Evaluation of an adoption strategy for a healthy diet programme for lower vocational schools.

This paper describes the evaluation of an adoption strategy for the school-based healthy diet programme Krachtvoer. Health promotion (HP) professionals from five Regional Public Health Services (RPHSs) in The Netherlands were asked to recruit a total of 25 schools to adopt the Krachtvoer programme in accordance with this strategy. Afterwards, they were interviewed about their adherence to and subjective evaluation of the strategy. The adoption rate of the programme was calculated and 10 adopting and 9 rejecting teachers were interviewed about the reasons for their decision. The HP professionals' adherence to the strategy was good, as well as their appreciation and the perceived feasibility of the strategy. The person-to-person approach that characterized this strategy was considered important. The strategy led to an adoption rate of 53.2%. On average, adopters mentioned 4.4 reasons and rejecters mentioned 5.4 reasons for their decision. Most reasons were school related and programme related and in case of the adopters also teacher related. The diversity of reasons revealed the complexity of teachers' decision making. Although there is some room for improvement of the adoption strategy and the programme itself, especially socio-political conditions in schools and in RPHSs need change for a further increase in programme adoption.