Measuring implementation of school programs and policies to promote healthy eating and physical activity among youth

Background. The measurement of program implementation and policy adoption i s an essential evaluation component of any health intervention program. Dat a on program implementation are used to monitor program progress; identify elements of a program to be strengthened or eliminated; provide accountabil ity; and help explain program effects. Method. This paper reviews approaches to measuring the implementation of sc hool-based programs and policy to promote physical activity and healthful e ating among youth. Areas examined include classroom instruction, food servi ce, physical activity classes, and school policies. Operational definitions of implementation and methods of collecting data are described and compare d. Results. Most implementation measures are focused on two dimensions: quanti ty (dose or completeness) and quality (fidelity), Data collection methods i nclude the use of teacher self-report recorded through checklists, question naires, and interviews. Classroom observations by a trained observer are al so used. Studies of policy development have used archival records and semi- structured interviews. Conclusions. Considerable variability exists across studies in how program of implementation is defined and measured. This is in part due to the need to tie measures closely to the content and format of the intervention. More work is needed to assess and compare the reliability and validity of vario us approaches to measuring implementation, (C) 2000 American Health Foundat ion and Academic Press.