***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE Assessed the feasibility , acceptability , and sustainability of Planet Health , an interdisciplinary , integrated health education curriculum implemented in six public middle schools . METHODS Workshops on Planet Health implementation were attended by 129 teachers ( language arts , math , science , and social studies ) over three school years ( 1999 - 2000 , 2000 - 2001 , and 2001 - 2002 ) . Question naires were administered post-implementation and in the fall and spring of each year . Outcomes were dose , acceptability , feasibility , and intent to continue use . RESULTS The average number of lessons taught per teacher per year was 1.7 to 3.1 , compared to a goal of 2 to 3 . Each year , teachers reported high acceptability and perceived feasibility of the intervention , and the majority indicated they intended to continue using the curriculum . CONCLUSIONS Planet Health was feasible and acceptable in a participatory research model involving a public school-university partnership , and it was also sustainable independent of the research effort Purpose . Examine the reach , efficacy , adoption , implementation , and maintenance of a physical activity and nutrition curriculum for middle-school students . Design . Nonexperimental pilot evaluation of a statewide dissemination trial . Setting . California middle schools during the 2006 to 2007 school year . Subjects . Sixteen classes ( N = 668 students and 16 teachers ) sample d from the statewide pool who used the program . Intervention . An eight-lesson nutrition and physical activity curriculum , “ Exercise Your Options ” ( EYO ) , including a teacher guide , video clips , a student activity booklet , and ancillary material s was made available to teachers . Measures . Program records , classroom observations , teacher surveys , and student presurveys and postsurveys ( assessing physical activity , sedentary behaviors , and dietary intake ) . Analysis . Descriptive statistics and multilevel r and om-coefficient modeling . Results . The EYO program reached 234 , 442 middle-school students in California . During the program , total physical activity increased ( p ≤ .001 ) , whereas watching TV/DVDs and playing electronic games/computer use decreased ( p ≤ .05 ) . Intake of dairy products increased ( p < .05 ) , whereas consumption of sugars/sweets decreased ( p < .001 ) . Forty-two percent of eligible middle-school classrooms ordered the program material s. Eighty-six percent of sample d teachers implemented all of the lessons . Over the past 5 years , 51 % of all middle-school students in California were exposed to the program . Conclusions . The EYO program showed its potential for moderate to high public health impact among California middle-school students Background The evidence -based Dutch Obesity Intervention in Teenagers ( DOiT ) program is a school-based obesity prevention program for 12 to 14-year olds attending the first two years of prevocational education . This paper describes the study protocol applied to evaluate ( a ) the nationwide dissemination process of DOiT in the Netherl and s , and ( b ) the relationship between quality of implementation and effectiveness during nationwide dissemination of the program in the Netherl and s. Methods In order to explore facilitating factors and barriers for dissemination of DOiT , we monitored the process of adoption , implementation and continuation of the DOiT program among 20 prevocational schools in the Netherl and s. The study was an observational study using qualitative ( i.e. semi-structured interviews ) and quantitative methods ( i.e. question naires and logbooks ) . Eight process indicators were assessed : recruitment , context , reach , dosage , fidelity , satisfaction , effectiveness and continuation .  All teachers , students and parents involved in the implementation of the program were invited to participate in the study . As part of the process evaluation , a cluster-controlled trial with ten control schools was conducted to evaluate the effectiveness of the program on students ’ anthropometry and energy balance-related behaviours and its association with quality of implementation . Discussion The identified impeding and facilitating factors will contribute to an adjusted strategy promoting adoption , implementation and continuation of the DOiT program to ensure optimal use and , thereby , prevention of obesity in Dutch adolescents . Trial registration Current Controlled Trials IS RCT N92755979 Reconnecting Youth ( RY ) is a school-based drug prevention program design ed to address academic , substance use and mood management goals among youth at risk of dropping out of high school . This paper presents the organizational factors and RY program characteristics that either promoted or hindered the implementation of the program during a r and omized controlled effectiveness trial in 10 schools in two school districts in the United States . Data were collected using surveys and interviews from teachers and school and district staff who participated in the implementation of the RY program in these schools . Results suggest that certain RY program characteristics made it difficult to implement . Small class size , re source -intensive procedures for student selection and recruitment and special training , qualities and skills needed to be an effective RY teacher meant that schools had to significantly change their usual practice s to implement the program . Organizational barriers included a lack of financial re sources and leadership support for program implementation , and low priority for non-academic courses for high-risk students . Transient student population s , staff turnover and district-wide scheduling and curriculum changes all result ed in high levels of organizational turbulence at most schools , further hindering program implementation Research consistently indicates that schools fail to implement m and atory physical activity policies . This review aim ed to describe factors ( barriers and facilitators ) that may influence the implementation of school physical activity policies which specify the time or intensity that physical activity should be implemented and to map these factors to a theoretical framework . A systematic search was undertaken in six data bases for quantitative or qualitative studies published between 1995-March 2016 that examined teachers ' , principals ' or school administrators ' reported barriers and /or facilitators to implementing m and ated school physical activity policies .  Two independent review ers screened texts , extracted and coded data from identified articles using the Theoretical Domains Framework ( TDF ) . Of the 10,346 articles identified , 17 studies met the inclusion criteria ( 8 quantitative , 9 qualitative ) . Barriers and facilitators identified in qualitative studies covered 9 and 10 TDF domains respectively . Barriers and facilitators reported in quantitative studies covered 8 TDF domains each . The most common domains identified were : ' environmental context and re sources ' ( e.g. , availability of equipment , time or staff ) , ' goals ' ( e.g. , the perceived priority of the policy in the school ) , ' social influences ' ( e.g. , support from school boards ) , and ' skills ' ( e.g. , teachers ' ability to implement the policy ) . Implementation support strategies that target these factors may represent promising means to improve implementation of  physical activity policies and increase physical activity among school-aged children . Future studies assessing factors that influence school implementation of physical activity policies would benefit from using a comprehensive framework to help identify if any domains have been overlooked in the current literature . REGISTRATION This review was prospect ively registered with PROSPERO ( CRD42016051649 ) on the 8th December 2016 Background A fundamental challenge of implementation is identifying context ual determinants ( i.e. , barriers and facilitators ) and determining which implementation strategies will address them . Numerous conceptual frameworks ( e.g. , the Consoli date d Framework for Implementation Research ; CFIR ) have been developed to guide the identification of context ual determinants , and compilations of implementation strategies ( e.g. , the Expert Recommendations for Implementing Change compilation ; ERIC ) have been developed which can support selection and reporting of implementation strategies . The aim of this study was to identify which  ERIC implementation strategies would best address specific CFIR-based context ual barriers . Methods Implementation research ers and practitioners were recruited to participate in an online series of tasks involving matching specific  ERIC implementation strategies to specific implementation barriers . Participants were presented with brief descriptions of barriers based on CFIR construct definitions . They were asked to rank up to seven implementation strategies that would best address each barrier . Barriers were presented in a r and om order , and participants had the option to respond to the barrier or skip to another barrier . Participants were also asked about considerations that most influenced their choices . Results Four hundred thirty-five invitations were emailed and 169 ( 39 % ) individuals participated . Respondents had considerable heterogeneity in opinions regarding which  ERIC strategies best addressed each CFIR barrier . Across the 39 CFIR barriers , an average of 47 different ERIC strategies ( SD = 4.8 , range 35 to 55 ) was endorsed at least once for each , as being one of seven strategies that would best address the barrier . A tool was developed that allows users to specify high-priority CFIR-based barriers and receive a prioritized list of strategies based on endorsements provided by participants . Conclusions The wide heterogeneity of endorsements obtained in this study ’s task suggests that there are relatively few consistent relationships between CFIR-based barriers and ERIC implementation strategies . Despite this heterogeneity , a tool aggregating endorsements across multiple barriers can support taking a structured approach to consider a broad range of strategies given those barriers . This study ’s results point to the need for a more detailed evaluation of the underlying determinants of barriers and how these determinants are addressed by strategies as part of the implementation planning process Background . The aim of the present study was to investigate factors influencing the adoption , implementation , and institutionalization process of JUMP-in — a multilevel school-based physical activity promotion program — to optimize the dissemination of the intervention and improve its effectiveness . The process evaluation concerned the constraints and success and failure factors at sociopolitical , organizational , user , and intervention levels . Methods . A mixed methods approach including qualitative and quantitative data was conducted during two school years ( 2006 - 2008 ) . Results . JUMP-in was successfully embedded in the Amsterdam municipal policy and in the organizational structure and daily practice s of the sectors involved . A general impeding factor was the complexity of the multilevel programme requiring multidisciplinary collaboration between organizations . In addition , there was a discrepancy between the recommendation to st and ardize and simplify the innovation and the need to tailor the strategies to local environmental , social , and cultural aspects . Conclusions . This process evaluation provides challenges and remedies for managing discrepancies between prerequisites for an effective innovation and dem and s of daily implementation practice . The main recommendations are ( a ) st and ardized , simplified guidelines ; ( b ) stepwise implementation ; ( c ) formalized coalitions , integration of policy , and synchronization of tasks and protocol s ; and ( d ) smart planning and control by clear communication and feedback instruments . If these recommendations are incorporated into the JUMP-in intervention and organization , increased effectiveness and long-term effects can be expected 
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Conclusions Implementation model use was predominately centered on the interpretation of results and analyses , with few examples of use across all study phases as a planning tool and to underst and results .
This lack of implementation models applied may explain the limited success of interventions when delivered under real-world conditions or at scale .