title: Community led active schools programme (CLASP) exploring the implementation of health interventions in primary schools: headteachers' perspectives.
abstract: BACKGROUND
  Schools are repeatedly utilised as a key setting for health interventions. However, the translation of effective research findings to the school setting can be problematic. In order to improve effective translation of future interventions, it is imperative key challenges and facilitators of implementing health interventions be understood from a school's perspective.
  
  
  METHODS
  Nineteen semi-structured interviews were conducted in primary schools (headteachers n = 16, deputy headteacher n = 1, healthy school co-ordinator n = 2). Interviews were transcribed verbatim and analysed using thematic analysis.
  
  
  RESULTS
  The main challenges for schools in implementing health interventions were; government-led academic priorities, initiative overload, low autonomy for schools, lack of staff support, lack of facilities and resources, litigation risk and parental engagement. Recommendations to increase the application of interventions into the school setting included; better planning and organisation, greater collaboration with schools and external partners and elements addressing sustainability. Child-centred and cross-curricular approaches, inclusive whole school approaches and assurances to be supportive of the school ethos were also favoured for consideration.
  
  
  CONCLUSIONS
  This work explores schools' perspectives regarding the implementation of health interventions and utilises these thoughts to create guidelines for developing future school-based interventions. Recommendations include the need to account for variability between school environments, staff and pupils. Interventions with an element of adaptability were preferred over the delivery of blanket fixed interventions. Involving schools in the developmental stage would add useful insights to ensure the interventions can be tailored to best suit each individual schools' needs and improve implementation.
authors.affiliation: College of Health and Human Science, Swansea University, Wales, SA2 8PP, UK. D.L.Christian@swansea.ac.uk.
authors.forename: Danielle
authors.initials: D
authors.lastname: Christian
authors.affiliation: College of Medicine, Swansea University, Swansea, SA2 8PP, UK. c.e.todd@swansea.ac.uk.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Todd
authors.affiliation: College of Medicine, Swansea University, Swansea, SA2 8PP, UK. h.davies@swansea.ac.uk.
authors.forename: Helen
authors.initials: H
authors.lastname: Davies
authors.affiliation: College of Health and Human Science, Swansea University, Wales, SA2 8PP, UK. j.y.rance@swansea.ac.uk.
authors.forename: Jaynie
authors.initials: J
authors.lastname: Rance
authors.affiliation: A-STEM College of Engineering, Swansea University, Wales, SA2 8PP, UK. G.Stratton@swansea.ac.uk.
authors.forename: Gareth
authors.initials: G
authors.lastname: Stratton
authors.affiliation: College of Medicine, Swansea University, Swansea, SA2 8PP, UK. f.l.rapport@swansea.ac.uk.
authors.forename: Frances
authors.initials: F
authors.lastname: Rapport
authors.affiliation: College of Medicine, Swansea University, Swansea, SA2 8PP, UK. s.brophy@swansea.ac.uk.
authors.forename: Sinead
authors.initials: S
authors.lastname: Brophy
mesh_terms: D002648:Child; D015444:Exercise; D005178:Faculty / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D010290:Parents; D012572:School Health Services / Q000458:organization & administration*