Presidential youth fitness program implementation: An antecedent to organizational change

IntroductionGrounded in organizational change theory, the purpose of this study was to investigate the efficacy of the Presidential Youth Fitness Program (PYFP) and its association with healthy cultures within schools.MethodsUsing a qualitative approach, data were collected through interviews, site visits and artifacts across 374 schools. An explanatory collective case study approach was used to identify key events related to implementation.ResultsPivotal antecedents to organizational change included prolonged, continual PD, direct support of PYFP implementation, and recognition. Further, three key themes of leveling of the playing field, strategically overcoming barriers, and recruiting teacher fitness champions were identified.ConclusionsCreating a healthy school culture was an unexpected, but feasible outcome stemming from the implementation of the PYFP. A collective effort, led by physical education teachers and fitness champions and embraced by the administration, faculty, and community, is necessary for the school culture to unfreeze from its present status.     

Case study of a health optimizing physical education-based comprehensive school physical activity program

In this article, we report a qualitative case study, in which we examined enablers and barriers related to the development, implementation, and sustainability of a comprehensive school physical activity program (CSPAP) aligned with the Health Optimizing Physical Education (HOPE) curriculum model at a middle school. Literature on program-diffusion and school-university partnerships guided data collection and analysis. Data sources included semi-structured interviews with the program implementation team (n = 9) and the school’s health and physical education teachers (n = 7); a focus group interview with students; documents (e.g., lesson plans), and observations. Constant comparison techniques were used to code and draw out themes from the data. Findings revealed the extensive effort needed for program implementation and highlighted the importance of strong external support mechanisms, conducting needs assessments, and training teachers to market physical activity programming. Partnerships may provide critical support for schools in their efforts to generate and sustain CSPAPs.     

An evaluation of immediate outcomes and fidelity of a drug abuse prevention program in continuation high schools: project towards no drug abuse (TND)

The present study provides an implementation fidelity, process, and immediate outcomes evaluation of Project Towards No Drug Abuse (TND), a drug prevention program targeting continuation high school youth (n=1426) at risk for drug abuse. A total of 24 schools participated in three randomized conditions: TND Only, TND and motivational interviewing follow-up, and no treatment control. Fidelity was high: across program schools the curriculum was implemented as intended and was received favorably by students. Relative to controls, intervention conditions produced effects on hypothesized mediators, including greater gains in program related knowledge, greater reductions in drug use intentions, and positive changes in motivation. However, few generalizations to attitudes and intentions regarding risky sexual behavior were found. The pattern of results suggests that the experimental manipulations worked as intended.     

The operation was a success but the patient died: A critique of “the implementation and evaluation of a problem-solving training program for adolescents”

This critique examines George S. Tellado's account of his evaluation of a problem-solving program for adolescents in a public junior high school in Pennsylvania. The program was apparently successful (i.e., it was shown by the evaluation to improve students' problem-solving capacities), and the evaluation was, for the most part, technically sound, but the program did not survive. This critique suggests that by examining the problem-solving program as an organizational change intervention, several problems can be uncovered regarding the program's design, implementation, evaluation, and institutionalization. In particular, it appears that the school system's staff did not have sufficient ownership of the program to understand it or to wish to carry it on after the program's originator and evaluator were no longer present. This article addresses these problems in detail and recommends techniques from the field of organizational change consultation to increase the likelihood that such programs will live on into the future.     

Building School,Family, and Community Partnerships: Developing a Theoretical Framework

School, family, and community partnerships are among the suite of strategies advocated for improved school outcomes in which social workers can play a valuable role. Such partnerships are complex to implement in practice and there is little systematic research to guide the practitioner. This study evaluated an early intervention partnership program involving school, family, community, and philanthropic partners implemented in two primary schools in rural Victoria, Australia. The findings highlighted challenges in the process of evaluation and program implementation and in the opportunities this provided to identify key enabling factors. These involved having: a shared vision and aims; democratic governance; a supportive policy and organisational environment including external funding; workers with skills and clear roles; activities for project momentum; and ongoing review and evaluation. These factors can be used by social workers and others working with schools as a valuable conceptual framework to facilitate school, family, and community partnership processes.     

Process evaluation of “Girls on the Run”: Exploring implementation in a physical activity-based positive youth development program

Many positive youth development programs rely on physical activity as a primary program component. Referred to as physical activity-based youth development programs, these program designs have great potential for promoting healthy youth development. This study examined how one such physical activity-based positive youth development program was implemented in order to identify design features critical to maximizing positive youth outcomes. This mixed method, multi-site process evaluation of Girls on the Run (GOTR) utilized focus groups, site visits, and self-report implementation checklists. Implementation scores were calculated to assess implementation fidelity across twenty-nine sites, and qualitative data were inductively analyzed to identify factors influential for implementation. Results reveal variability in how GOTR was implemented. Five themes emerged from the data that represented factors serving as facilitators or barriers to programmatic implementation. These included contextual/environmental factors (e.g., parental involvement, relationships with school personnel), organizational factors (e.g., implementation support and responsiveness of staff), program-specific factors (e.g., curriculum design), coach factors (e.g., existing relationships with participants, responsiveness to participant's needs), and youth factors (e.g., behavioral and discipline issues). Study findings have implications for improving the design of physical activity-based and other positive youth development programs, with relevance to evaluators, program planners, youth development leaders, and others working with children and youth.     

Planning an integrated agriculture and health program and designing its evaluation: Experience from Western Kenya

Multi-sectoral programs that involve stakeholders in agriculture, nutrition and health care are essential for responding to nutrition problems such as vitamin A deficiency among pregnant and lactating women and their infants in many poor areas of lower income countries. Yet planning such multi-sectoral programs and designing appropriate evaluations, to respond to different disciplinary cultures of evidence, remain a challenge. We describe the context, program development process, and evaluation design of the Mama SASHA project (Sweetpotato Action for Security and Health in Africa) which promoted production and consumption of a bio-fortified, orange-fleshed sweetpotato (OFSP). In planning the program we drew upon information from needs assessments, stakeholder consultations, and a first round of the implementation evaluation of a pilot project. The multi-disciplinary team worked with partner organizations to develop a program theory of change and an impact pathway which identified aspects of the program that would be monitored and established evaluation methods. Responding to the growing demand for greater rigour in impact evaluations, we carried out quasi-experimental allocation by health facility catchment area, repeat village surveys for assessment of change in intervention and control areas, and longitudinal tracking of individual mother-child pairs. Mid-course corrections in program implementation were informed by program monitoring, regular feedback from implementers and partners’ meetings. To assess economic efficiency and provide evidence for scaling we collected data on resources used and project expenses. Managing the multi-sectoral program and the mixed methods evaluation involved bargaining and trade-offs that were deemed essential to respond to the array of stakeholders, program funders and disciplines involved.     

Evaluation of the In Touch training program for the management of alcohol and other drug use issues in schools

In Touch is a professional training program designed to develop staff skills and support structures so as to enable schools to manage alcohol and other drug (AOD) matters in a coordinated manner that maximizes beneficial outcomes for at-risk students, while at the same time maintaining school discipline and community relationships. This study is an evaluation of the impact of the program on alcohol and other drug (AOD) related knowledge, attitudes and activity of participating school staff, and on AOD management practice in their schools. Data from 53 intervention participants and 21 controls were compared at pre- and post-intervention. These data indicated a 46% increase in AOD knowledge among those who participated in In Touch training. Attitudes favorable to integrated, supportive management of AOD issues also increased significantly in this group, as did desirable practice. However, change in school practice was limited. Significantly more schools whose staff participated in In Touch training had a written drug policy at post-intervention, but schools' usual responses to AOD-related incidents were substantially the same. These findings indicate that professional training on the management of AOD matters can change the understanding and practice of individual staff, but if school structures and practice are to be substantially influenced, a broader program is required.     

Evaluation of a comprehensive school physical activity program: Be a Champion!

BackgroundComprehensive School Physical Activity Programs (CSPAPs) are widely supported to increase physical activity (PA) in schools, but little has been reported to inform a comprehensive evaluation effort. The purpose of this report is to describe a comprehensive evaluation and monitoring strategy for CSPAP implementation.MethodsThe System for Observing Staff Promotion of Activity and Nutrition (SOSPAN), System for Observing Student Movement in Academic Routines and Transitions (SOSMART), and System for Observing Play and Leisure Activity (SOPLAY) were employed to record student and staff behaviors (2642 total scans). To assess policies, practices, and environments, a CSPAP Policies and Practices questionnaire was used, which included components of the School Health Index, the School PA Policy Assessment, the School Environment and Policies Survey, and the School Health Policies and Practices Study. Youth PA (minutes/day) was assessed using accelerometers.ResultsWorking with school sites to ascertain the number of opportunities that are provided for PA and the amount of PA students engage in is challenging but feasible. The use of systematic observation, accelerometers, and questionnaires can provide a comprehensive representation of policies, practices, and behaviors to aid in establishing targeted PA action items.ConclusionsDeveloping an evaluation framework that was rigorous enough to assess the physical, social, and policy environment of a school in order to answer the overarching research questions of the study but flexible enough to be feasibly streamlined for utilization by a school implementation team proved to be challenging but possible.     

Mixed results in a transitional planning program for alternative school students

Disciplinary alternative schools have a reputation as gateways to the juvenile and criminal justice systems. The authors conducted an evaluation of an intervention (Strategies for Success) designed to divert seventh-, eighth-, and ninth-grade alternative school students from this gateway. They used propensity score matching and a multivariate random effects model to estimate program impacts and found that the program not only increased attendance rates, at least in the short term, but also increased the likelihood of reassignment to alternative schools. The discussion focuses on possible reasons and solutions for high rates of return to alternative school and for the erosion of program effects.     

Systematic dissemination of a preschool physical activity intervention to the control preschools

For public health interventions to have a meaningful impact on public health, they must be disseminated to the wider population. Systematic planning and evaluation of dissemination efforts can aid translation from experimental trials to larger dissemination programs. The Study of Health and Activity in Preschool Environments (SHAPES) was a group-randomized intervention trial conducted in 16 preschools that successfully increased the physical activity of preschool age children. Following the completion of the research study protocol, the intervention was abbreviated, modified and implemented in four preschools that participated as control preschools in the original research study. The purposes of the current study were to describe the process of refining the intervention for dissemination to the control preschools, and to assess the acceptability of the resulting abbreviated intervention delivery. Five overarching behavioral objectives, informed by process evaluation, data from the original trial and collaboration with intervention teachers, were used to guide the implementation. Teachers in the dissemination classrooms reported high levels of acceptability, potential for sustainability of the program, and positive results in knowledge, skills, and child outcomes. Researchers can include a systematic approach to dissemination of effective intervention elements to the control participants in experimental studies to inform future dissemination efforts and begin to bridge the dissemination gap.     

Implementation of physically active lessons: A 2-year follow-up

Combining physical activity and academic content is a promising way to improve health and academic learning in schoolchildren. This paper examined the continuation of physically active lessons (PAL) in five Norwegian elementary schools, two years after a 10-month intervention period, which consisted of weekly minimum 2 x 45 min of PAL. Data were collected through semi-structured interviews with nine teachers and five school leaders. The Level of Use instrument was used to assess how the teachers integrated PAL into the school day. Two years after the intervention period, seven of nine teachers conducted PAL regularly, on average one lesson per week. Teachers’ implementation progress varied from struggling with logistics, to stable routine and creative adaption. Perceived benefits for the children, active leadership, and ongoing implementation support seem important for continuation. Introduction of PAL as a school development project, systematic planning from the onset and a gradual introduction of PAL, can be an effective strategy for continuation and long-term sustainability. In addition, the Level of Use instrument was useful to better understand which support mechanisms are needed at different stages in the implementation of PAL.     

Physical activity and nutrition program for adults with metabolic syndrome: Process evaluation

IntroductionThe Vietnam Physical Activity and Nutrition (VPAN) program aimed to improve physical activity and nutrition for adults aged 50–65 years with Metabolic Syndrome in Vietnam. The VPAN program consisted of a range of resources and strategies, including an information booklet, resistance band, face-to-face education sessions, and walking groups. This process evaluation assessed the participation, fidelity, satisfaction, and reasons for completing and not-completing the VPAN.MethodsData were collected by mixed-methods from a sample of 214 intervention participants. Quantitative data were collected via surveys (n = 163); qualitative data via face-to-face exit interviews with intervention program completers (n = 10) and non-completers (n = 10), and brief post education session discussions.ResultsMost participants (87%–96%) reported the program resources and strategies useful, assisting them to increase their physical activity level and improving their diet. The education sessions were the most preferred strategy (97%) with high attendance (>78% of participants). The main reasons for withdrawal were work commitments and being too busy.ConclusionThe evaluation indicated that the program reached and engaged the majority of participants throughout the six-month intervention. The combination of printed resources and face-to-face intervention components was a suitable approach to support lifestyle behavioural change in the Vietnamese population.     

Process evaluation of a preschool physical activity intervention using web-based delivery

Background and purposePreschool/childcare settings offer a practical target for physical activity interventions. Online learning programs have the potential for greater public health reach and impact. The SHAPES-Dissemination (SHAPES-D) project adapted the original SHAPES in-person intervention for online delivery to teachers. The purpose of this paper is to describe the implementation monitoring and process evaluation for the SHAPES-D project.MethodsNine preschools with 26 classrooms participated. A total of 41 teachers were trained via online learning to implement the SHAPES-D program in their classrooms. The dose received, completeness, and fidelity of implementation were assessed through website metrics, teacher surveys and interviews, and classroom observations.ResultsDose received was adequate (73%). Observed completeness and physical activity enjoyment fidelity were high (100%), although moderate-to-vigorous physical activity fidelity and social environment fidelity were low (25% each). Overall implementation was high (91%).DiscussionResults indicate that the online method of delivery is viable for dissemination. The online delivery system provides an easy method of monitoring dose received. This may be the first structural intervention to monitor dose received through web metrics.ConclusionThe adaptation of an in-person intervention to an online delivery system increases the potential for dissemination of a successful program to increase physical activity in preschool settings.     

Innovating Practices to Prepare Students for Graduate School: Lessons From a Social Work MOOC

This article describes the implementation of a massive open online course (MOOC) developed by a school of social work and piloted in the incoming 2016 MSW class (N=397). Using implementation science as a framework, we describe the MOOC as an intervention for preparing students for graduate school and share findings from the pilot evaluation. We argue that MOOCs can represent an innovative approach for other schools of social work, but our lessons learned suggest that they also require resources, time investment, organizational support, and understanding of the implications for students and the school. Future questions for research include examining the long-term benefits of MOOCs to students, their broader application, and the cost-benefit analysis for schools interested in developing MOOCs.     

Working on Womanhood (WOW): A participatory formative evaluation of a community-developed intervention

The well-documented disparities in availability, accessibility, and quality of behavioral health services suggest the need for innovative programs to address the needs of ethnic minority youth. The current study aimed to conduct a participatory, formative evaluation of “Working on Womanhood” (WOW), a community-developed, multifaceted, school-based intervention serving primarily ethnic minority girls living in underserved urban communities. Specifically, the current study aimed to examine the feasibility, acceptability, and initial promise of WOW using community-based participatory research (CBPR) and represented the third phase of a community-academic partnership. Qualitative and quantitative data were collected from 960 WOW participants in 21 urban public schools, as well as WOW counselors, parents, and school staff over the course of one academic year. Results demonstrated evidence of acceptability of WOW and noteworthy improvements for WOW participants in targeted outcomes, including mental health, emotion regulation, and academic engagement. Findings also indicated several challenges to implementation feasibility and acceptability, including screening and enrollment processes and curriculum length. Additionally, we discuss how, consistent with participatory and formative research, findings were used by program implementers to inform program improvements, including modifications to screening processes, timelines, curriculum, and trainings – all in preparation for a rigorous effectiveness evaluation.     

An organization-environment framework for assessing program implementation

Evaluations of health programs are typically conducted from a rational bureaucratic framework in which client change and client outcome are seen as logical outcomes of program activity. This paper proposes a theoretical framework for examining organizational consequences of program implementation. Factors in the internal environment (e.g., the hospital) and the external environment (e.g., the community) which contribute to the program's success or failure, are considered. Observational and structured interview data are used to compare two state funded perinatal projects, one an organizational "success" and the other a costly failure. Attributes of external environments which may be important to successful implementation include demand for services, provider competition, access to information, social beliefs, and professional commitment. Important features of the internal environment include host organization commitment and conflict, and structural attributes: complexity, formalization, centralization, and coordination. The paper concludes with theoretically-based questions which serve as guidelines for process evaluation.     

ViSC Social Competence Program

The ViSC Social Competence Program has been implemented in Austrian schools within the scope of a national strategy plan, Together Against Violence. The program is a primary preventive program designed for grades 5 to 8. The prevention of aggression and bullying is defined as a school development task, and the initial implementation of the program lasts one school year. The program consists of universal and specific actions that are implemented through in-school teacher training and a class project for students. The program was evaluated with a randomized intervention control group design. Data were collected from teachers and students. Results suggest that the program reduces aggression in schools.     

Formative evaluation on a physical activity health promotion program for the group home setting

Physical inactivity and high rates of chronic conditions is a public health concern for adults with intellectual disability. Few health promotion programs target the group home setting which is the pre-dominant form of residential accommodation for persons with intellectual disability. A process evaluation of a physical activity health promotion program, Menu-Choice, was conducted with five group home sites for adults with intellectual and developmental disabilities. Menu-Choice assists group home staff in including physical activity goals within resident schedules. The physical activity program was designed based on theoretical frameworks, community-based participatory approaches, and established health promotion guidelines for adults with disabilities. Fourteen program coordinators (age M 39; 77% females), 22 staff (age M 39; 82% females), and 18 residents (age M 59; 72% females; 56% ambulatory) participated. Results from the fidelity survey and program completion highlight potential challenges with implementation. Findings will assist with the refinement of the program for continued implementation trials in the group home community.