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Table 7 Implementation barriers and benefits and reflections on the intervention as reported by school staff

From: Implementation of the HealthKick intervention in primary schools in low-income settings in the Western Cape Province, South Africa: a process evaluation

Themes identified Supporting quotations
Perceived benefits  
Curriculum “The way it is set out man, it is simplified and it is not like an encyclopaedia where you have to search and do research, it is all there, like if you need information you don’t need any other resources. You can just use that and it will give you ample information.” (Educator LO head)
School environment improved  
Health of school staff Yes, especially for me personally it made a big difference. Because every time I come here to weigh myself and I find out I am risk it worries me and I think I must reduce my weight and I must look at what I eat. Also my heart, my high blood pressure it went down I think because of my diet especially because I do not eat red meat anymore now I cut red meat it helped for me. (Female educator, urban school)
Implementation Barriers  
School environment and resources “The biggest problem is that we have very little space. Not only our premises, the whole area [or] space is a problem here in…” (Principal, rural school)
Parents and socio-economic environment “And then the environment in which we live plays a large role in what they [children] eat. They have to eat what they get… because there is little money for them to make changes to their diet. If it’s bread and coffee there is not much you can do about it.” (Educator, urban school)
Time pressures and human resources “I think because sometimes we are too busy, like I think last year there were things happening, like, teachers that are going to have training sessions.” (Educator, urban school)
Reflections on the intervention  
More structured/focused/higher intensity approach needed if we had somebody who can come over and show us how to do it, because we needed gardening and we need the soil and that will also help us be responsible maybe, because now we should have now you know, say we have this but we couldn’t take care of it I think it’s things like that, I think one project, if we have just one project, because that would have been a project that would stay here at school understand, it’s things like that, it’s things we can do and see them next time I think that would be very wise. (Educator, urban school)
Importance of champion/principal/ management Moderator: “You said it is a (school name) project, yes? How would one get buy-in from the staff? How do you get the staff to…?”
“Through the principal, the principal is the one where the buck stops. You should shake him up, you just contact him, [and] he shakes us up. (Laughing) (Group of educators, urban school)
More parent involvement/education “The planning, yes, from our side the planning was very poor, definitely; and I think it can work the way you put it. If the parents and the School Governing Body are involved as well as most of the school teachers, because … and I cannot do everything, it’s impossible.” (Educator and tuck shop coordinator, rural school)