School climate and implementation of the Pathways study.
BACKGROUND
Pathways was a multisite school-based study to prevent obesity in American Indian school children by encouraging healthy eating and physical activity.


METHODS
Over the 3-year study, a total of 290 in-depth interviews were conducted with school administrators, food service managers, classroom teachers, and physical education instructors in all 21 intervention schools to examine support and barriers for Pathways. Analysis included qualitative assessment of key themes using NUD*IST and quantitative modeling of the impact of a school climate score on implementation of intervention components.


RESULTS
Overall, teachers, food service managers, and physical education instructors were supportive of the Pathways interventions. School administration and lack of family participation were perceived barriers at some schools. Attitudes toward the program ranged from neutral to positive during the first year, with about two-thirds giving positive ratings, with greater variation in successive years. Overall, the mean score was 3.5 on a 5-point scale (1=very negative, 5=very positive). School climate score was positively associated with classroom curriculum and student exposure indices, but not with family attendance, food service, or physical activity implementation indices. The latter two indices were associated with site.


CONCLUSIONS
An assessment of school climate through interviews is useful in understanding successes and failures in a school-based health intervention and can predict implementation success for some programs.
Gittelsohn
Joel
J
Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205-2179, USA. jgittels@jhsph.edu
Merkle
Sarah
S
Story
Mary
M
Stone
Elaine J
EJ
Steckler
Allan
A
Noel
Jessica
J
Davis
Sally
S
Martin
Catherine J
CJ
Ethelbah
Becky
B
D002648:Child; D002664:Child Nutritional Physiological Phenomena; D005069:Evaluation Studies as Topic; D005260:Female; D005522:Food Services; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D008297:Male; D015337:Multicenter Studies as Topic; D009765:Obesity / Q000208:ethnology* / Q000517:prevention & control*; D010806:Physical Education and Training; D011322:Primary Prevention; D012574:Schools; D011795:Surveys and Questionnaires; D014481:United States