title: Expanding a successful community-based obesity prevention approach into new communities: Challenges and achievements.
abstract: A previously successful community-based obesity prevention intervention with a focus on school settings was expanded into new communities with varying contexts. In order to understand the complexities involved in implementing health promotion activities in schools, this study examined experiences of school staff and project officers including barriers, contextual factors and achievements.
  
  
  
  School environment assessments were conducted in schools across four Victorian communities with school staff (n=1-5 staff plus a trained researcher per group in 9 primary and 8 secondary schools) 12-18 months post-intervention. Process reports from project officers were also reviewed and analysed (n=4).
  
  
  
  School staff commonly reported time pressures as a barrier to implementation and project officers working within schools reported competing priorities and limited health promotion experience of staff; lack of stakeholder engagement; low participation in some activities and insufficient implementation time. Contextual factors included community socioeconomic status, student ethnicity and living rurally. Achievements included student and staff enjoyment from programme activities, staff capacity building, partnerships, embedding activities into existing infrastructure and programmes, and having consistent health-related messages repeated through a variety of strategies.
  
  
  
  Community-based interventions with a focus on school settings need to consider system level, organisational and contextual (i.e. socioeconomic, ethnicity, family and town characteristics) factors when expanding previously effective strategies into new communities. Implementation benefits may have added whole of school benefits in addition to child health. Focussing on overcoming the challenges experienced in this complex initiative is required for future interventions.
  
  
  
  ACTRN12609000892213.
authors.affiliation: WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia. Electronic address: kristy.bolton@deakin.edu.au.
authors.forename: Kristy A
authors.initials: KA
authors.lastname: Bolton
authors.affiliation: School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Kremer
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Gibbs
authors.affiliation: WHO Collaborating Centre for Obesity Prevention, Deakin University, Geelong, Australia; Population Nutrition and Global Health, University of Auckland, Auckland, New Zealand.
authors.forename: Boyd
authors.initials: B
authors.lastname: Swinburn
authors.affiliation: Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Waters
authors.affiliation: Centre of Applied Oral Health Research, Dental Health Services Victoria, Carlton, Australia; Melbourne Dental School, The University of Melbourne, Carlton, Australia.
authors.forename: Andrea
authors.initials: A
authors.lastname: de Silva
mesh_terms: D000293:Adolescent; D001290:Attitude; D006293:Health Promotion; D006297:Health Services Accessibility; D006801:Humans; D063766:Pediatric Obesity / Q000517:prevention & control*; D012111:Residence Characteristics; D012572:School Health Services; D000070777:School Teachers; D012574:Schools; D014739:Victoria
keywords: Community-based intervention; Expanding; Learnings; Obesity prevention; School-based