ArticleInternational journal of environmental research and public health2020
Implementation of KEIGAAF in Primary Schools: A Mutual Adaptation Physical Activity and Nutrition Intervention.
Article in International journal of environmental research and public health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Applying the Integrated Sustainability Framework to explore the long-term sustainability of nutrition education programmes in schools: a systematic review.Public health nutrition · 2023Pooled it
- Exploring the implementation of the school-based obesity prevention Familie+ intervention: a pilot mixed-methods study of teachers' perceptions.Health education research · 2026Article
- Feeding change: school meal support in the Netherlands and the perspectives of primary school professionals.BMC public health · 2026Article
- Physical Activity on Prescription "Not a Quick Fix": School Nurses' Experiences of Promoting and Tailoring Physical Activity to Children in Swedish Compulsory School.The Journal of school nursing : the official publication of the National Association of School Nurses · 2025Article
- Influencing factors for the implementation of school-based interventions promoting obesity prevention behaviors in children with low socioeconomic status: a systematic review.Implementation science communications · 2024Review
- Interventions to promote healthy nutrition and lifestyle and to tackle overweight and obesity amongst children in need in Europe: a rapid literature review.Frontiers in nutrition · 2024Review
- Fidelity, adaptation and integration of whole-school health promotion within Dutch schools: a cross-sectional survey study.Health promotion international · 2023Article
- Capacity building in participatory stakeholder groups: results from a German research consortium on active lifestyles.Health promotion international · 2021Article
- Changing the preschool setting to promote healthy energy balance-related behaviours of preschoolers: a qualitative and quantitative process evaluation of the SuperFIT approach.Implementation science : IS · 2021Article
- Effects of the KEIGAAF intervention on the BMI z-score and energy balance-related behaviors of primary school-aged children.The international journal of behavioral nutrition and physical activity · 2020Article
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Authors and funding
7 authors.
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Abstract
School health promotion is advocated. Implementation studies on school health promotion are less often conducted as effectiveness studies and are mainly conducted conventionally by assessing fidelity of "one size fits all" interventions. However, interventions that allow for local adaptation are more appropriate and require a different evaluation approach. We evaluated a mutual adaptation physical activity and nutrition intervention implemented in eight primary schools located in low socioeconomic neighborhoods in the Netherlands, namely the KEIGAAF intervention. A qualitative, multiple-case study design was used to evaluate implementation and contextual factors affecting implementation. We used several qualitative data collection tools and applied inductive content analysis for coding the transcribed data. Codes were linked to the domains of the Consolidated Framework for Implementation Research. NVivo was used to support data analysis. The implementation process varied greatly across schools. This was due to the high level of bottom-up design of the intervention and differing contextual factors influencing implementation, such as differing starting situations. The mutual adaptation between top-down and bottom-up influences was a key element of the intervention. Feedback loops and the health promotion advisors played a crucial role by navigating between top-down and bottom-up. Implementing a mutual adaptation intervention is time-consuming but feasible.
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