PDF(Pubmed)
Abstract：
BACKGROUND: Despite the uncontested benefits of physical activity, its promotion lags behind in the public health agenda of low- and middle-income countries (LMICs). School-based interventions are promising strategies to foster health during childhood, but evidence of their effectiveness is limited and inconclusive for LMICs. Thus, further investigation is needed on contextual factors associated with intervention implementation in low-resource settings. We studied the acceptability and feasibility of the KaziKidz health promotion intervention and its implementation and make recommendations to improve future adoption and sustainability.
METHODS: KaziKidz was implemented in four primary schools from low-income communities in South Africa in 2019. Semi-structured interviews with four school principals, three focus group interviews with 16 educators, and another three with 16 caregivers were conducted between October and November 2021. Participants were purposively recruited. Interview transcripts were analyzed via thematic analysis using a deductive and reflexive approach.
RESULTS: Three main themes influencing intervention implementation and adoption were identified: (1) prioritizing teachers\' needs (2), integrating the program into the school structure, and (3) creating opportunities in the community. Supporting recommendations included: (theme 1) adopting intervention approaches that are inclusive of educators\' health and providing them with capacity development and external support; (theme 2) fostering a feeling of ownership and belonging among school stakeholders to adapt interventions to specific resources and needs; and (theme 3) raising community awareness to encourage individuals to claim power over and actively engage with the program.
CONCLUSIONS: Comprehensive interventions comprising health support, adequate training, and ongoing assistance for educators combined with school-wide and community outreach actions seeking to strengthen program ownership, accountability, and engagement can enhance uptake of school-based interventions and long-term maintenance.
BACKGROUND: ISRCTN15648510, registered on 17/04/2020.
METHODS: KaziKidz was implemented in four primary schools from low-income communities in South Africa in 2019. Semi-structured interviews with four school principals, three focus group interviews with 16 educators, and another three with 16 caregivers were conducted between October and November 2021. Participants were purposively recruited. Interview transcripts were analyzed via thematic analysis using a deductive and reflexive approach.
RESULTS: Three main themes influencing intervention implementation and adoption were identified: (1) prioritizing teachers\' needs (2), integrating the program into the school structure, and (3) creating opportunities in the community. Supporting recommendations included: (theme 1) adopting intervention approaches that are inclusive of educators\' health and providing them with capacity development and external support; (theme 2) fostering a feeling of ownership and belonging among school stakeholders to adapt interventions to specific resources and needs; and (theme 3) raising community awareness to encourage individuals to claim power over and actively engage with the program.
CONCLUSIONS: Comprehensive interventions comprising health support, adequate training, and ongoing assistance for educators combined with school-wide and community outreach actions seeking to strengthen program ownership, accountability, and engagement can enhance uptake of school-based interventions and long-term maintenance.
BACKGROUND: ISRCTN15648510, registered on 17/04/2020.
摘要：
背景：尽管体力活动的好处无可争议，在低收入和中等收入国家（LMICs）的公共卫生议程中，其推广滞后。以学校为基础的干预措施是促进儿童健康的有希望的策略，但其有效性的证据是有限的，并没有定论。因此，需要进一步调查与在低资源环境中实施干预相关的背景因素.我们研究了KaziKidz健康促进干预措施及其实施的可接受性和可行性，并提出了改善未来采用和可持续性的建议。
方法：KaziKidz于2019年在南非低收入社区的四所小学实施。对四位校长的半结构化访谈,对16名教育工作者进行了三次焦点小组访谈，在2021年10月至11月期间，进行了另外3次与16名护理人员的护理。参与者是故意招募的。访谈笔录通过主题分析使用演绎和反身方法进行分析。
结果：确定了影响干预实施和采用的三个主要主题：（1）优先考虑教师的需求（2），将该计划整合到学校结构中，（3）在社区中创造机会。支持的建议包括：（主题1）采用包括教育工作者健康在内的干预方法，并为他们提供能力发展和外部支持；（主题2）培养学校利益相关者的主人翁感和归属感，以使干预措施适应特定的资源和需求；（主题3）提高社区意识，以鼓励个人对该计划主张权力并积极参与。
结论：包括卫生支持在内的综合干预措施，充分的培训,以及对教育工作者的持续援助，以及寻求加强计划所有权的全校和社区外展行动，问责制,和参与可以加强对基于学校的干预措施和长期维护的吸收。
背景：ISRCTN15648510，于2020年4月17日注册。
方法：KaziKidz于2019年在南非低收入社区的四所小学实施。对四位校长的半结构化访谈,对16名教育工作者进行了三次焦点小组访谈，在2021年10月至11月期间，进行了另外3次与16名护理人员的护理。参与者是故意招募的。访谈笔录通过主题分析使用演绎和反身方法进行分析。
结果：确定了影响干预实施和采用的三个主要主题：（1）优先考虑教师的需求（2），将该计划整合到学校结构中，（3）在社区中创造机会。支持的建议包括：（主题1）采用包括教育工作者健康在内的干预方法，并为他们提供能力发展和外部支持；（主题2）培养学校利益相关者的主人翁感和归属感，以使干预措施适应特定的资源和需求；（主题3）提高社区意识，以鼓励个人对该计划主张权力并积极参与。
结论：包括卫生支持在内的综合干预措施，充分的培训,以及对教育工作者的持续援助，以及寻求加强计划所有权的全校和社区外展行动，问责制,和参与可以加强对基于学校的干预措施和长期维护的吸收。
背景：ISRCTN15648510，于2020年4月17日注册。
