| Title: |
Exploring meso- and macro-level contextual factors associated with inequalities in program adoption during statewide scale-up of TransformUs Primary, a whole-school physical activity intervention |
| Authors: |
Ganakas, E; Salmon, J; Ma, J; Lamb, KE; Barnett, L; Bauman, A; Telford, A; Ridgers, ND; Timperio, A; Koorts, H |
| Publisher Information: |
BMC |
| Publication Year: |
2025 |
| Collection: |
The University of Melbourne: Digital Repository |
| Description: |
Background: Contextual influences on program implementation exist across micro (individual), meso (organization), and macro (government/environment) system levels, yet macro factors are less frequently explored in implementation research. This retrospective study explored differences in adoption across meso- and macro-system levels using data from the 2018–2022 state-wide hybrid effectiveness-implementation trial of TransformUs Primary, a whole-school physical activity intervention. Aims were to: (1) assess differences in contextual characteristics between adopting and non-adopting schools and implications for equity, and (2) assess associations between macro-level events and dissemination events with program adoption over time. Methods: Descriptive statistics (number and %) and chi-squared tests were used to assess differences in contextual characteristics between adopting and non-adopting schools (Aim 1). A time-series analysis of daily data was used to explore associations between the number of dissemination events promoting program awareness (e.g., media, newsletters), macro-level policy events (e.g., education department policies), COVID-19-related remote/on-site learning periods, school term dates (i.e., during/outside of school term) and program adoption (i.e., the number of TransformUs Primary registrations per day) (Aim 2). Results: No differences in either school type (i.e., primary, combined, or special) or community level socio-educational advantage between adopting (n = 519) and non-adopting schools (n = 1,423) were identified. A higher proportion of adopting schools were located in major cities (71.7% vs. 54.5%; chi-square p < 0.001) and were government (public sector) schools (80.0% vs. 63.1%; chi-square p < 0.001). Time-series analysis results indicated that the likelihood of adopting TransformUs Primary decreased from the date of program launch to the end of the scale-up period (IRR 0.999, 95% CI 0.999–1.000; p < 0.005). Both school term date (IRR 5.95, 95% CI 4.78–7.41; p < 0.001) ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
1479-5868 |
| Relation: |
https://hdl.handle.net/11343/361970 |
| Availability: |
https://hdl.handle.net/11343/361970 |
| Rights: |
https://creativecommons.org/licenses/by/4.0 ; CC BY |
| Accession Number: |
edsbas.D250EB61 |
| Database: |
BASE |