Barriers and facilitators to nationwide dissemination of a school-based obesity prevention program

in a paper just published in the European Journal of Public Health we -with Dr. Femke van Nassau as first author- describe a study on the barriers and facilitating factors to the adoption, implementation and continuation of the Dutch Obesity Intervention in Teenagers (DOiT) programme in the Netherlands.
We evaluated the adoption, implementation and continuation of the programme at 20 prevocational schools, based on interviews with DOiT school coordinators and teachers at the end of the first and second school year of the 2-year implementation period. Identified barriers and facilitating factors were categorized into four groups: (i) organizational factors, (ii) individual factors, (iii) characteristics of the programme and (iv) characteristics of the implementation strategy.
Teachers and DOiT coordinators identified various implementation barriers -such as lack of planning, other urgent unforeseen priorities, no plan to cope with teacher turnover and high teacher workload- as well as facilitating factors (e.g. involvement of DOiT coordinator and support from the DOiT office, sufficient communication and collaboration between teachers, strong teacher motivation and flexibility of the programme). Barriers for successful implementation were mainly at the school and teacher level. The results of our
study can be used for further improvement of the DOiT programme and for the development and improvement of other health promotion programmes in the school setting.