title: A Cascade of Champions: A Qualitative Study about the MA-CORD Media Competition Implementation.
abstract: A media competition was part of the Massachusetts Childhood Obesity Research Demonstration (MA-CORD) Study. Criss et al., previously outlined the development and implementation of the competition, including variation in reach and adoption of the intervention across schools and afterschool programs. In this qualitative study, we examine community, provider, and organizational factors that explain the variation of media competition reach in school and afterschool programs, and describe the awareness of the media competition across other community sectors. Durlak and DuPre's ecological framework for understanding effective implementation provided the theoretical underpinnings for this study. Fifty-four key informant interviews were conducted, transcribed, and analyzed. Organizational capacity of committed teachers/staff and adaptability of the media competition seemed to be drivers for higher reach within school and afterschool programs. Salient themes that emerged as facilitators of effective implementation were having a cascade of champions and providing opportunity to participate in the media competition outside traditional class time. Clinics and coalitions were identified as additional sectors aware of the media competition. Specifically, our findings offer a new perspective on intervention design and a recommended direction for further study.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA. scriss@mail.harvard.edu.
authors.forename: Shaniece
authors.initials: S
authors.lastname: Criss
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. alvintran@mail.harvard.edu.
authors.forename: Alvin
authors.initials: A
authors.lastname: Tran
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. cgehre@hsph.harvard.edu.
authors.forename: Claudia
authors.initials: C
authors.lastname: Ganter
authors.affiliation: Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. aaftosme@hsph.harvard.edu.
authors.forename: Alyssa
authors.initials: A
authors.lastname: Aftosmes-Tobio
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA. sgortmak@hsph.harvard.edu.
authors.forename: Steven
authors.initials: S
authors.lastname: Gortmaker
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA. vish_viswanath@dfci.harvard.edu.|Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, USA. vish_viswanath@dfci.harvard.edu.
authors.forename: Kasisomayajula
authors.initials: K
authors.lastname: Viswanath
authors.affiliation: Massachusetts Department of Public Health, Bureau of Community Health and Prevention, 250 Washington Street, Boston, MA 02108, USA. jo-ann.kwass@state.ma.us.
authors.forename: Jo-Ann
authors.initials: JA
authors.lastname: Kwass
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building, Boston, MA 02115, USA. kdavison@hsph.harvard.edu.|Department of Nutrition, Harvard T.H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, USA. kdavison@hsph.harvard.edu.
authors.forename: Kirsten K
authors.initials: KK
authors.lastname: Davison
mesh_terms: D000293:Adolescent; D000328:Adult; D003146:Communications Media; D005260:Female; D006293:Health Promotion; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D063766:Pediatric Obesity / Q000517:prevention & control*; D036301:Qualitative Research; D012574:Schools; D055815:Young Adult
keywords: ecological framework for understanding effective implementation; elementary school; implementation; media competition; qualitative