Feasibility study of the SWITCH implementation process for enhancing school wellness

Chen, Senlin
Vazou, Spyridoula
Dzewaltowski, David
Rosenkranz, Richard
Lanningham-Foster, Lorraine
Vazou, Spyridoula
Gentile, Douglas
Lee, Joey
Braun, Kyle
Wolff, Maren
Welk, Gregory
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Food Science and Human NutritionKinesiologyPsychology

Background: There is a need to identify strategies that enhance the implementation of evidence-based school wellness intervention programs in real-world settings. The present study evaluates the feasibility of empowering school wellness leaders to deliver an evidence-based, childhood obesity-prevention program called Switch ™. We specifically evaluated the feasibility of a new implementation framework, based on the robust Healthy Youth Places framework, to increase capacity of school leaders to lead school wellness programming. Methods: The SWITCH (School Wellness Integration Targeting Child Health) implementation process was evaluated in a convenience sample of eight Iowa elementary schools. Teams of three leaders from each school attended an in-person school wellness conference followed by five online webinar sessions delivered by two SWITCH team members. The capacity-building and quality improvement process was designed to empower schools to lead wellness change using methods and concepts from the original 16-week Switch ™ program. School wellness leaders completed checklists on two occasions to assess overall school-level implementation as well as setting-level changes in physical education, classrooms, and the lunchroom. Student acceptability of SWITCH was evaluated by the degree of behavior tracking using an online SWITCH Tracker system that promoted self-monitoring. School acceptability and practicality were assessed through an exit survey completed by school leaders. Results: All school staff reported satisfaction with the SWITCH implementation process. Reports of schooland setting-level implementation were relatively high (2.0 to 2.8 on a 3-point scale) but student engagement, based on use of the online tracking system, varied greatly over time and across schools. Three high implementation schools had average tracking rates exceeding 70% (range: 72–90%) while three low implementation schools had rates lower than 30% (range = 0–23%). Conclusions: This feasibility study supports the utility of the new implementation framework for promoting school and student engagement with SWITCH. Further testing regarding effectiveness and scale-up of this evidence-based school wellness intervention program is warranted.


This article is published as Chen, S., Dzewaltowski, D.A., Rosenkranz, R.R., Lanningham-Foster, L., Vazou, S., Gentile, D.A., Lee, J.A., Braun,K.J., Wolff, M.M., Welk, G.J.,Feasibility study of the SWITCH implementation process for enhancing school wellness. BMC Public Health; 2018, 18;1119. DOI: 10.1186/s12889-018-6024-2.