Implementation Drivers of COVID-19 Prevention Strategies in K-12 School Settings: A Qualitative Analysis.

Background: In August 2020, the Centers for Disease Control and Prevention (CDC) released guidance to prevent transmission of coronavirus disease 2019 (COVID-19) in K-12 education settings. Schools varied in the degree to which they were able to implement COVID-19 prevention strategies during the height of the pandemic.

Methods: An evaluation team conducted interviews with state education staff and focus groups with district and school staff over 2 years to explore contextual factors that influenced the implementation of CDC's recommended COVID-19 prevention strategies.

Results: Eight implementation drivers influenced COVID-19 response efforts in school settings, including COVID-19 guidance, political climate, communication challenges, state health and education agency support, partnerships, physical and financial resources, staffing, and student needs.

Implications for school health policy, practice, and equity: Evaluation results offer insights for future guidance and support for schools and educators as they continue efforts to prevent the spread of COVID-19 and other infectious diseases for safe in-person learning.

Conclusions: The authors describe key drivers and conditions that influenced, facilitated, and/or impeded schools' implementation of COVID-19 prevention strategies. Federal, state, district, and school leadership can use the results to bolster future emergency preparedness and response efforts to protect student and school employee health.