System-wide adoption of health promotion practices by schools: evaluation of a telephone and mail-based dissemination strategy in Australia

Abstract

Schools can potentially benefit from system-wide approaches to the dissemination of health promotion practices. This intervention study undertaken in the Hunter Region of NSW, Australia, used a pre-post design to assess whether a phone and mail intervention dissemination strategy was associated with an increase in the proportion of 218 primary schools undertaking eight health promotion practices. Health promotion practices addressed the prevention of harm associated with five agreed health issues-smoking, nutrition, playground safety, asthma and infectious diseases. The study also assessed acceptability of the dissemination strategy to schools, cost and whether intervention schools' characteristics were associated with uptake of health promotion practices. Compared to baseline a significant improvement in prevalence was observed at both 1 and 2 year follow-up for seven of the eight health promotion practices addressed. The greatest improvement occurred in the first year of the project. There was a greater uptake of the practice of providing information regarding passive smoking in urban schools. The dissemination strategy was found to have a cost per adopted practice of 121 Australian dollars and to be acceptable to the large majority (>90%) of schools. The results suggest that the dissemination strategy may represent a relatively low cost method of enhancing health promotion practices in schools and of monitoring such practices. Further research addressing the methodological issues of this study is needed to confirm these findings.

In Preparation of the Nationwide Dissemination of the School‐Based Obesity Prevention Program DOiT: Stepwise Development Applying the Intervention Mapping Protocol

“…From the interviews and also supported by previous studies, it became clear that a personal support system could narrow the gap between the developers of the program and the users. During the initial study and the pilot study, the principal researcher was the contact person for all implementation issues for the schools.…”

Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial

“…In addition, as the implementation of programs by schools has been reported to be associated with school characteristics such as number of students, and socioeconomic and geographic characteristics, further evidence is required regarding the effectiveness of such strategies for different types of schools [38,39]. …”

Vegetable and fruit breaks in Australian primary schools: prevalence, attitudes, barriers and implementation strategies

“…Low rates of program adoption (<30%), however, have been found for those national distribution programs which provide subsidised as opposed to free vegetables and fruit for children to consume at school [28], or require schools to source funding to permit vegetable or fruit consumption [29]. As International evidence regarding the implementation of school-based health promotion programs generally, however, suggests that schools often face a number of barriers to the implementation of health promotion initiatives [31][32][33]. These barriers include an already "crowded curriculum", inadequate resources to implement programs, limited support from school executive staff, a lack of training for school staff and poor communication strategies between teachers and parents limiting the extent to which health messages are reinforced at home [31].…”

“…These barriers include an already "crowded curriculum", inadequate resources to implement programs, limited support from school executive staff, a lack of training for school staff and poor communication strategies between teachers and parents limiting the extent to which health messages are reinforced at home [31]. Other school characteristics, such as number of students, and socioeconomic and geographic characteristics have also been associated with uptake of health policies and practices [32,33].…”