title: The adaptive nature of implementation practice: case study of a school-based nutrition education intervention.
abstract: OBJECTIVE
  To describe how and why nutritionists implement and strategize particular program operations across school contexts.
  
  
  METHODS
  Instrumental case study with empirical propositions from Actor-Network Theory (ANT). Data derived from interviews with interventionists and observations of their practices.
  
  
  METHODS
  Seven primary schools from disadvantaged Montreal neighborhoods.
  
  
  METHODS
  Six nutritionists implementing the nutrition intervention in grades 4 and 5. From 133 nutrition workshops held in 2005/06, 31 workshops were observed with audio-recordings.
  
  
  METHODS
  Little Cooks--Parental Networks aims to promote healthy eating behaviors through engagement in food preparation and promotion of nutrition knowledge.
  
  
  METHODS
  The program-context interface where interventionists' practices form interactively within a given social context.
  
  
  METHODS
  Coding inspired by ANT. Interview analysis involved construction of collective implementation strategies. Observations and audio-recordings were used to qualify and quantify nutritionists' practices against variations in implementation.
  
  
  RESULTS
  Nutritionists privileged intervention strategies according to particularities of the setting. Some such variation was accounted for by school-level social conditions, individual preferences and nutritionists' past experiences.
  
  
  CONCLUSIONS
  Implementation practices are strategic and aim to engage educational actors to achieve intervention goals. These results challenge implementation frameworks centered on purely technical considerations that exclude the social and interpretive nature of practice.
authors.affiliation: Department of Social and Preventive Medicine, Centre de recherche Léa-Roback sur les inégalités sociales de santé de Montréal & IRSPUM, Université de Montréal Public Health Research Institute, Québec, Canada. Sherri.Bisset@criucpq.ulaval.ca
authors.forename: Sherri
authors.initials: S
authors.lastname: Bisset
authors.forename: Louise
authors.initials: L
authors.lastname: Potvin
authors.forename: Mark
authors.initials: M
authors.lastname: Daniel
mesh_terms: D002648:Child; D002675:Child, Preschool; D003296:Cooking; D005247:Feeding Behavior; D006266:Health Education / Q000458:organization & administration*; D006284:Health Plan Implementation / Q000379:methods* / Q000458:organization & administration; D006801:Humans; D008960:Models, Psychological; D019982:Organizational Case Studies; D011203:Poverty; D011593:Psychology, Social; D011792:Quebec; D012574:Schools