt

Scheller

Flechtner-Mors

et al. 2023

Front. Public Health

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BackgroundStudies have shown that policies to promote physical activity in schools can have a positive impact on children's physical activity behavior. However, a large research gap exists as to what determinants may influence the adoption of such policies. Applying the Consolidated Framework for Implementation Research (CFIR), we investigated barriers and facilitators to the adoption of physical activity policies in elementary schools in Baden-Wuerttemberg, Germany, from the perspective of school principals.MethodsA cross-sectional study was conducted between May and June 2021. School principals from elementary and special needs schools (n = 2,838) were invited to participate in the study. The online questionnaire used was developed based on the CFIR and included questions on school characteristics and constructs of the CFIR domains inner setting, characteristics of individuals, and process. Logistic regression analyses were performed to examine associations between policy adoption and school characteristics as well as CFIR determinants.ResultsIn total, 121 schools (4%) participated in the survey, of which 49 (40.5%) reported having adopted a policy to promote physical activity. Positive associations with policy adoption were found for general willingness among teaching staff [odds ratio (OR): 5.37, 95% confidence interval (CI): 1.92–15.05], available resources (OR: 2.15, 95% CI: 1.18–3.91), access to knowledge and information (OR: 2.11, 95% CI: 1.09–4.09), and stakeholder engagement (OR: 3.47, 95% CI: 1.24–9.75).ConclusionsThis study provides a first insight into potential barriers and facilitators at the organizational level of schools that may be relevant to the adoption of physical activity policies, from the perspective of school principals. However, due to a low response rate, the results must be interpreted with caution. A strength of this study includes theoretical foundation through the use of the CFIR. The CFIR could be well-adapted to the school setting and provided valuable support for developing the questionnaire and interpreting the study results.

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Policy-influencer perspectives on the development, adoption, and implementation of provincial school-based daily physical activity policies across Canada: A national case study

Cited by 7 publications

References 34 publications

Policy diffusion theory, evidence-informed public health, and public health political science: a scoping review

Policy diffusion theory, evidence-informed public health, and public health political science: a scoping review

An evaluation of the ‘bottom-up’ implementation of the Active at school! programme in Quebec, Canada

Barriers and facilitators to the adoption of physical activity policies in elementary schools from the perspective of principals: An application of the consolidated framework for implementation research–A cross-sectional study

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