Critical implementation conditions in interventions and policies for obesity prevention: findings from DEDIPAC case study

Abstract

Background: The aim of the qualitative case studies was to gain a better understanding of what health promotion professional and policy makers think are important facilitators and barriers to a successful implementation and transfer of both multi-component interventions and policies in Poland. Method: Interviews were conducted with 8 stakeholders and implementers of three policies and one intervention. The cases were: (1) The “European Schools for Healthy Food – Slow Food in the Canteen†an intervention promoting the consumption of fresh and healthy foods in primary school canteens, (2) “Fit Student†policy preventing obesity among children and adolescents through identifying students at risk for obesity, (3) “Tasty, Healthy, Valuable†policy promoting a healthy diet through advice provided by a municipality-employed specialist, and (4) “Fit City†a city-based program aiming to form pro-health behaviors in the local community. Thematic analysis was applied, guided by the RE-AIM model for implementation and findings from a systematic review on 83 conditions for successful implementation. Findings: For the intervention, thirteen facilitating conditions (including process evaluation, simplicity, training for implementation) and two barriers (e.g. referring to setting characteristics) to implementation were found. For policies, ten facilitating conditions (including delivery characteristics such as dose and fidelity) and nine barriers (e.g. referring to government involvement, adoption to physical environment) to implementation were identified. Conclusions: The vast majority of elicited conditions referred to the adoption and implementation components of the RE-AIM model whereas reach and maintenance conditions were rarely indicated by the stakeholders and implementers.