title: Association of School Characteristics and Implementation in the X:IT Study-A School-Randomized Smoking Prevention Program.
abstract: Assessment of implementation is essential for the evaluation of school-based preventive activities. Interventions are more easily implemented in schools if detailed instructional manuals, lesson plans, and materials are provided; however, implementation may also be affected by other factors than the intervention itself-for example, school-level characteristics, such as principal support and organizational capacity. We examined school-level characteristics of schools in groups of high, medium, and low implementation of a smoking prevention intervention.
  
  
  
  The X:IT study is a school-randomized trial testing a multicomponent intervention to prevent smoking among adolescents. Our data came from electronic questionnaires completed by school coordinators at 96.1% of participating intervention schools (N = 49) at first follow -up.
  
  
  
  Schools that implemented the X:IT intervention to a medium or high degree had higher levels of administrative leadership (77.3% and 83.3% vs 42.9%), school climate/organizational health (95.5% and 91.7% vs 66.7%), mission-policy alignment (90.9% and 100.0% vs 71.4%), personnel expertise (81.8% and 75.0% vs 46.7%), school culture (77.3% and 91.7% vs 53.3%), positive classroom climate (91.4% and 96.2% vs 82.9%) compared with low implementation schools.
  
  
  
  Our findings highlight the importance of considering the school context in future health prevention initiatives.
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, Copenhagen 1353, Denmark.
authors.forename: Lotus S
authors.initials: LS
authors.lastname: Bast
authors.affiliation: Statens Institut for Folkesundhed, Syddansk Universitet, National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, Copenhagen 1353, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Due
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, Copenhagen 1353, Denmark.
authors.forename: Annette K
authors.initials: AK
authors.lastname: Ersbøll
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, Copenhagen 1353, Denmark.
authors.forename: Mogens T
authors.initials: MT
authors.lastname: Damsgaard
authors.affiliation: National Institute of Public Health, University of Southern Denmark, Oester Farimagsgade 5A, Copenhagen 1353, Denmark.
authors.forename: Anette
authors.initials: A
authors.lastname: Andersen
mesh_terms: D000293:Adolescent; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D008297:Male; D011322:Primary Prevention / Q000379:methods*; D012572:School Health Services / Q000458:organization & administration*; D012574:Schools / Q000458:organization & administration; D012907:Smoking / Q000453:epidemiology; D000074606:Smoking Prevention; D012931:Social Environment; D012944:Social Support; D013334:Students / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: implementation evaluation; implementation fidelity; school-based research; school-randomized trial; smoking prevention