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Table 1 Multi-strategy intervention to facilitate implementation of vegetable and fruit breaks in intervention schools

From: Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial

Change strategy Strategy components
Consensus processes, leadership support & endorsement · Memorandum of Understanding [27] signed with New South Wales Department of Education & Communities and Catholic Schools Office (Hunter New England region) supporting the implementation of the program.
  · Expert advisory group consisting of health promotion practitioners, School Education Directors, local Principals and teachers, academics with experience working with schools, parent representatives and dietitians supported program planning and implementation.
  · Regional school Directors of both Government and Catholic schools disseminated a “guiding principles” document recommending all schools in their jurisdiction to implement a vegetable and fruit break.
  · Regional and cluster school Directors advocated for the introduction of such breaks at Principal network meetings and with individual school Principals during their school visits.
  · Presentations at school Principal cluster meetings to promote the program by program staff.
  · Recruitment of “school champions”, a staff member within each school that will take responsibility for implementation.
  ·Individual school specific vegetable and fruit break policy- To support, establish and sustain the program schools developed a vegetable and fruit break policy outlining how the program will be implemented and monitored and strategies for ensuring no child misses out due to financial difficulties.
Staff training & professional development · 1-day (6 hour) ‘healthy eating’ workshop for school champions held across the Hunter New England region. Fifteen workshops were held across the region to allow maximum access by schools.
  · 1-day teacher relief funding (AU$250) for small schools (less than 300 students) for “school champion” to attend training.
  · 2 hr video-conference or self-paced online module for non-attending schools.
Provision of curriculum resources and materials, and information for parents · Resources were provided to schools: an easy-to-follow manual and a CD containing curriculum material (the same as that available for comparison schools), policy templates, information for parents, and newsletter articles (available for download
Incentives · Following certification (that is once schools developed a school policy committing to implement the program everyday in at least 80 % of classes and to ensuring that no child misses out due to financial difficulties) schools received a free water bottle for every student and teacher.
Follow-up support · Scripted 15-minute computer-assisted telephone interviews (CATI) with school champions up to three weeks after the workshop to: assess school readiness to implement the program; identify barriers to implementing the program; support schools to overcome the barriers; and identify schools requiring further support.
· If during the scripted 15 minute CATI it was determined the school required more specific support the school was offered additional support calls from a trained health promotion support officer. Schools received a maximum of two phone calls over a three-month period. The support officer called the school contact to further discuss the barriers identified in the CATI and to offer advice or resources to meet the needs of that school.
· Quarterly Good for Kids, Good for Life newsletter e-mailed to school champion to promote the program, celebrate successes, describe case studies in local schools and review future programs and support.
Implementation performance monitoring and feedback · A one-off tailored ‘school report’ based on the Principal’s responses to the baseline telephone interview were provided to Principals and school champions. The report identified the vegetable and fruit break policies and programs that the school had in place and recommended specific strategies, resources or support that the study could offer to improve their vegetable and fruit break.
· Regional Directors and School Education Directors were provided two six-monthly reports, which described the proportions of their schools that participated in the workshops and were “certified” for vegetable and fruit breaks. Directors were asked to disseminate these results to Principals through existing communication channels such as Principal meetings and newsletters.