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Table 2 Quotations illustrating factors facilitating adoption, implementation and maintenance

From: Barriers and facilitators to adoption, implementation and sustainment of obesity prevention interventions in schoolchildren– a DEDIPAC case study

(RE)AIM Parameters (Bold)  
 Collaboration and Communication …“these Travel Officers and other officers in (NGO) already have an open door into these schools. They have built up a relationship” (Civil Servant, Government Department B).
  …“Officers around the country would come up with different things and then at our meetings we show them to each other… Then we have a shared database that we all link into” [GSTO].
 Characteristics of settings …“the class teachers were very, like they were really good like we just said this is all happening, this is invading your classroom…and they were like yeah grand and they all just hopped to it” [FD School Coordinator/Teacher]
  …“we have a lady that kind of goes around with our school would get fruit...and some sandwiches as well delivered (and)…kind of sorted that out into baskets, so she also did the em fruit and veg for us”. [FD School Coordinator/Teacher]
 Implementers characteristics …“it’s really about how interested the coordinator is within the school… they’re the people, the drivers within the school that really push the theme through” [Intermediary Agency A, Management Official].
“I also think the travel theme is one where the chidren are really, really central. It’s driven by the chidren as well, like we have to make sure tht the ideas that we’ll say we’ll do happen” [GS Coordinator].
 Implementation delivery, protocols, fidelity (including dose) “…There would be phone calls on day 4 and day 5 where the programme changes…so the first school days of the programme the children have to take a bite in order to be rewarded. But from day 5 through to day 16, you have to eat a portion... So there would be phone calls just to check that the coordinators would remind all teachers…There would be visit again on day 16… depending on the degree of support that the teachers needed and if they had extra queries… and then we’d have a visit approximately 4 to 6 weeks later,… for phase 2, to see how they are getting on.” [FD PMC Official]
  …“Like schools would have walk to school days, WoW (Walk on Wednesdays) days or CoW (Cycle on Wednesdays) days and where it’s … recorded” [GSTO].
 Adaptation and customisation “We have a few children that maybe just wouldn’t kind of like fruit and veg at all. And they actually did try it, because they really wanted the prize”. [FD School coordinator/ Primary School Teacher]
  …“with special schools it’s been very much about working with the teachers in those schools to apply the principles behind the programme, em but to match them to the needs of the children and their specific need. So even within a class in a special school there might be different children who are being rewarded for doing different things…for some if they have a terrible aversion to em to bananas or yellow foods,… it’s about edging them closer and closer to eating”. [FD PMC Official]
  “It’s about kind of… meshing it into this fabric of the school day…by doing it during our little break and big break and kind of doing the video then” [FD School Coordinator)
  “I know the paperwork has kind of come down the last couple of themes, it is more tick the box or list out which is great for the kids… because it did feel like writing essays at one stage” [Green Schools Coordinator]
 Incentives and rewards …“it’s about the class and about their attitude in terms of the Golden Boot (award) you know you’re putting them one step away from getting the Golden Boot. Yeah but also like they (pupils) want to (achieve it).” [GSTO].
 Process evaluation ...“it’s hands up surveys in schools which is fine and you don’t expect young kids to lie” [Civil Servant, Government Department B]
 Simplicity of the intervention “We designed a system whereby the rewards would be packaged and labelled per phase and per day …it could be packed per classroom as well. So the teacher would open the box for his or her own classroom inside that would be all the phase 1 rewards, clearly packaged and labelled day 1 reward, day 2 reward, day 3 and so forth… and then the same for phase 2…” [FD PMC Official].
 Training …“we just step in and out and give them the lead and support and run a demonstration or a workshop” [Intermediary Agency A, NGO, Green Schools Management Official].
 Integration into existing structures ...“we would have healthy eating in place for years…there was a survey done and the parents wanted a healthy eating policy” [FD School Coordinator / Primary School Teacher]