Table 1 Overarching themes, descriptions, and subthemes
From: Initial insights into the impact and implementation of Creating Active Schools in Bradford, UK
Themes | Theme description | Sub-themes |
|---|---|---|
Implementation outcomes | ||
Adoption 1 | The initial decision to onboard and adopt CAS * | Attractiveness of the CAS ethos 1.1 |
Existing commitment to a physical activity agenda though locality-based projects 1.2 | ||
Initial financial incentive 1.3 | ||
School implementation readiness 1.4 | ||
Dose delivered 2 | Intended CAS components delivered by delivery team | CAS Champions facilitating delivery 2.1 |
Reach 3 | Proportion of the intended priority audience (schools and school staff) participating in CAS. | Limited visibility & permeation of CAS in schools 3.1 |
Identified approaches to increase reach of CAS 3.2 | ||
Fidelity 4 | The extent to which CAS is implemented as prescribed in the intervention protocol - by the delivery team | CAS Champions to act as friendly critics to schools 4.1 |
Sustainability 5 | Whether CAS continues to be delivered and/or individual behaviour change is maintained | Implementation efforts to ensure sustainability 5.1 |
CAS Champion support a necessity for sustainability 5.2 | ||
Implementation determinants | ||
Context 6 | Aspects of the larger social, political, & economic environment that may influence CAS implementation | Opportunities and challenges provided by Covid-19 6.1 |
Impact of financial differences between schools 6.2 | ||
Added value of CAS to other locality initiatives addressing health inequalities in Bradford 6.3 | ||
Ofsted priorities misalign with CAS 6.4 | ||
Staff turnover implications on CAS implementation 6.5 | ||
Limited opportunity for CAS Champion training 6.6 | ||
Acceptability 7 | Perceptions among the delivery team that CAS is agreeable, palatable, or satisfactory | Initial enthusiasm and anticipation for CAS 7.1 |
CAS Champion support promotes wider school buy-in 7.2 | ||
Adaptability 8 | Extent to which CAS can be adapted, tailored, refined, or reinvented to meet local needs | Simplification of CAS tools to increase useability 8.1 |
Flexibility in the school delivery model 8.2 | ||
Feasibility 9 | Perceptions among the delivery team that CAS can be successfully used or carried out within school/s | Staff’s (limited) Capacity 9.1 |
In-school CAS lead’s autonomy to make decisions 9.2 | ||
Compatibility (appropriateness) 10 | Extent to which CAS fits with the mission, priorities, and values of schools | CAS meeting an identified need in school 10.1 |
School’s see value of CAS 10.2 | ||
Incompatibility and less perceived value of CAS 10.3 | ||
Cost 11 | Money spent on design, adaptation, and implementation of CAS | Financial and opportunity costs of releasing CAS Champion 11.1 |
Culture 12 | Schools’ norms, values, & basic assumptions around selected health outcomes (physical activity) | Recognition for whole-school culture around physical activity 12.1 |
Idealism of school physical activity policy (currently missing in schools) 12.2 | ||
SLT support of CAS required to leverage whole-school buy-in 12.3 | ||
How CAS is operationalised in school (endemic top-down school approach) 12.4 | ||
CAS seen as synonymous with PE & Sport 12.5 | ||
Challenges to staff buy-in 12.6 | ||
Changes to staff’s mindset since adopting CAS 12.7 | ||
Dose (satisfaction) 13 | Delivery team’s satisfaction with CAS (and encompassing components) and with interactions with the support system | General satisfaction with CAS 13.1 |
CAS Champions and facilitator 13.2 | ||
CAS communities of practice facilitating networking opportunities 13.3 | ||
Administrative tasks (e.g. profiling tool) seen as laborious but generally beneficial 13.4 | ||
JU:MP related satisfaction 13.5 | ||
Complexity 14 | Perceptions among the delivery team that CAS is relatively difficult to understand and use; number of different intervention components | Multiple health-based projects in Bradford causing perplexity 14.1 |
Initial bewilderment alleviated over time 14.2 | ||
CAS Champion support increasing clarity for school staff 14.3 | ||
Self-efficacy 15 | Delivery team’s belief in its ability to execute courses of action to achieve implementation goals | Development of school staff’s confidence 15.1 |
CAS Champions differing capabilities 15.2 | ||
Perceived effectiveness 16 | Anecdotal effectiveness on whole-school physical activity aligning to the CAS framework (PESO) | Positive changes to school policy 16.1 |
Positive changes to the school environment 16.2 | ||
Positive changes to school-based stakeholders 16.3 | ||
Increases in physical activity opportunities 16.4 | ||
Perceived impact on children’s physical activity levels 16.5 | ||