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Table 1 Description of PACE implementation strategies and the joint display of quantitative implementation indicators (adoption and acceptability), usefulness and relevant qualitative themes for each

From: Identifying essential implementation strategies: a mixed methods process evaluation of a multi-strategy policy implementation intervention for schools

Strategy

Description

Adoption

Acceptability

Usefulness/importance for program implementation

1. Centralise technical assistance and provide ongoing consultation with one or more experts in the strategies used to support implementing the innovation (External ongoing support)

Project officers (a PE teacher and health promotion practitioner) employed by the health service provided technical assistance to ISC throughout the study period (12 months) in-person and/or email/telephone. Their role was to provide expertise, advice and resources to ISC to help them problem solve barriers to policy implementation.

Adapted PACE: via distance correspondence only (email/telephone)

ISC (the primary source of contact) from each school engaged in communication with, and support offered by, project officers (project records): 47/48 (98%)

- PACE: 23/24 (96%)

- Adapted PACE: 24/24 (100%)

The support I received from the project officer to implement PACE at my school was adequate (ISC):

40/46 (87%)

- PACE: 16/18 (89%)

- Adapted PACE: 24/28 (86%)

*23/28 (82%) indicated that support received from the project officer to deliver the teacher education session was adequate.

This was not ranked within the top 3 for ‘most important strategy’ by any project officers.

Qualitative themes:

(i) An engaging innovation via: Project officer characteristics [facilitator];

(ii) Limited time/competing demands of staff [barrier].

2. Mandate change

2a. Project officers had one × 1 h meeting, in-person and/or by email/telephone, with school principals and school executives to communicate the importance and benefits of the policy and gain their commitment for policy implementation over the school year.

Adapted PACE: via distance correspondence only (email/telephone)

Schools with principals that participated in the meeting and provided verbal commitment (project records): 48/48 (100%)

- PACE: 24/24 (100%)

- Adapted PACE: 24/24 (100%)

N/A

This was considered the most important strategy (ranked first) by 5/6 project officers.

Qualitative themes:

(i) Supportive executive [facilitator];

(ii) School physical activity culture [facilitator]; and

(iii) ISC power-interest - Player [facilitator], Context Setter [barrier], Subject or Crowd Member [barrier].

Having principal/executive support to schedule physical activity was useful/extremely useful: (ISC): 37/44 (84%)

- PACE: 16/XX (94%)

Adapted PACE: ISC: 21/X (79%)

2b. School executives were asked to demonstrate their commitment to implementing the NSW policy through the development of a school-level policy (‘Sport and Physical Activity Procedures document’) as required by the state-level policy.

Principals that indicated their school had a physical activity policy (principals): 13/33 (39%)

- PACE: 5/15 (33%)

- Adapted PACE: 8/18 (44%)

Principals that indicated their school had a physical activity policy – existing or in development (principals): 26/33 (79%)

- PACE: 12/15 (80%)

- Adapted PACE: 14/18 (78%)

N/A

2c. Principals and school executives were asked to demonstrate their support for, and the importance of, the policy by communicating to the broader school community (e.g., via newsletters, assemblies and staff meetings) that the implementation of the policy was a school priority and expected of all staff.

Principals that communicated their support (full or partial) for the implementation of the policy to teachers (principals): 27/32 (84%)

- PACE: 13/14 (98%)

- Adapted PACE: 14/18 (78%)

Principals that indicated PACE was a school priority (principals): 23/32 (72%)

- PACE: 10/14 (71%)

- Adapted PACE: 13/18 (72%)

Teachers that agreed/strongly agreed they had support from their school executive to implement PACE (teachers): 161/229 (70%)

- PACE: 67/94 (71%)

- Adapted PACE: 94/135 (70%)

N/A

3. Identify and prepare champions

3a. Each school nominated one to two ISC (existing teacher(s) at the school) who, with the support of the project officer, were responsible for leading the development and implementation of the policy in the school over the next 12 months.

Teachers that agreed/strongly agreed they had support from their ISC to implement PACE (teachers): 137/182 (75%)

- PACE: 57/76 (75%)

- Adapted PACE: 80/106 (75%)

The assistance I received from my ISC was acceptable (teachers): 126/173 (73%)

- PACE: 48/69 (70%)

- Adapted PACE: 78/104 (75%)

This was considered an important strategy (top three) by 100% of project officers; one of which ranked it first most important.

Qualitative themes:

(i) ISC power-interest – Player [facilitator], Context Setter, Subject or Crowd Member [barrier];

(ii) An engaging innovation via: experiential learning [facilitator] and project officer characteristics [facilitator]; and

(iii) Adaptability/flexibility of PACE: a choice-based model [facilitator].

Having an ISC located within the school was useful/extremely useful: (ISC): 35/45 (78%)

PACE: 13/17 (76%)

Adapted PACE: 22/28 (79%)

3b. ISC attended 1 × full day (5 h) training workshop with ≤20 ISC from other schools. These workshops covered: education about the policy, instruction and demonstration of energisers, active lessons and PE lessons, time to begin action planning, identification of barriers/ facilitators to implementation and possible solutions to overcome these. The training was accredited by the state educational authority and provided teachers continuing professional development hours.

ISC that actively participated in the workshop education and activities (project records): 80/80 (100%)

- PACE: 38/38 (100%)

- Adapted PACE: 42/42 (100%)

 

4. Develop a formal implementation blueprint

ISC were supported to develop a plan for policy implementation in their school. The plan identified what the school was aiming to achieve, the strategies to do so and by when, and the resources available or required. The plan was segmented into school terms to break up the more complex policy requirements into achievable tasks.

ISC were provided with time to complete this strategy during strategy 3b, the ISC workshop (project records): 100%

The physical activity plan developed by the ISC was acceptable in assisting me to schedule physical activity in my class (teachers): 114/172 (66%)

- PACE: 41/69 (59%)

- Adapted PACE: 73/103 (71%)

This was not ranked within the top 3 for ‘most important strategy’ by any project officers; however it was noted as occurring as part of the ISC workshop (strategy 3b).

Qualitative themes:

(i) An engaging innovation via quality resources [facilitator]; and

(ii) Staff turnover [barrier].

The creation of the school physical activity policy, scope and sequence document and whole school physical activity timetable was useful/extremely useful: (ISC): 34/44 (77%)

- PACE: 14/17 (82%)

- Adapted PACE: 20/27 (74%)

5. Conduct educational outreach visits

School staff attended 1 × 1–2 h information and training session delivered by an external representative (led in-person by a project officer) during a school staff meeting. Teachers were provided with an overview of the policy, the importance of and requirements for its implementation. The plan for their schools’ implementation of the policy was presented including the timeline of when key milestones were expected. They participated in practical demonstrations of suggested physical activities (e.g., energisers and active lessons) which they could incorporate into their normal classroom routines.

Adapted PACE: peer-delivered by ISC

Schools in which staff participated in the staff information and training session (project records): 40/48 (83%)

- PACE: 23/24 (96%)

Adapted PACE: 17/24 (71%)

*3 unknown

Overall: The whole school staff meeting was acceptable in assisting me to schedule physical activity in my class (teachers): 126/176 (72%)

- PACE: 59/72 (82%)

- Adapted PACE: 67/104 (64%)

Content: The information provided at the whole school meeting was acceptable in assisting me to schedule physical activity in my class (teachers): 125/176 (71%)

- PACE: 58/72 (81%)

- Adapted PACE: 67/104 (64%)

(As above) Adapted PACE schools only: The support I received from the project officer to deliver the teacher education session was adequate (ISC): 23/28 (82%)

This was considered an important strategy (top three) by 4/6 of project officers.

Qualitative themes:

(i) Teachers’ attitudes, beliefs and level of support [implementation facilitator];

(ii) Adaptability/flexibility of PACE: a choice-based model [facilitator];

(iii) An engaging innovation via experiential learning [facilitator];

(iv) Limited time/competing demands of staff [barrier];

(v) Staff turnover [barrier];

(vi) Adapted PACE only - ISC power-interest – Player [facilitator], Context Setter, Subject, or Crowd Member [barrier]; and

(vii) PACE only - An engaging innovation via: project officer characteristics [facilitator].

PACE schools only: Having the project officer conduct the one-hour educational outreach visit was useful/extremely useful (ISC survey): 15/17 (88%)

6. Develop and distribute educational materials

6a. ISC received an “intervention manual” inclusive of policy templates as well as examples of a physical activity timetable and PE curriculum.

ISC were provided with these materials during strategy 3b, the workshop (project records): 100%

The information on the online portal was acceptable (teachers): 74/173

(43%)

- PACE: 33/70 (47%)

- Adapted PACE: 41/103 (39%)

Resources were considered an important strategy (top three) by 2/6 of project officers.

Qualitative theme:

(i) An engaging innovation via quality resources [facilitator].

Responses of ‘yes’ - the resources available through the online portal were useful in helping to schedule physical activity (teachers): 97/150 (65%)

PACE: 45/62 (73%)

Adapted PACE: 52/88 (59%)

6b. ISC and teachers received educational materials during their respective training sessions. These resources included ideas and strategies for practical games that increase physical activity during class time, example timetables etc.

PACE resources: Teachers’ that used PACE resources (e.g., online portal, booklet and equipment pack) to help schedule physical activity (teachers): 118/202 (58%)

- PACE: 56/86 (65%)

- Adapted PACE: 62/116 (53%)

Online portal (schools): Schools with at least one teacher that accessed the online portal (project records: web analytics): 43/48 (90%)

- PACE: 22/24 (92%)

- Adapted PACE: 21/24 (88%)

Online portal (teachers): Teachers that accessed the resources on the online portal (teachers): 98/228 (43%)

- PACE: 42/95 (44%)

- Adapted PACE: 56/133 (42%)

6c. ISC and teachers were provided access to professional learning videos which reinforced information received during their respective training sessions. ISC were asked to view the videos and to organise a time for their colleagues to watch them during a staff meeting.

Schools in which at least one professional online learning video was viewed by teachers and ISC (project records: web analytics):

Teachers: 24/48 (50%)

- PACE: 11/24 (46%)

- Adapted PACE: 13/24 (54%)

ISC: 35/48 (80%)

- PACE: 12/24 (50%)

- Adapted PACE: 23/24 (82%)

(As above) The information on the online portal was acceptable (teachers): 74/173 (43%)

- PACE: 33/70 (47%)

- Adapted PACE: 41/103 (39%)

7. Capture and share local knowledge (success stories)

ISC and teachers were provided access to case studies from other schools. Case studies described “success stories” of how ISC and teachers had overcome frequently reported barriers to implement the policy in their school.

Schools in which at least one teacher accessed the online portal (project records: web analytics): 43/48 (90%)

- PACE: 22/24 (92%)

- Adapted PACE: 21/24 (88%)

(As above) The information on the online portal was acceptable (teachers): 74/173

(43%)

- PACE: 33/70 (47%)

- Adapted PACE: 41/103 (39%)

This was not ranked within the top 3 for ‘most important strategy’ by any project officers.

8. Change physical structure and equipment (equipment pack)

8a. Each school was provided with a physical activity pack consisting of items to engage in suggested activities (i.e., activities advertised in educational materials and/or exemplified during the ISC workshop and teacher training) such as bean bags, balls, hoops, etc.

ISC were provided an equipment pack during strategy 3b, the workshop (project records): 100%

(As above) Teachers’ that used PACE resources (e.g., online portal, booklet and equipment pack) to help schedule physical activity (teachers): 118/202 (58%)

- PACE: 56/86 (65%)

- Adapted PACE: 62/116 (53%)

The equipment pack was acceptable in assisting me to schedule physical activity in my class (teachers):

Total: 123/217 (57%)

- PACE: 57/88 (65%)

- Adapted PACE: 66/129 (51%)

Providing schools with an equipment pack was considered an important strategy (top three) by 2/6 of project officers.

Qualitative theme:

(i) An engaging innovation via quality resources [facilitator]

8b. ISC were encouraged to develop classroom physical activity packs for all teachers using existing school sport equipment. These packs were to be kept in each classroom, enabling teachers to implement suggested activities more easily.

ISC that purchased equipment packs (ful or partial) for all classrooms (ISC): 34/44 (77%)

- PACE: 13/16 (81%)

- Adapted PACE: 9/28 (32%)

 
  1. Abbreviations: ISC In-school champion
  2. Note: Quantitative data retrieved from project records (project records), ISC surveys (ISC), principal surveys (principals), and teacher surveys (teachers)