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Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework

Danielle Christian Orcid Logo, Charlotte Todd Orcid Logo, Jaynie Rance Orcid Logo, Gareth Stratton Orcid Logo, Kelly Mackintosh Orcid Logo, Frances Rapport Orcid Logo, Sinead Brophy Orcid Logo

PLOS ONE, Volume: 15, Issue: 4, Start page: e0230745

Swansea University Authors: Danielle Christian Orcid Logo, Charlotte Todd Orcid Logo, Jaynie Rance Orcid Logo, Gareth Stratton Orcid Logo, Kelly Mackintosh Orcid Logo, Frances Rapport Orcid Logo, Sinead Brophy Orcid Logo

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Abstract

Although interventions delivered in school settings have the potential to improve children’s health and well-being, the implementation of effective interventions in schools presents challenges. Previous research suggests facilitating greater autonomy for schools to select interventions aligned to th...

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ISSN: 1932-6203
Published: Public Library of Science (PLoS) 2020
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Previous research suggests facilitating greater autonomy for schools to select interventions aligned to their needs could improve implementation and maintenance. The aim of this mixed-methods outcome and process evaluation was to explore whether involving headteachers in the developmental stages of health interventions influenced adoption, effectiveness (e.g. pupil fitness and physical activity, assessed quantitatively), implementation and maintenance (assessed quantitatively and qualitatively).Three UK primary schools were provided with a choice of five evidence-based physical activity interventions: Playground scrapstore, daily classroom refreshers, alternative afterschool clubs, parent and child afterschool activities and an &#x2018;In the Zone&#x2019; playground intervention. To evaluate the impact of this autonomous approach, semi-structured interviews with headteachers (n = 3), teachers (n = 3), and a private coach, and focus groups with pupils aged 9&#x2013;11 (n = 6, 31 pupils, 15 boys), were undertaken. This was alongside an outcome and process evaluation, guided by the RE-AIM framework. This study assessed the impacts on adoption, implementation and maintenance of the autonomous approach and the effect on physical activity (seven day accelerometry&#x2013;GENEActiv) and aerobic fitness (20m shuttle run). All three schools adopted different intervention components; alternative afterschool clubs, parent and child afterschool activities and daily classroom refreshers. Headteachers welcomed greater autonomy in developing school-based interventions and appreciated the more collaborative approach. Mixed results were reported for the effectiveness, implementation and maintenance of the interventions adopted. Allowing pupils choice and promoting a positive school environment were key factors for enhancing engagement. Moreover, promoting inclusive physical activity projects with a consideration of existing curriculum pressures aided implementation. 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spelling 2021-11-25T17:19:51.0536527 v2 53850 2020-03-23 Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework f887c2a5af97901b39445a4baf3bfc45 0000-0003-1117-6127 Danielle Christian Danielle Christian true false 74c92c91e05d8cb8de38e27de34c9194 0000-0002-3183-2403 Charlotte Todd Charlotte Todd true false 14360f4993b452995fbc22db857cabf7 0000-0002-9504-0675 Jaynie Rance Jaynie Rance true false 6d62b2ed126961bed81a94a2beba8a01 0000-0001-5618-0803 Gareth Stratton Gareth Stratton true false bdb20e3f31bcccf95c7bc116070c4214 0000-0003-0355-6357 Kelly Mackintosh Kelly Mackintosh true false 489cdf0e062781ca298433091b631488 0000-0002-4428-2826 Frances Rapport Frances Rapport true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2020-03-23 PMSC Although interventions delivered in school settings have the potential to improve children’s health and well-being, the implementation of effective interventions in schools presents challenges. Previous research suggests facilitating greater autonomy for schools to select interventions aligned to their needs could improve implementation and maintenance. The aim of this mixed-methods outcome and process evaluation was to explore whether involving headteachers in the developmental stages of health interventions influenced adoption, effectiveness (e.g. pupil fitness and physical activity, assessed quantitatively), implementation and maintenance (assessed quantitatively and qualitatively).Three UK primary schools were provided with a choice of five evidence-based physical activity interventions: Playground scrapstore, daily classroom refreshers, alternative afterschool clubs, parent and child afterschool activities and an ‘In the Zone’ playground intervention. To evaluate the impact of this autonomous approach, semi-structured interviews with headteachers (n = 3), teachers (n = 3), and a private coach, and focus groups with pupils aged 9–11 (n = 6, 31 pupils, 15 boys), were undertaken. This was alongside an outcome and process evaluation, guided by the RE-AIM framework. This study assessed the impacts on adoption, implementation and maintenance of the autonomous approach and the effect on physical activity (seven day accelerometry–GENEActiv) and aerobic fitness (20m shuttle run). All three schools adopted different intervention components; alternative afterschool clubs, parent and child afterschool activities and daily classroom refreshers. Headteachers welcomed greater autonomy in developing school-based interventions and appreciated the more collaborative approach. Mixed results were reported for the effectiveness, implementation and maintenance of the interventions adopted. Allowing pupils choice and promoting a positive school environment were key factors for enhancing engagement. Moreover, promoting inclusive physical activity projects with a consideration of existing curriculum pressures aided implementation. This mixed-methods study provides valuable insights about autonomous approaches to inform further development, implementation and maintenance for future interventions. Journal Article PLOS ONE 15 4 e0230745 Public Library of Science (PLoS) 1932-6203 2 4 2020 2020-04-02 10.1371/journal.pone.0230745 COLLEGE NANME Medicine COLLEGE CODE PMSC Swansea University 2021-11-25T17:19:51.0536527 2020-03-23T13:12:11.7517252 Faculty of Science and Engineering School of Engineering and Applied Sciences - Uncategorised Danielle Christian 0000-0003-1117-6127 1 Charlotte Todd 0000-0002-3183-2403 2 Jaynie Rance 0000-0002-9504-0675 3 Gareth Stratton 0000-0001-5618-0803 4 Kelly Mackintosh 0000-0003-0355-6357 5 Frances Rapport 0000-0002-4428-2826 6 Sinead Brophy 0000-0001-7417-2858 7 53850__16999__ce1a346b41e64994bb32d6fd2883cfd0.pdf 53850.pdf 2020-04-03T10:00:35.4065931 Output 1295112 application/pdf Version of Record true Released under the terms of a Creative Commons Attribution License (CC-BY). true eng http://creativecommons.org/licenses/by/4.0/
title Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
spellingShingle Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
Danielle Christian
Charlotte Todd
Jaynie Rance
Gareth Stratton
Kelly Mackintosh
Frances Rapport
Sinead Brophy
title_short Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
title_full Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
title_fullStr Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
title_full_unstemmed Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
title_sort Involving the headteacher in the development of school-based health interventions: A mixed-methods outcome and process evaluation using the RE-AIM framework
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author_id_fullname_str_mv f887c2a5af97901b39445a4baf3bfc45_***_Danielle Christian
74c92c91e05d8cb8de38e27de34c9194_***_Charlotte Todd
14360f4993b452995fbc22db857cabf7_***_Jaynie Rance
6d62b2ed126961bed81a94a2beba8a01_***_Gareth Stratton
bdb20e3f31bcccf95c7bc116070c4214_***_Kelly Mackintosh
489cdf0e062781ca298433091b631488_***_Frances Rapport
84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
author Danielle Christian
Charlotte Todd
Jaynie Rance
Gareth Stratton
Kelly Mackintosh
Frances Rapport
Sinead Brophy
author2 Danielle Christian
Charlotte Todd
Jaynie Rance
Gareth Stratton
Kelly Mackintosh
Frances Rapport
Sinead Brophy
format Journal article
container_title PLOS ONE
container_volume 15
container_issue 4
container_start_page e0230745
publishDate 2020
institution Swansea University
issn 1932-6203
doi_str_mv 10.1371/journal.pone.0230745
publisher Public Library of Science (PLoS)
college_str Faculty of Science and Engineering
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hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Uncategorised{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Uncategorised
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description Although interventions delivered in school settings have the potential to improve children’s health and well-being, the implementation of effective interventions in schools presents challenges. Previous research suggests facilitating greater autonomy for schools to select interventions aligned to their needs could improve implementation and maintenance. The aim of this mixed-methods outcome and process evaluation was to explore whether involving headteachers in the developmental stages of health interventions influenced adoption, effectiveness (e.g. pupil fitness and physical activity, assessed quantitatively), implementation and maintenance (assessed quantitatively and qualitatively).Three UK primary schools were provided with a choice of five evidence-based physical activity interventions: Playground scrapstore, daily classroom refreshers, alternative afterschool clubs, parent and child afterschool activities and an ‘In the Zone’ playground intervention. To evaluate the impact of this autonomous approach, semi-structured interviews with headteachers (n = 3), teachers (n = 3), and a private coach, and focus groups with pupils aged 9–11 (n = 6, 31 pupils, 15 boys), were undertaken. This was alongside an outcome and process evaluation, guided by the RE-AIM framework. This study assessed the impacts on adoption, implementation and maintenance of the autonomous approach and the effect on physical activity (seven day accelerometry–GENEActiv) and aerobic fitness (20m shuttle run). All three schools adopted different intervention components; alternative afterschool clubs, parent and child afterschool activities and daily classroom refreshers. Headteachers welcomed greater autonomy in developing school-based interventions and appreciated the more collaborative approach. Mixed results were reported for the effectiveness, implementation and maintenance of the interventions adopted. Allowing pupils choice and promoting a positive school environment were key factors for enhancing engagement. Moreover, promoting inclusive physical activity projects with a consideration of existing curriculum pressures aided implementation. This mixed-methods study provides valuable insights about autonomous approaches to inform further development, implementation and maintenance for future interventions.
published_date 2020-04-02T04:07:02Z
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