RESUMEN
BACKGROUND: There is a lack of effective intervention strategies that promote physical activity (PA) in school children. Furthermore, there is a gap between PA intervention research and the delivery of programmes in practice. Evaluation studies seldom lead to adaptations in interventions that are subsequently evaluated by implementation on a wider scale. The stepwise development and study of JUMP-in aims to add knowledge to better understand how, when and for whom intervention effects (or lack of effects) occur. METHODS: This paper describes the stepwise development of JUMP-in, a Dutch school-based multi-level intervention programme, aimed at the promotion of PA behaviour in 6-12-year-old children. JUMP-in incorporates education, sports, care and policy components. JUMP-in consists of six programme components: 1. Pupil Follow-up Monitoring System; 2. School sports clubs; 3. In-class exercises with "The Class Moves!"; 4. Personal workbook "This is the way you move!"; 5. Parental Information Services; 6. Extra lessons in physical education, Motor Remedial Teaching and extra care. The process and effect outcomes of a pilot study were translated into an improved programme and intervention organisation, using the RE-AIM framework (Reach, Efficacy, Adoption, Implementation and Maintenance). This paper presents the process and results of the application of this framework, which resulted in a widescale implementation of JUMP-in. RESULTS: The application of the RE-AIM framework resulted in challenges and remedies for an improved JUMP-in intervention. The remedies required changes at three different levels: (1) the content of the programme components; (2) the organisation and programme management; and (3) the evaluation design. CONCLUSIONS: Considering factors that determine the impact of PA interventions in 'real life' is of great importance. The RE-AIM framework appeared to be a useful guide by which process and effect outcomes could be translated into an improved programme content and organisation.
Asunto(s)
Ejercicio Físico/fisiología , Promoción de la Salud/métodos , Servicios de Salud Escolar , Niño , Educación en Salud , Implementación de Plan de Salud , Política de Salud , Humanos , Países Bajos , Evaluación de Resultado en la Atención de Salud , Padres , Proyectos Piloto , Evaluación de Programas y Proyectos de Salud , Instituciones Académicas , Deportes/fisiología , Enseñanza/normasRESUMEN
JUMP-in is a systematically developed intervention aimed at promoting physical activity among primary school children. It is a joint project involving different authorities and entails six school-based programme components. Measuring effects of such an intervention is a complex challenge. A common problem is the lack of valid instruments to measure physical activity and its determinants. In addition, it usually takes years to find improvements in physical activity and related constructs like weight and fitness, or even in causal factors. For this reason different authors advocate for the establishment of 'health promotion outcomes'; (i) health literacy, (ii) social action and influence and (iii) healthy public policy and organizational practice. It is presumed that these health promotion outcomes lead to changes in determinants, behaviour and finally in health. Insight in these health promotion outcomes and information about input and through-put are important in discussing the impact and output. The formative evaluation study of the JUMP-in pilot shows the health promotion outcomes of the intervention. The health promotion outcomes 'social action and influence' and 'healthy public policy and organizational practices' were found to be positive. By measuring the presence of the conditions to achieve 'health literacy', it became clear that more attention must be paid to implementation in the future. Based on the health promotion outcomes, we expect that JUMP-in will be an effective intervention in the future. (AU)