Rieka von der Warth, Mirjam Körner, Erik Farin-Glattacker
Health literacy of trans and gender diverse individuals -a cross sectional survey in Germany
BMC public health
comprehensive schoolbased programs applying health promoting school model potential initiate sustain behavior change impact health however since often include intervention efforts schools policies physical environment curriculum health care involving parents communities significantly intrude complex system aimed primarily education health promotion insights concrete strategies therefore needed regarding adoption implementation sustainment processes address challenge sustainable implementation hps initiatives primarily educational setting study consequently evaluates adoption implementation sustainment processes amsterdams jumpin healthy nutrition hps intervention multistakeholder perspective conducted semistructured interviews focus groups involved stakeholders n 131 ie jumpin health promotion professionals n 5 school principals n 7 atschool jumpin coordinators n 7 teachers n 20 parents n 50 9 groups children n 42 7 groups 10 primary schools enrolled jumpin school year 20162017 included schools higher prevalence overweight andor obesity dutch average located amsterdams lowsep neighborhoods data analyzed using directed content analysis determinants innovation model used obtaining theorybased predetermined codes supplemented new codes emerging data intervention adoption stakeholders emphasized importance parental support accompanying workshops promotional materials additionally parents teachers indicated shared responsibility childrens health nuanced framing health messages important implementation stakeholders needed clear guidelines support structures teachers children highlighted importance peer influence social norms uniform application guidelines school staff also found tailoring intervention dealing financial constraints important longterm intervention sustainment incorporating intervention policies school statutes crucial according health promotion professionals qualitative evaluation provides valuable insights factors influencing adoption implementation sustainment processes dietary interventions importance transparent consistent intervention guidelines clear communication regarding rationale behind intervention guidelines stakeholders involvement decisionmaking