International Journal of Behavioral Nutrition and Physical Activity | |
From policy to practice: implementation of physical activity and food policies inschools | |
Patti-Jean Naylor2  Daniel Naiman1  Louise C Mâsse1  | |
[1] School of Population and Public Health, University of British Columbia,F508-4480 Oak Street, Vancouver, BC V6H3V4, Canada;School of Exercise Science, Physical and Health Education, University ofVictoria, Vancouver, BC, Canada | |
关键词: Qualitative; Facilitators; Barriers; Uptake; Implementation; School guidelines; School policies; Nutrition; Physical activity; Physical education; | |
Others : 806907 DOI : 10.1186/1479-5868-10-71 |
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received in 2012-11-17, accepted in 2013-05-17, 发布年份 2013 | |
【 摘 要 】
Purpose
Public policies targeting the school setting are increasingly being used to address childhood obesity; however, their effectiveness depends on their implementation. This study explores the factors which impeded or facilitated the implementation of publicly mandated school-based physical activity and nutrition guidelines in the province of British Columbia (BC), Canada.
Methods
Semi-structured interviews were conducted with 50 school informants (17 principals - 33 teacher/school informants) to examine the factors associated with the implementation of the mandated Daily Physical Activity (DPA) and Food and Beverage Sales in Schools (FBSS) guidelines. Coding used a constructivist grounded theory approach. The first five transcripts and every fifth transcript thereafter were coded by two independent coders with discrepancies reconciled by a third coder. Data was coded and analysed in the NVivo 9 software. Concept maps were developed and current theoretical perspectives were integrated in the later stages of analysis.
Results
The Diffusion of Innovations Model provided an organizing framework to present emergent themes. With the exception of triability (not relevant in the context of mandated guidelines/policies), the key attributes of the Diffusion of Innovations Model (relative advantage, compatibility, complexity, and observability) provided a robust framework for understanding themes associated with implementation of mandated guidelines. Specifically, implementation of the DPA and FBSS guidelines was facilitated by perceptions that they: were relatively advantageous compared to status quo; were compatible with school mandates and teaching philosophies; had observable positive impacts and impeded when perceived as complex to understand and implement. In addition, a number of contextual factors including availability of resources facilitated implementation.
Conclusions
The enactment of mandated policies/guidelines for schools is considered an essential step in improving physical activity and healthy eating. However, policy makers need to: monitor whether schools are able to implement the guidelines, support schools struggling with implementation, and document the impact of the guidelines on students’ behaviors. To facilitate the implementation of mandated guidelines/policies, the Diffusion of Innovations Model provides an organizational framework for planning interventions. Changing the school environment is a process which cannot be undertaken solely by passive means as we know that such approaches have not resulted in adequate implementation.
【 授权许可】
2013 Mâsse et al.; licensee BioMed Central Ltd.
【 预 览 】
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20140708101501506.pdf | 247KB | download |
【 参考文献 】
- [1]Institute of Medicine (IOM): Preventing childhood obesity: Health in the balance. Washington, DC: The National Academies Press; 2005.
- [2]Institute of Medicine (IOM): Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation. Washington, DC: The National Academies Press; 2012.
- [3]Institute of Medicine (IOM): Nutrition standards for foods in schools: leading the way toward healthier youth. 2007. http://books.nap.edu/openbook.php?isbn=0309103835 webcite
- [4]Kelder SH, Springer AS, Barroso CS, Smith CL, Sanchez E, Ranjit N, Hoelscher DM: Implementation of Texas Senate Bill 19 to increase physical activity in elementary schools. J Public Health Policy 2009, 30(Suppl 1):S221-S247.
- [5]Slater SJ, Nicholson L, Chriqui J, Turner L, Chaloupka F: The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of US public elementary schools. Arch Pediatr Adolesc Med 2012, 166(4):311-316.
- [6]Boles M, Dilley JA, Dent C, Elman MR, Duncan SC, Johnson DB: Changes in local school policies and practices in Washington State after an unfunded physical activity and nutrition mandate. Prev Chronic Dis 2011, 8(6):A129.
- [7]Kubik MY, Wall M, Shen L, Nanney MS, Nelson TF, Laska MN, Story M: State but not district nutrition policies are associated with less junk food in vending machines and school stores in US public schools. J Am Diet Assoc 2010, 110(7):1043-1048.
- [8]Kubik MY, Farbakhsh K, Lytle LA: Two years later: wellness councils and healthier vending in a cohort of middle and high schools. J Adolesc Health 2011, 49(5):550-552.
- [9]Kim J: Are physical education-related state policies and schools’ physical education requirement related to children’s physical activity and obesity? J Sch Health 2012, 82(6):268-276.
- [10]Sanchez-Vaznaugh EV, Sanchez BN, Rosas LG, Baek J, Egerter S: Physical education policy compliance and children’s physical fitness. Am J Prev Med 2012, 42(5):452-459.
- [11]Taber DR, Stevens J, Evenson KR, Ward DS, Poole C, Maciejewski ML, Murray DM, Brownson RC: State policies targeting junk food in schools: racial/ethnic differences in the effect of policy change on soda consumption. Am J Public Health 2011, 101(9):1769-1775.
- [12]Levy DT, Mabry PL, Wang YC, Gortmaker S, Huang TT, Marsh T, Moodie M, Swinburn B: Simulation models of obesity: a review of the literature and implications for research and policy. Obes Rev 2011, 12(5):378-394.
- [13]Cradock AL, McHugh A, Mont-Ferguson H, Grant L, Barrett JL, Wang YC, Gortmaker SL: Effect of school district policy change on consumption of sugar-sweetened beverages among high school students, Boston, Massachusetts, 2004-2006. Prev Chronic Dis 2011, 8(4):A74.
- [14]Singh A, Uijtdewilligen L, Twisk JW, van MW, Chinapaw MJ: Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment. Arch Pediatr Adolesc Med 2012, 166(1):49-55.
- [15]Florence MD, Asbridge M, Veugelers PJ: Diet quality and academic performance. J Sch Health 2008, 78(4):209-215.
- [16]Hoyland A, Dye L, Lawton CL: A systematic review of the effect of breakfast on the cognitive performance of children and adolescents. Nutr Res Rev 2009, 22(2):220-243.
- [17]Riis J, Grason H, Strobino D, Ahmed S, Minkovitz C: State school policies and youth obesity. Matern Child Health J 2012, 16(Suppl 1):S111-S118.
- [18]Taber DR, Chriqui JF, Perna FM, Powell LM, Chaloupka FJ: Weight status among adolescents in States that govern competitive food nutrition content. Pediatrics 2012, 130(3):437-444.
- [19]Agron P, Berends V, Ellis K, Gonzalez M: School wellness policies: perceptions, barriers, and needs among school leaders and wellness advocates. J Sch Health 2010, 80(11):527-535.
- [20]McKenna ML: Issues in implementing school nutrition policies. Can J Diet Pract Res 2003, 64(4):208-213.
- [21]Johnston LD, Delva J, O’Malley PM: Soft drink availability, contracts, and revenues in american secondary schools. Am J Prev Med 2007, 33(4, Supplement 1):S209-S225.
- [22]Dodson EA, Fleming C, Boehmer TK, Haire-Joshu D, Luke DA, Brownson RC: Preventing childhood obesity through state policy: qualitative assessment of enablers and barriers. J Public Health Policy 2009, 30(Suppl 1):S161-S176.
- [23]Pan Canadian Joint Consortium for School Health: Stakeholder engagement for improved school policy: development and implementation. Can J Public Health 2010, 101(Suppl 2):S20-S23.
- [24]Schwartz MB, Henderson KE, Falbe J, Novak SA, Wharton CM, Long MW, O’Connell ML, Fiore SS: Strength and comprehensiveness of district school wellness policies predict policy implementation at the school level. J Sch Health 2012, 82(6):262-267.
- [25]Constitution Act, 1867, 30 & 31 Victoria, c. 3. (U.K.), R.S.C. 1985, App. II, No.11. [Cited 13 A.D. Apr 6]. 1867. http://www.canlii.org/en/ca/const/const1867.html webcite
- [26]Active Healthy Kids Canada: Don’t Let This Be The Most Physical Activity Our Kids Get After School. The Active Healthy Kids Canada 2011 Report Card on Physical Activity for Children and Youth. 2011. [cited 13 A.D. Apr 6]; http://dvqdas9jty7g6.cloudfront.net/reportcard2011/ahkcreportcard20110429final.pdf webcite
- [27]Health Canada: Canada’s Food Guide - Main Page. http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/index-eng.php webcite 2008 October 7 [cited 2009 Apr 21]; http://www.hc-sc.gc.ca/fn-an/alt_formats/hpfb-dgpsa/pdf/food-guide-aliment/view_eatwell_vue_bienmang-eng.pdf webcite
- [28]Rideout K, Levy-Milne R, Martin C, Ostry AS: Food sales outlets, food availability, and the extent of nutrition policy implementation in schools in British Columbia. Can J Public Health 2007, 98(4):246-250.
- [29]Glaser BG, Strauss AL: The discovery of grounded theory. Chicago, IL: Aldine; 1967.
- [30]Charmaz K: Constructing grounded theory: A practical guide through qualitative analysis. London, England: Sage Publications; 2003.
- [31]Miles MB, Huberman AM: An expanded sourcebook: Qualitative data analysis. Thousand Oaks, CA: Sage; 1994.
- [32]Rogers EM: Diffusion of Innovations. 5th edition. New York: Free Press; 2003.
- [33]McKenna ML: Policy options to support healthy eating in schools. Can J Public Health 2010, 101(Suppl 2):S14-S17.
- [34]Woodward-Lopez G, Gosliner W, Samuels SE, Craypo L, Kao J, Crawford PB: Lessons learned from evaluations of California’s statewide school nutrition standards. Am J Public Health 2010, 100(11):2137-2145.
- [35]Naylor PJ, Macdonald HM, Reed KE, McKay HA: Action schools! BC: a socioecological approach to modifying chronic disease risk factors in elementary school children. Prev Chronic Dis 2006, 3(2):A60.