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Process evaluation of public health interventions is important for understanding intervention results and can help explain why interventions succeed or fail. This study evaluated implementation of a school-based intervention combining educational and environmental strategies to prevent stress among Danish high school students. We investigated dose delivered, dose received, fidelity, appreciation, barriers and facilitators at the 15 intervention schools using mixed methods and multiple data sources: questionnaires among students, teachers and school coordinators; semi-structured interviews with school coordinators; telephone interviews with student counsellors; and focus group interviews with students and teachers. Implementation varied by schools and classes. Half of the intervention schools delivered the environmental strategies. For the educational strategies, dose delivered differed according to intervention provider. Students reported a lower dose received compared with dose delivered reported by school staff. Overall, student counsellors, school coordinators and students--especially those with low perceived stress--were satisfied with the stress preventive initiatives while teacher satisfaction varied. Five main barriers and three facilitators for implementation were identified. The use of multiple data sources and data methods created new knowledge of the implementation process which is important for the interpretation of effect evaluation and development of future interventions.

Aim: In this study, using national survey data from 2014 and 2019, we tested the hypothesis that students at schools who introduced a common alcohol policy in 2017 drank less than students at schools without a common policy. Methods: We used survey data from 41 high schools that participated in the Danish National Youth Study in 2014 and 2019. We perceived the introduction of a common high-school alcohol policy in 2017 among local groups of high schools as a natural experiment and assessed it using difference-in-difference analyses. We assessed drinking patterns from 2014 and 2019 among students at schools with and without a common alcohol policy combined and stratified by sex in negative binominal regression and logistic regression models. Drinking patterns were measured as average weekly alcohol use, average alcohol intake at last school party, proportion of non-drinkers and frequent binge drinkers. Results: Drinking patterns were similar among students in schools with and without a common alcohol policy. For example, among students at schools with a common alcohol policy, the average alcohol intake at the last school party among drinkers was 8.7 units in 2014 and 8.5 units in 2019, whereas average alcohol intake among students at schools without a common alcohol policy was 8.8 units in 2014 and 8.9 units in 2019 (p =0.413). Conclusions: No statistically significant effects were observed following the introduction of a common alcohol policy on students' drinking patterns, and alcohol consumption among high-school students was stable and remained high in 2014 and in 2019. [ABSTRACT FROM AUTHOR]

Peer-led interventions are highlighted as promising strategies to promote health among adolescents, but little is known about the mechanisms underlying this approach. To better understand the role of peer mentors (PMs) as implementers in school-based health promotion, we combined participant observations, focus group interviews and video recordings to explore high school students' reception of a peer-led intervention component (Young & Active). Young & Active aimed to increase well-being among first-year high school students (∼16 years of age) through the promotion of movement and sense of community and was implemented during the school year 2016–2017 in a larger school-based intervention study, the Healthy High School study in Denmark. The Healthy High School study was designed as a cluster-randomized controlled trial with 15 intervention schools and 15 control schools. At each intervention school, university students in Sports Science and Health (members of the research group) facilitated an innovation workshop aiming at inspiring all first-year students to initiate movement activities at schools. The findings illustrate potentials and challenges implied in the PM role. The peer mentors' profound commitment, as well as their response and sensibility to situational contingencies, were found to be significant for the students' reception and experience of the intervention. In conclusion, the specific job of PMs as implementers seems to consist of simultaneously following a manual and situationally adjusting in an emerging context balancing commitment and identification to the target group and the intervention project. [ABSTRACT FROM AUTHOR]

Background: The first Danish Report Card on Physical Activity (PA) for Children and Youth describes Denmark's efforts in promoting and facilitating PA and PA opportunities for children and youth. Methods: The report card relies primarily on a synthesis of the best available research and policy strategies identified by the Report Card Research Committee consisting of a wide presentation of researchers and experts within PA health behaviors and policy development. The work was coordinated by Research and Innovation Centre for Human Movement and Learning situated at the University of Southern Denmark and the University College Lillebaelt. Nine PA indicators were graded using the Active Healthy Kids Canada Report Card development process. Results: Grades from A (highest) to F (lowest) varied in Denmark as follows: 1) Overall Physical Activity (D+), 2) Organized Sport Participation (A), 3) Active Play (INC; incomplete), 4) Active Transportation (B), 5) Sedentary Behaviors (INC), 6) Family and Peers (INC), 7) School (B), 8) Community and the Built Environment (B+), and 9) Government strategies and investments (A-). Conclusion: A large proportion of children in Denmark do not meet the recommendations for PA despite the favorable investments and intensions from the government to create good facilities and promote PA. [ABSTRACT FROM AUTHOR]

Background: There is increasing awareness of the benefits of both physical and psychosocial interventions to empower and benefit people with dementia and their caregivers. However, the potential additional benefits of combining physical and psychosocial interventions have only been sparsely explored. The aim of this pilot study was to investigate the acceptability and potential impact of a multicomponent intervention comprising physical exercise, cognitive stimulation therapy (CST), psychoeducation and counselling for people with early-stage dementia. Design: A 15-week multicomponent group-based intervention was offered to people with early-stage dementia in Denmark (N = 44). A mixed-methods design combining interviews, observations, tests of cognitive and physical functioning and an interviewer-assisted questionnaire on quality of life was applied to (1) investigate acceptability of the intervention, including whether people with dementia and their caregivers found the intervention meaningful and (2) to explore and assess changes in participants' physical and cognitive functioning and quality of life. The study was conducted between June 2018 and August 2019. Results: The pilot study demonstrated that the multicomponent intervention was acceptable for people with early-stage dementia and their caregivers. Test results did not show significant changes in measures of participants' physical and cognitive functioning or quality of life. However, qualitative data revealed that participants perceived the intervention as meaningful and found that it had a positive influence on their physical and social well-being. In addition, interaction and support from peers and staff members was considered important and rewarding. Conclusion: This multicomponent intervention constitutes a meaningful and beneficial activity for people with early-stage dementia and their caregivers. It provides an opportunity to engage in social interactions with peers and experience professional support. The study also underlines the importance of providing prolonged and sustainable interventions for people with dementia to maintain personal and social benefits. [ABSTRACT FROM AUTHOR]