|Hall, William - University Of North Carolina|
|Schneider, Margaret - University Of California|
|Thompson, Deborah - Debbe|
|Volpe, Stella - Drexel University|
|Steckler, Allan - University Of North Carolina|
|Hall, John - University Of North Carolina|
|Fisher, M - University Of North Carolina|
Submitted to: Translational Behavioral Medicine
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/22/2013
Publication Date: 6/1/2014
Citation: Hall, W.J., Schneider, M., Thompson, D.J., Volpe, S.L., Steckler, A., Hall, J.M., Fisher, M.R. 2014. School factors as barriers to and facilitators of a preventive intervention for pediatric type 2 diabetes. Translational Behavioral Medicine. 4(2):131-140.
Interpretive Summary: Schools are an important place to provide healthy information to children. To be effective, however, it is beneficial to identify school factors that make it easy (facilitators) or hard (barriers) to do this. This research found that teacher frustration over taking time away from key school activities such as standardized test preparation, student resistance and misbehavior, equipment problems, cost and availability of nutritious foods, and large class sizes were reported as barriers to program implementation. However, student engagement, having direct control over food service, and support from school leaders facilitated implementation. It also found that teacher/staff/student engagement, classroom management, and adequate space were reported as both barriers and facilitators, depending on the school. This research emphasizes the importance of taking school-specific barriers into consideration to help ensure successful delivery of school-based health interventions.
Technical Abstract: School-based interventions are essential to prevent pediatric obesity and type 2 diabetes. School environmental factors influence implementation of these interventions. This article examines how school factors acted as barriers to and facilitators of the HEALTHY intervention. The HEALTHY study was a cluster-randomized trial of a multicomponent intervention implemented in 21 schools. Interview data were analyzed to identify barriers and facilitators. Barriers included teacher frustration that intervention activities detracted from tested subjects, student resistance and misbehavior, classroom management problems, communication equipment problems, lack of teacher/staff engagement, high cost and limited availability of nutritious products, inadequate facility space, and large class sizes. Facilitators included teacher/staff engagement, effective classroom management, student engagement, schools with direct control over food service, support from school leaders, and adequate facilities and equipment. Contextual barriers and facilitators must be taken into account in the design and implementation of school-based health interventions.