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Youth engagement is often purported as a critical dimension of health promotion for young people, but the strategies used to facilitate this engagement are seldom evaluated or studied. This study explored the strategies used to engage youth in a strategic planning process to develop comprehensive health and wellness plans in 28 US school districts. Participating school districts conducted listening sessions, administered anonymous surveys, included youth on a district task force, and employed other strategies to engage youth. Following this initiative, semi-structured interviews were conducted with representatives from all school districts (n = 34) to enumerate the use of these strategies across districts and understand their perspectives related to the effectiveness and importance of these strategies for engaging youth in health promotion. The most prevalent strategy used by districts was listening sessions (27 districts; 564 youth), followed by including youth on the task force (19 districts; 39 youth), anonymous surveys (18 districts; 1988 youth) and other methods (5 districts). Interviewees clarified the benefits and challenges of each strategy and provided commentary on youth engagement for health promotion. The results stress the importance of building trusting relationships with youth, using multiple strategies to engage youth, and embodying an equity mindset throughout the development and implementation of youth engagement efforts.

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BACKGROUND: Partnerships are best positioned for success when the readiness of those engaged is assessed and discussed from the outset. Doing so requires an approach to readiness that is responsive to the particular context of the partnership. OBJECTIVES: This study contributes to the topic of partnership readiness through a readiness assessment used with rural local public health agencies (LPHAs) to partner with a university research team on implementing a Kindergarten to 12th-grade school-based health intervention called Assess, Identify, Make it happen. METHODS: Through case study methodology, we explored the readiness of LPHAs to partner with a university on this initiative as well as the role the readiness assessment played in facilitating this partnership. We conducted semistructured interviews with directors and agency staff in five rural LPHAs before (n = 8) and after (n = 5) they implemented Assess, Identify, Make it happen. We also documented their work with Kindergarten to 12th-grade schools and in partnership with us throughout the initiative. RESULTS: The findings of this study are presented in three phases. Phase 1 outlines the results from the initial readiness assessment interviews as aligned with select constructs of readiness. Phase 2 recounts how these constructs materialized through partnership between LPHAs and the university. Phase 3 includes findings from a postintervention interview focused on readiness for partnership. Collectively, these findings portray prospective, operational, and retrospective perspectives on LPHA readiness for partnership. CONCLUSIONS: This study contributes to the constructs of readiness for partnership, highlights the distinction between assessing and cultivating readiness, and demonstrates the benefits of a multiphase approach to readiness for partnership.

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Background: One pathway to addressing childhood obesity is through implementing evidence-based practices (EBPs) shown to promote nutrition and physical activity in K-12 school settings. Assess, Identify, Make it happen (AIM) is a strategic planning process to engage stakeholders in implementing EBPs in their K-12 schools. Local Public Health Agencies (LPHAs) are a potential partner to facilitate this process to a broader audience of rural school communities. Methods: A process and outcome evaluation design was applied in this study to examine the extent to which LPHAs effectively implemented AIM with rural/frontier schools in comparison to university staff. Data collection included post-meeting surveys completed by facilitators, a post-intervention interview with facilitators, a survey of school task force members at the end of the AIM process, and systematic documentation of the intervention. Results: Reach -Among the 26 eligible elementary schools, 18 (69%) agreed to participate. Effect -In total, schools facilitated by LPHAs fully implemented an average of 4.0 changes per school, while schools facilitated by the university staff fully implemented an average of 3.7 changes. Adoption -Among the five LPHAs in the target region, all five agreed to partner on the initiative, but some agencies were unable to identify sufficient personnel to facilitate all schools in their catchment area. Implementation -(1) In total, 89 of 94 (95%) meetings scheduled by LPHA facilitators occurred. 47 of 48 (98%) meetings scheduled by the university staff occurred. (2) The university staff self-reported 93% of agenda items in the AIM process as "completely" followed while LPHA facilitators reported 41% of agenda items as "completely" followed. (3) Task force satisfaction with the AIM process and facilitator showed limited variance across LPHAs and university-facilitated schools. Maintenance -Of the 16 school districts that agreed to participate in the school-based version of AIM, 9 (56%) also participated in a district-wide version of AIM 2 years later. Conclusion: AIM is an effective process for implementing EBPs in elementary schools when facilitated by LPHAs. Effective partnerships, a nuanced approach to fidelity, scalability considerations, and the role of technical assistance and training all contributed to the successful implementation of this LPHA-Elementary school partnership.