[Assessment of the implementation of a national intersectoral strategy for the prevention of childhood obesity in Brazil].

This study assessed the implementation of PROTEJA, which is a national intersectoral strategy for the prevention and treatment of childhood obesity targeting small municipalities. Through a qualitative multiple-case study grounded in implementation science, 35 interviews were conducted with municipal technical leaders from the five macroregions of Brazil from different human development scenarios and different degrees of adherence to innovation. The identification and categorization of facilitators and barriers with regards to implementation was based on the Consolidated Framework for Implementation Research (CFIR) using content analysis. The facilitators identified were intersectoral governance, participatory territorial planning and diagnosis, technical support for management, adaptability to local situations, compatibility with the list of health services, and the perception of relative advantage over similar programs. The main barriers were difficulty in the use of financial resources, the high turnover of technical leaders, difficulty in coordinating agendas for the full functioning of spaces of governance, resistance from healthcare professionals, and low relative priority given to childhood obesity as a public health problem by municipal authorities. The implementation of PROTEJA was made possible by coordinating guidelines, technical support, and financial incentives. The analysis guided by CFIR revealed how the interaction among technical (planning instruments and goals), organizational (intra- and intersectoral structures and networks), and human (capabilities and learning curves) elements facilitated or hindered the implementation of the policy.