Page 42 - ON THE WAY TO HEALTHIER SCHOOL CANTEENS - Irma Evenhuis

Chapter 3. Development of the implementation plan METHODS
This study, conducted between January and October 2015, involved three steps to develop the implementation plan guided by the “Grol and Wensing Implementation of Change Model” [60] and the Intervention Mapping protocol [58] (see Figure 3.1). Both models integrate and emphasize the use of theory, evidence and stakeholder involvement and have overlapping steps [58, 60]. The Implementation of Change Model was chosen because it provides clear guidance for the needs assessments and selection of determinants to change, while the Intervention Mapping approach provides a more extensive guide to selecting behaviour change methods, strategies and materials. To understand which factors stakeholders perceive as impeding or facilitating the implementation of the canteen guidelines, we first performed a qualitative study consisting of semi-structured interviews. The Measurement Instrument of Determinants in Innovations (MIDI) [95] and the Behavioural Change Wheel (BCW) [96] were used to develop the interview guide. Second, to reach consensus about the factors that should be addressed by the implementation plan, we prioritized the identified factors through an expert meeting using the World Café Method [98]. Third, to create implementation tools that influence these factors, we used Behavioural Change Taxonomies [62, 64] to select behavioural change methods and evidence-based implementation strategies [65], which were then specified into tools and together formed the implementation plan.
Step 1: Identification of factors that impede or facilitate implementation
What
To recruit participants based on their level of experience: To define the interview guide:
Step 2: Prioritization of factors
What
To organise the factors to let stakeholder prioritise them: To structure the discussion among stakeholders:
Input
- Rogers’ diffusion of innovation theory [94]
- Measurement Instrument for Determinants of Innovation [95]
- The Behavioural Change Wheel [96]
Input
- Stage Theory of Organizational Change [125] - World Café Method [98]
Step 3: Selecting evidence-based implementation strategies and tools
What
To translate factors into methods:
To translate methods into strategies:
To specify the strategies into tools:
Input
- Using Behaviour Change Taxonomies [62, 64]
- Evidence-based Implementation Strategy Compilation [65]
- Input from international studies to implementation of school health promotion, among others school canteens policy/guidelines - Input from experts in the field of health promotion policy, practice and science
- Use of existing tools of the Dutch Healthy School Canteen Program
Figure 3.1. The three-step approach used to develop the implementation plan. 40