Translating the PLAYgrounds program into practice: A process evaluation using the RE-AIM framework

Janssen, Mirka; Toussaint, H.M.; Mechelen, Willem van; Verhagen, Evert

doi:10.1016/j.jsams.2012.06.009

Cited by 17 publications

(29 citation statements)

References 24 publications

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“…Forthcoming outcome results will provide indicators of intervention effectiveness, though because of the dynamic, multi-dimensional school environment, an array of confounding factors is not uncommon [ 42 ] and should be assessed before drawing conclusions regarding changes in student food consumption as a direct effect of SLM [ 43 ]. Findings indicated the potential for contamination in the larger school environment (e.g., nutrition education) that may have supported positive food choices and thereby diminished the apparent impact of the SLM intervention.…”

Section: Discussionmentioning

confidence: 99%

Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation

et al. 2016

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BackgroundThis paper presents design and findings from the process evaluation of a randomized controlled trial (RCT) testing the effectiveness of Smarter Lunchrooms Movement (SLM) interventions to encourage consumption of either fruit, vegetables, or unflavored milk in middle school cafeterias (grades 6–8, typically children ages 10–14 years). Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework adapted for environmental interventions, the process evaluation monitored fidelity to SLM protocol, determined barriers and facilitators influencing fidelity, and identified the training and support needs of implementers.MethodsUnder research team guidance, community partners (interventionists) assisted school food service staff (providers) with a six week implementation of protocol items in 13 public middle school cafeterias (two milk treatment, three vegetable treatment, four fruit treatment, and four control) in New York State during the 2013–2014 academic year. Process evaluation measures included semi-quantitative measures of implementation and maintenance (lunchroom audits) and qualitative data (environmental assessments and semi-structured interviews with school food service staff). Analyses identified challenges and opportunities for improving intervention delivery.ResultsApproximately 75 % of enrolled students participated in school lunch programs and thus were exposed to the SLM intervention. Findings indicated potential contamination by other nutrition-related activities in the lunchroom and larger school environment may have affected the intervention impact. Modest implementation fidelity scores were observed for intervention treatments. Providers reported treatments were acceptable and feasible, however interventionists confirmed motivation and perceived effectiveness varied among schools. Post-intervention audits revealed limited maintenance of intervention protocols. Strategies to enhance buy-in and communication among providers and increased interventionist support are recommended.ConclusionsRE-AIM was a valuable framework for this process evaluation. Results highlighted implementation barriers and facilitators, and findings will enhance interpretation of forthcoming outcome data. Results will inform future iterations of the SLM RCT and provide valuable insights for those designing environmental interventions in school cafeterias.

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Section: Discussionmentioning

confidence: 99%

Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation

et al. 2016

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“…The RE-AIM framework [ 33 ] was used to evaluate the public health impact of the intervention and to examine the barriers and facilitators to the implementation of the program at the school level. Table 3 , which was adapted from Janssen et al [ 7 ] summarises the relevant three elements of RE-AIM explored in the process evaluation of the program implemented in the intervention schools, along with a brief description of the outcome measures and methods of assessment associated with the three elements.…”

Section: Methodsmentioning

confidence: 99%

“…Table 3 , which was adapted from Janssen et al [ 7 ] summarises the relevant three elements of RE-AIM explored in the process evaluation of the program implemented in the intervention schools, along with a brief description of the outcome measures and methods of assessment associated with the three elements.…”

Section: Methodsmentioning

confidence: 99%

“…Schools are considered a key health setting to promote PA since young people attend and spend a considerable amount of time in school [ 7 ]. The convenience of targeting existing curricular opportunities like physical education (PE), in addition to extra-curricular opportunities such as sport programs makes schools an obvious setting in which to deliver programs designed to promote PA participation.…”

Section: Introductionmentioning

confidence: 99%

“…Process evaluation of multicomponent interventions can be complex and mixed method research designs are required to understand the variety of contexts and settings [ 13 , 15 ]. The RE-AIM model (reach, effectiveness/efficacy, adoption, implementation and maintenance) provides a systematic framework by which researchers can evaluate the external validity of multicomponent interventions within real-world settings such as schools [ 16 ], and has been used to evaluate school-based PA interventions, mostly in primary schools [ 7 , 17 , 18 ] and recently in a secondary school [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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Linking secondary school physical education with community sport and recreation for girls: a process evaluation

et al. 2014

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BackgroundThe purpose of this study was to undertake a process evaluation to examine the reach, adoption and implementation of a school-community linked physical activity (PA) program for girls aged 12 – 15 years (School Years 7 – 9) using the RE-AIM framework.MethodsVarious approaches were used to assess 'reach’, 'adoption’ and implementation: (a) a school environment survey of intervention schools (n = 6); (b) teacher feedback regarding the professional development component (91.1% response rate) and lesson implementation (60.8% response rate); and (c) post-intervention focus group interviews with physical education (PE) teachers (n = 29), students (n = 125), coaches (n = 13) and instructors (n = 8) regarding program experiences.ResultsReach and Adoption: Seven schools (n = 1491 Year 7–9 female student enrolment; 70% adoption rate), five tennis clubs, eight football clubs and five leisure centres participated in the program during 2011. Implementation: Program design and professional development opportunities (training, resource manual and opportunities to work with coaches and instructors during PE classes) supported implementation and student engagement in PA. However, there was a lack of individual and organisational readiness to adopt program principles. For some deliverers there were deeply embedded ideologies that were not aligned with the Game Sense teaching approach upon which the program was based. Further, cognitive components of the program such as self-management were not widely adopted as other components of the program tended to be prioritised.ConclusionThe program design and resources supported the success of the program, however, some aspects were not implemented as intended, which may have affected the likelihood of achieving further positive outcomes. Barriers to program implementation were identified and should be considered when designing school-community linked interventions. In particular, future programs should seek to assess and adjust for organizational readiness within the study design. For example, shared commitment and abilities of program deliverers to implement the program needs to be determined to support program implementation.Trial registrationACTRN12614000446662. April 30th 2014.

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Considering Context in Quality Improvement Interventions and Implementation: Concepts, Frameworks, and Application

McDonald

2013

Academic Pediatrics

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Translating the PLAYgrounds program into practice: A process evaluation using the RE-AIM framework

Cited by 17 publications

References 24 publications

Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation

Implementing Smarter Lunchrooms Makeovers in New York state middle schools: an initial process evaluation

Linking secondary school physical education with community sport and recreation for girls: a process evaluation

Considering Context in Quality Improvement Interventions and Implementation: Concepts, Frameworks, and Application

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