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BMC Public Health

, 15:347

Health behavior, health promotion and society


BackgroundSmokeFree Sports SFS was a multi-component sport-for-health intervention aiming at preventing smoking among nine to ten year old primary school children from North West England. The purpose of this study was to evaluate the process and implementation of SFS, examining intervention reach, dose, fidelity, acceptability and sustainability, in order to understand the feasibility and challenges of delivering such interventions and inform interpretations of intervention effectiveness.

MethodsProcess measures included: booking logs, 18 focus groups with children n = 95, semi-structured interviews with teachers n = 20 and SFS coaches n = 7, intervention evaluation questionnaires completed by children, n = 1097; teachers, n = 50, as well direct observations by researchers, n = 50 observations and self-evaluations completed by teachers, n = 125 of intervention delivery e.g. length of sessions, implementation of activities as intended, children’s engagement and barriers. Descriptive statistics and thematic analysis were applied to quantitative and qualitative data, respectively.

ResultsOverall, SFS reached 30.8% of eligible schools, with 1073 children participating in the intervention across 32 schools. Thirty-one schools completed the intervention in full. Thirty-three teachers 55% female and 11 SFS coaches 82% male attended a bespoke SFS training workshop. Disparities in intervention duration range = 126 to 201 days, uptake only 25% of classes received optional intervention components in full, and the extent to which core mean fidelity score of coaching sessions = 58% and optional components no adaptions made = 51% of sessions were delivered as intended, were apparent. Barriers to intervention delivery included the school setting and children’s behaviour and knowledge. SFS was viewed positively 85% and 82% of children and teachers, respectively, rated SFS five out of five and recommendations to increase school engagement were provided.

ConclusionSFS was considered acceptable to children, teachers and coaches. Nevertheless, efforts to enhance intervention reach at the school level, teachers’ engagement and sustainability must be considered. Variations in dose and fidelity likely reflect challenges associated with complex intervention delivery within school settings and thus a flexible design may be necessary. This study adds to the limited scientific evidence base surrounding sport-for-health interventions and their implementation, and suggests that such interventions offer a promising tool for engaging children in activities which promote their health.

KeywordsSmoking Children School Intervention Sport Process evaluation Implementation AbbreviationsPEPhysical education

PSHEPersonal social health and economic

SFSSmokeFree Sports

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Autor: Joanne Trigwell - Ciara E McGee - Rebecca C Murphy - Lorna A Porcellato - Michael Ussher - Katy Garnham-Lee - Zoe R Kno


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