Evaluating InPACT Intervention-Context Fit in Resource-Limited School Districts in Central Michigan.

Abstract

Background: Many school-based physical activity (PA) interventions are implemented without adequately assessing their contextual fit, which can hinder their effectiveness and sustainment, ultimately reducing their impact on student health and well-being. This study aimed to assess the pre-implementation fit of the Interrupting Prolonged Sitting with ACTivity (InPACT) classroom PA intervention in one resource-limited intermediate school district (ISD; encompassing 16 local districts and 32 elementary schools) in central Michigan.

Methods: Assessments were conducted by the regional school health coordinator and ISD support staff during 2020-2021, using the Hexagon Discussion and Analysis Tool. Ratings on a 5-point Likert scale were totaled for need, fit, support, evidence, usability, and capacity.

Results: The first assessment score was 19/30; the second assessment score was 28/30, indicating a 47% increase in fit over a year. Field notes revealed a growing need for school-based PA due to limited opportunities during COVID-19. Improvements in support, fit, evidence, usability, and capacity were linked to enhanced knowledge and capacity of the regional school health coordinator.

Implications for school health policy, practice, and equity: The initial misalignment between intervention and context highlights the importance of addressing contextual barriers in resource-limited schools to effectively promote PA equity.

Conclusions: By conducting multiple assessments, schools can identify and address barriers to intervention fit, increasing readiness and the likelihood of successful implementation.