Table 2

Challenges and remedies for JUMP-in with regard to the five RE-AIM dimensions

ChallengesRemedies
Reach

  1. To identify and select the target groups (children at risk: overweight, inactivity, motor disabilities)

  2. To increase the reach among children at risk

  3. To increase the reach of parents of children at risk

  1. Use of smart risk profiles in the JUMP-in pupil follow-up system (Pupil Follow-up System; for description, see part 4)

  2. Personal approach with tailored solutions (see part 4 extra care);

  3. Focus on parents of children at risk:

    • ▶

      ▶. Involve parents when a child is at risk. If necessary, parents receive an invitation from the youth health care or hospital

    • ▶

      ▶. Parental Information Service is embedded in the entire JUMP-in programme and contains multimedia alternatives for tailor-made information and advice

Efficacy

  1. To quantify the reach, especially of the groups at risk

  2. To increase the focus on highrisk groups

  3. To increase the focus on the role of environmental factors

  4. Adequate assessment of PA

  5. To gain insight into the working mechanism of the programme and effects on PA behaviour and determinants

  1. Registration of school sport and club extra participation and registration of referrals

  2. Tailored solutions aimed at risk reduction, such as adapted sports offers, tailored information and courses for parents of children at risk

  3. The evaluation study includes self-reported and objective measures of the environment

  4. Objective PA measurement with an accelerometer

  5. The evaluation study includes:

    • ▶

      ▶. Measurements among parents

    • ▶

      ▶. Measures of potential mediating variables as well as process measures, which can help to understand how intervention effects (or lack of effect) occur

    • ▶

      ▶. Objective secondary outcome measurements: body composition and fitness

    • ▶

      ▶. Registration of the progress and quality of the implementation

Adoption

  1. Commitment of all implementers, including the school staff

  2. To overcome impeding factors that hamper participation among implemeters

  1. Besides school directors and PE teachers, the school staff are explicitly required to commit to and support the decision to participate

    • ▶

      ▶. For the adoption a “flow diagram” is used, which is divided into phases. Each phase needs to be successfully finished before proceeding to the next phase

  2. Factors that support adoption:

    • ▶

      ▶. Efficient and sufficient communication about the project, starting in the adaptation phase

    • ▶

      ▶. Equal and clear expectations about tasks and responsibilities

    • ▶

      ▶. Sufficient preparation time for all implementers

    • ▶

      ▶. Introduction of contracts for school directors and city districts concerning the implementation aims, costs, tasks, efforts and responsibilities

    • ▶

      ▶. The preparation period is divided into phases and each phase needs to be successfully finished before proceeding to the next phase

Implementation

  1. Implementers have sufficient skills to fulfil their tasks

  2. More attention for communication and information:

    • ▶

      ▶. To improve the clarity of programme components, instruments and protocols and to reduce the level of complexity in content and delivery

    • ▶

      ▶. To reduce the types and levels of resources necessary to effectively deliver the intervention

  3. To make the implementation measurable in terms of evaluation criteria

  4. Sufficient sports clubs in terms of distance, availability and sufficient qualified sports trainers

  1. Tailored implementation training and instructional presentations for PE teachers, sports trainers and school staff, carried out by professionals, with contents in line with the teachers' jargon, goals and needs

  2. More attention for communication and information:

    • ▶

      ▶. For the implementation phase a “flow diagram” is used, which is divided into phases. Each phase needs to be successfully finished before proceeding to the next phase

    • ▶

      ▶. Well-defined and protocolised programme components; clearly described and evaluable objectives, applications and criteria for use

    • ▶

      ▶. Formal guidelines about how to fulfil all sets of tasks

    • ▶

      ▶. Information services and technical assistance at a central location; instruments and tools available on the JUMP-in website. Availability of required materials, tools and information less complex and less time-consuming

  3. Registration of implementation progresses at organisation level in order to control progress of implementation and quality

  4. Practical solutions such as building dependences in the school, and influencing the local sports policy

Maintenance

  1. Structural embedding of the programme in practice and policy of schools, city districts and programme partners at local and even national level

  2. Community coalitions aiming at effective local planning and action

  1. Structural embedding by:

    • ▶

      ▶. Structural employment of PE teachers and coordinators to fulfil the tasks

    • ▶

      ▶. Participation in the public health policy debate on a local and national level in order to generate attention and finances for structural implementation

    • ▶

      ▶. Structural professional centralised service centre for the provision of technical assistance, information, instruments, tools, cues, reinforcement and training

  2. Highly structured cooperation with clearly described and evaluable objectives and sets of tasks between municipal authorities, schools, youth health care, dieticians, school supervisory services, local sport services and sports clubs