Purpose: Exploring the adoption of interventions is critical to better understanding the scale up process needed for population-wide impact. Uptake of school-based programs is a slow and challenging process, with intervention characteristics and organisational culture particularly important. It is suggested interventions supported by educational stakeholders play is important in legitimising programs and supporting adoption. In partnership with 16 organisations, Transform-Us! is being disseminated to all Victorian primary schools (n=1,794) as a 'real-world' program embedded into education practice and policy. We investigated the experiences and learnings of partner organisations disseminating the program to their educational networks in the first 12 months.

Methods: Partner consultation has been ongoing since 2017 with 16 organisations ranging from government departments (n=4), professional societies (n=3), educational bodies (n=3), advocacy organisations (n=2), community organisations (n=2), sporting clubs (n=1), and charities (n=1). Semi-structured interviews were performed with representatives of each partner following 12 months of dissemination. Interviews were audio-recorded, transcribed and coded anonymously. Thematic analysis was performed independently by two researchers. Descriptive statistics of adopting schools stem from an online survey school leaders and teachers completed at registration. School level characteristics were compared between adopting and non-adopting schools using the MySchools database.

Results: Partners reported multiple dissemination channels to increase adoption (web links, email listserves, newsletters, professional networks, conferences, and workshops). Partners outlined several local, regional and state organisations to partner with and provided comment on the preferred content and timing of dissemination activities for their networks. Suggestions relating to content, timing and channels resulted in a detailed dissemination plan. Dissemination activities resulted in 191 schools (Government 78.1%, Catholic 19.5%, Independent 2.4%) and 293 individual teachers adopting Transform-Us! in the first 12 months from inner regional (15.9%), major cities (73.2%), outer regional (8.5%), and remote areas (2.4%) of Victoria.

Conclusion: Experiences of targeted dissemination activities of key partner organisations to scale the Transform-Us! program provides valuable information regarding the challenges and successes of embedding research within government and school systems for preventative programs.

Purpose: Worldwide lifestyle-related diseases are increasing. A pedagogical system combining physical activity with learning has shown promising results. Studies show that active learning may contribute to reduction in risk factors for cardiometabolic diseases and improve academic performance. Other studies fail to show similar results, as small sample sizes and short study periods implies uncertainty regarding the effect. Horten municipality in Norway took initiative to implement active learning in all elementary schools as a part of a long term health promotion campaign for children to prevent future lifestyle related diseases.  

Methods: HOPP, with seven intervention and two control schools (n=2300), aims to increase physical activity through active learning pedagogy during a school day by 45 minutes. Uniquely, teachers are trained to implement the program by the municipality. Annual measurements of anthropometrics, risk factors, physical activity, aerobic capacity, physical fitness, blood values, QoL, diet habits, executive function and academic performance are collected between 2015-2021.

Preliminary results: In HOPP’s fifth year, no longitudinal effect has been analysed. Several papers on baseline data and one-year effect have been published. No one-year effect was found. Reference values for serum lipids, hand-grip strength and anthropometrics were established, in addition to factors affecting running performance. Waist-to-height ratio (WHtR) was found to predict fitness in children, however, no clustering of cardiometabolic risk factors in 6-12 year old children was shown, although 14% were overweight. A weight increase in Norwegian children has subsided, however, WHtR and waist circumference have increased compared to a decade ago, indicating more abdominal adiposity. Physical activity level is well above 60 minutes of MVPA a day. However, a tendency of diminishing activity with age is evident, with a 4-minute decline per year. QoL in Norwegian children is high, and increasing with age, however, parents by proxy score their children lower overall, and decreasing with age.

Conclusion: Data from HOPP has given important knowledge of a wide range of children’s physical and mental health. There is yet a large proportion yet to be explored from a database now spanning across five years. 

Purpose: Schools provide an ideal setting for promoting healthy lifestyles in youth, but it has proven difficult to widely disseminate evidence-based programs in a cost-effective way. Through a USDA-funded project called SWITCH, we adapted and utilized an established implementation framework to help schools develop strategies to plan, implement, and operate school wellness programming on their own. We studied various facets of the implementation process over time to identify factors that facilitated or inhibited school wellness programming, and will share how these steps enhanced the planned dissemination.

Methods: The SWITCH implementation framework was based on an established training and implementation model, but adaptations and refinement were needed prior to broad dissemination efforts with the project. Effective dissemination also necessitated the development of a robust web-based platform to provide a structure for school-wellness programming efforts. Over the course of three years, we conducted several planned implementation studies to test and refine various aspects of the implementation framework and the integrated web-based platform.

Results: The sequential evaluation steps helped to refine the implementation process over time. An early evaluation documented the utility of the web-based self-monitoring system for promoting behavior change. A subsequent cluster randomized trial compared two distinct implementation strategies to clarify the best options for broader dissemination. Finally, a detailed process evaluation and mixed method approach provided insights about the capacity-building process and the challenges and barriers faced by schools in creating system changes. Schools have been able to plan and carry out programming on their own, but results have documented the importance of building capacity and the value of supplemental support provided by county extension coordinators that can work locally with schools.

Conclusions: The incremental adaptations informed by our ongoing analyses have helped to refine the SWITCH process and have facilitated the planned transition to sustained delivery through the 4H Youth Development arm of the state-wide Cooperative Extension system. We have gradually enrolled larger samples of schools over time (expanding from 6 to 60+) while laying the foundation for planned multi-state expansion through other state extension networks.