Successful dissemination of Fun 5 — a physical activity and nutrition program for children

Abstract

Examine the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) of an evidence-based physical activity and nutrition curriculum disseminated to after-school programs. Program components included nutrition, physical activity, and sustainability, adapted to after-school settings and disseminated across 4years (2004)(2005)(2006)(2007)(2008). The RE-AIM framework was used to evaluate dissemination quality through direct observations, surveys, and interviews. In the final year, the Fun 5 program was implemented in 90% (>22,000 students) of Hawai'i after-school sites. Despite substantial annual increases in program reach, implementation and adoption remained consistently effective, and students' physical activity levels during program activities peaked in the final year. Further, evaluations demonstrated strong long-term program sustainability potential. The Fun 5 program demonstrated promise for long-term maintenance with potential for a public health impact among Hawai`i after-school students. Future emphasis on wide-spread program dissemination is encouraged, bridging research and community efforts to improve our children's health and impact public health.

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

“…For school-based programs, inadequate staffing and administrative support hindered sustainment. This finding is consistent with recent studies that suggest that administrative support, consistent resources, and staff stability and buy-in are particularly important in the school context (70,84,90,146).Several studies have focused on the sustainability of coalitions aimed at implementing EBIs, including the Communities That Care (CTC) coalition-based prevention system (51) and the PROSPER community-university partnership model (56). A study of 110 CTC sites in Pennsylvania found that 90% of coalitions continued after the three-year initial funding period, with 3-8% of sites terminating each year after (36).…”

Authors’ response

“…[1] Frankly, this comment has no relevance to the reported Fun 5 program. As we reported previously, the program only costs $1/ month/child [2]-which includes the cost of a comprehensive evaluation (removing the comprehensive evaluation would decrease costs by about 1/3). Further, the enthusiasm of the group leaders implementing Fun 5, as evidenced in the reported process evaluation, sustainability, and organizational results are overwhelmingly positive, especially as the program reached maturity in the later years [2].…”

“…As we reported previously, the program only costs $1/ month/child [2]-which includes the cost of a comprehensive evaluation (removing the comprehensive evaluation would decrease costs by about 1/3). Further, the enthusiasm of the group leaders implementing Fun 5, as evidenced in the reported process evaluation, sustainability, and organizational results are overwhelmingly positive, especially as the program reached maturity in the later years [2]. Now to the bigger picture-our paper was sharing the lessons learned from a successful dissemination, which we believe can be successful in similar contexts and among similar child groups.…”

“…In this vain, we welcome critical evaluation of our work. Unfortunately, the commentary [1] on our documentation of our successful effort to disseminate Fun 5-a physical activity and nutrition program for children [2]-is, we feel, misplaced and missing the larger issues at hand.Critically re-evaluating our physical activity (PA) evidence supporting successful dissemination of the Fun 5 program, which used Sports, Play and Active Recreation for Kids (SPARK) AR as its main evidence-based PA component, we cannot agree with Beets and Huberty's conclusions. The pilot study revealed positive results in terms of lesson context, whereby intervention sites increased time devoted to play and decreased class management time compared to control sites [3].…”

“…In this vain, we welcome critical evaluation of our work. Unfortunately, the commentary [1] on our documentation of our successful effort to disseminate Fun 5-a physical activity and nutrition program for children [2]-is, we feel, misplaced and missing the larger issues at hand.…”