Exploring the long-term sustainability of school-based nutrition and food programs: What works, where and why?

Leila I Fathi; Danyu Yang; Jacqueline L Walker; Mark Robinson; Robyn A Littlewood; Helen Truby

doi:10.1002/hpja.847

Exploring the long-term sustainability of school-based nutrition and food programs: What works, where and why?

Health Promot J Austr. 2024 Feb 15. doi: 10.1002/hpja.847. Online ahead of print.

Authors

Leila I Fathi¹, Danyu Yang¹, Jacqueline L Walker^{1

2}, Mark Robinson³, Robyn A Littlewood^{1

2}, Helen Truby¹

Affiliations

¹ School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia.
² Health and Wellbeing Queensland, Brisbane, Queensland, Australia.
³ Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia.

PMID: 38361362
DOI: 10.1002/hpja.847

Abstract

Issue addressed: Most food and nutrition programs cease within 2 years. Understanding the determinants of program sustainability is crucial to maximise output from funding, whilst allowing sufficient time for program benefits to be achieved. This study applied the Consolidated Framework for Implementation Research (CFIR) to map the barriers and enablers of successful long-term implementation of school-based nutrition and food programs.

Methods: Qualitative methods with purposive and snowball sampling were used to recruit experts who were identified as being influential in implementing and sustaining long-term (>2 years) school-based food and nutrition programs. Semi-structured interviews with global experts were conducted, transcribed verbatim and coded deductively (by applying the CFIR constructs) and inductively when required. Thematic analysis informed the development of themes.

Results: Interviews were conducted with 11 experts including researchers, government employees, and a consultant of an international agency, from seven countries. Forty-eight deductive codes and eight inductive codes identified six main themes: (1) funding and integrity of its source; (2) political landscape; (3) nutrition policies and their monitoring; (4) involvement of community actors; (5) adaptability of the program and (6) effective program evaluation. Themes related mainly to the 'outer setting' domain of the CFIR.

Conclusions: The CFIR highlighted pertinent factors that influence the successful long-term implementation of school-based food and nutrition programs. SO WHAT?: The findings suggest that to sustain program implementation beyond its initial funding, relationships across government departments, local organisations and communities, need to be nurtured and prioritised from the outset.

Keywords: health promotion; implementation science; obesity prevention; paediatric obesity; schools; sustainability.

Abstract

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