Date of Award

2015

Document Type

Open Access Dissertation

Department

Exercise Science

Sub-Department

Norman J. Arnold School of Public Health

First Advisor

Russell R. Pate

Abstract

In the past decade, numerous interventions have been developed and tested to increase physical activity in children and adolescents. Among these interventions, those that reported higher levels of program implementation appear to have better program outcomes. However, relatively little is known about the specific factors that contributed to successful implementation in youth physical activity interventions. The overall purpose of this dissertation was to identify a set of core factors that are most important in explaining implementation of physical activity interventions in youth-serving settings. Three studies, an expert panel study and two prospective observational studies, were conducted to address the purpose of this dissertation.

In the first study, an expert panel was convened to identify factors that are most important in achieving successful implementation of physical activity interventions in youth-serving organizations. Five recognized experts participated in a four-round, modified Delphi process to identify factors related to implementation of youth physical activity interventions, and to quantify the importance of the identified factors. Experts’ opinions were translated into Bayesian predictive models for factor selections. These processes resulted in a final list of 15 factors, in which five factors were classified as organizational characteristics, six factors as implementation processes, two factors as provider characteristics, and two factors as program characteristics and community-level factors, respectively.

The second study analyzed data from a previously completed preschool based intervention. Participants were preschool classrooms enrolled in the first two years of the intervention (year 1: n= 19, year 2: n=17). The purpose was to examine the direct and indirect effects of preschool characteristics, teacher characteristics, and quality of implementation processes on level of implementation. The results of Bayesian path analysis show that the three selected factors were not significantly associated with level of implementation in year 1. Preschool characteristics were found to be directly associated with level of implementation in year 2. The third study analyzed data from a previously studied physical activity intervention carried out in 24 residential children’s homes (RCHs). The purpose was to examine the direct and indirect effects of RCH characteristics, wellness team characteristics, and quality of implementation processes on level of implementation. The results of Bayesian path analysis reveal that RCH characteristics and wellness team characteristics are directly associated with level of implementation. Overall, this dissertation found consistent evidence supporting the direct contribution of organizational characteristics in achieving successful implementation of physical activity interventions in youth-serving organizations. However, the influence of provider characteristics and quality of implementation processes on level of implementation appear to vary across interventions with different designs, at different implementation stages, and in different implementation settings.

Rights

© 2015, Yuen Yan Lau

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