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Table 5 Characteristics of CDC tools that influence support system use [14]

From: School health implementation tools: a mixed methods evaluation of factors influencing their use

Characteristics of tools

Credibility of source

Value of CDC as the source of the tools

“I really appreciate the tools that come out of CDC with them being research-based and best practice. Because with prevention, that’s really all we have behind us is to tell people that it works.”

Evidence strength and quality

• The tools’ guidance is supported by evidence

“SHG it’s always, for me, been a go-to document. It’s very rich. Rich with the evidence and the strategies”

Compatibility

• Congruence with state, district, and school priorities, resources, and needs and with tools already using

“In terms of the education component, we never had much of a role in supporting health education. It was always around physical education, because clearly it’s the one area that supports not only physical activity, but physical education and the components of physical education. Also the link to cognitive improvement and academic achievement through physical activity and movement. That’s been our primary focus”

Complexity

• Tools are long and complicated

• State- and district-level staff appreciated tools’ comprehensiveness

• Major barrier to school staffs’ use of tools

“It depends on who your end user is, I guess. For somebody, like me, who has attended multiple trainings and oversees school health as an umbrella, I think it’s a little bit easier to grasp. For some of my school people, who are really just looking for the biggest bang for their buck, “What can I do?”, boots on the ground, I think it’s a little bit less user-friendly.”

Relative advantage

Benefit (or lack of) that CDC tools provided relative to other tools

SPARK book is described as more useable than CDC tool because it “is set up to where you can basically just read it off and have instant activities. You don’t even have to see the lesson. You just look at it be like ‘This is what we’re doing.’ Boom…[SPARK is] super ready to go. You just take one page and one page, put ‘em together.”

Adaptability

Value of being able to extract and use one or more components of a tool

I really tried to educate our local health departments to go out into the schools and have them do the assessments of the components, and then approach and say it looks like you’re doing three out of the five components of this framework of CSPAP. How can we incorporate or get another component, work on a component for this year?

Design quality and packaging

Perceptions of how well the tool is assembled and presented

“the user friendly of how it looks, how it can be pieced together, how it can be paired together, [and] the sections.”