Beyond the problem and the intervention: understanding contextual factors influencing adoption of a comprehensive school health program

Abstract

The focus of this qualitative research was to explore the factors that influence schools' decisions to adopt a comprehensive school health program - Go Girls! in Thunder Bay, Ontario. I interviewed administrators and teachers in four different schools who had been involved with having the Go Girls! program delivered in their schools and key informants involved in program delivery in various ways. Go Girls! is a healthy active living program delivered by a community organization for Grades seven and eight female students. A multiple case study approach was used to provide an in-depth understanding of the decision-making process for adopting the program within the specific schools' contexts. My analysis reinforces the idea that evidence-based interventions do not guarantee that such interventions fit in all settings. Findings from this study suggest that compatibility of the program to existing school values and its ability to address the needs of students were foremost in the schools' decision to adopt the program - a driver to adoption was the interplay of students' needs, often connected to several social determinants of health and the schools' resources. The fact that the school had little to no responsibility in program delivery contributed to the ease of adopting the program. Results from this study highlight the ways in which the composition of a school’s student body affects the need for and usefulness of programs offered by external organizations within the school setting and school time. This information can be used as a resource for those who design school health programs. In addition, schools that are considering adopting similar programs can draw on lessons learnt by administrators from participating schools and the ways in which they incorporated Go Girls! within the schedule of their school day.