Nationwide implementation of guided supermarket tours in the Netherlands: a dissemination study

The purpose of this study was to assess adoption, implementation and mainte nance of a guided supermarket tour program of nutrition education by Dutch Public Health Services (PHSs), and the factors associated with program diss emination. A first questionnaire was sent to all 60 PHSs, and measured prog ram adoption, perceived program attributes, and characteristics of the adop ting organization and person. A second questionnaire was only sent to adopt ing PHSs, and measured extent and success of implementation, intentions to continue the program, and characteristics of the main implementing person. Of the 59 PHSs who responded, 30 adopted the program and 17 implemented it sufficiently. Perceived program complexity, social influence within the PHS toward program participation and existence of a separate health education department were predictors of adoption. Perceived program complexity was al so a predictor of extent of implementation, The number of health educators within each PHS was a predictor of sufficient implementation, It was conclu ded that adoption and implementation of the program was reasonable, conside ring the limited dissemination strategy. Dissemination might have been more successful if the program had been less complex and required less effort, if positive social influence had been generated, and if specific attention had been given to PHSs without a separate health education department.