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Peer-reviewedCC BY 4.0Nutrients

Implementation Experiences of a School-Based Adolescent Nutrition Education Intervention: A Post-Intervention Qualitative Study Guided by Consolidated Framework for Implementation Research and the Social Ecological Model

  • Humaira Mahmood1
  • Babar Tasneem Shaikh1
  • Farrah Pervaiz2
  • Azka Naseem3
  • Mehvish Idrees4
  • Abdul Momin Rizwan Ahmad5,6
  • Yasir Waheed7,8,9,10
  • Saleh A. Alsanie11,12
12 affiliations
  1. 1School of Public Health, Health Services Academy, Islamabad 44000, Pakistan
  2. 2Department of Community Medicine, Rawalpindi Medical University, Rawalpindi 46000, Pakistan
  3. 3Department of Research and Development, Rawalpindi Medical University, Rawalpindi 46000, Pakistan
  4. 4Public Health Department, University of Azad Jammu and Kashmir, Muzaffarabad 13100, Pakistan
  5. 5Department of Human Nutrition and Dietetics, NUST School of Health Sciences, National University of Sciences and Technology (NUST), Sector H-12, Islamabad 44000, Pakistan
  6. 6Department of Health Sciences, University of York, York YO10 5DD, UK
  7. 7NUST School of Health Sciences, National University of Sciences and Technology (NUST), Sector H-12, Islamabad 44000, Pakistan
  8. 8Irfan Suat Gunsel Operational Research Institute, Near East University, 99138 Nicosia, Turkey
  9. 9Faculty of Health Sciences, Széchenyi István University, Egyetem Square 1, 9026 Győr, Hungary
  10. 10Department of Health Sciences, VIZJA University, 01-043 Warsaw, Poland
  11. 11Department of Basic Health Sciences, College of Applied Medical Sciences, Qassim University, Buraydah 52581, Saudi Arabia
  12. 12Department of Clinical Nutrition, Medical City, Qassim University, Buraydah 52581, Saudi Arabia
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Abstract

Background/Objectives: School-based nutrition education provides a platform that could help in the promotion of healthy eating habits among adolescents. Nonetheless, information about the factors influencing the success of these interventions in low- and middle- income countries is still lacking. The objective of the study was to identify facilitators and barriers to effective implementation of school-based nutrition education by applying the Consolidated Framework for Implementation Research (CFIR) and interpreting findings across levels of the Social Ecological Model (SEM). Methods: A qualitative study was conducted after eight to ten weeks of nutrition education intervention in an urban school setting. Data were collected through two focus group discussions with sixteen students (eight students in each group), in-depth interviews with four teachers, six parents and key informant interviews with two school administrators. A semi-structured, CFIR- and SEM-based guide was used to conduct the data collection. Thematic analysis was conducted following Braun and Clarke’s six-phase approach, with deductive and inductive coding conducted independently by two researchers and reconciled through consensus. Results: Five themes were aligned with CFIR domains, including intervention characteristics, outer setting, inner setting, character of individuals, and implementation process. In general, the stakeholders agreed to the importance of relevance and contextualization of the intervention and the use of multi-mediums (classroom-based and online) to deliver the intervention, which they perceived to support improved knowledge of nutrition among adolescents. Implementation of the programme faced challenges arising from the incongruence between messages delivered in classrooms and those served in the school canteens, economic hurdles from home, cultural practices related to food consumption, social influence on peers and media, lack of time among staff, and largely passive parent participation. Conclusions: Nutrition education was perceived as inadequate on its own to support sustainable behaviour related dietary change. Factors that may influence whether nutrition messages can be translated into practice were identified by the study participants and include the school food environment (canteen), the development of the curriculum, policy integration, and shift in parental participation from passive learning to active collaboration.

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Cite

BibTeXRIS
BibTeX
@article{mahmood2026implementation,
  title = {{Implementation Experiences of a School-Based Adolescent Nutrition Education Intervention: A Post-Intervention Qualitative Study Guided by Consolidated Framework for Implementation Research and the Social Ecological Model}},
  author = {Humaira Mahmood and Babar Tasneem Shaikh and Farrah Pervaiz and Azka Naseem and Mehvish Idrees and Abdul Momin Rizwan Ahmad and Yasir Waheed and Saleh A. Alsanie},
  journal = {Nutrients},
  year = {2026},
  month = nov,
  doi = {10.3390/nu18213652},
  url = {https://www.mdpi.com/2072-6643/18/21/3652},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Implementation Experiences of a School-Based Adolescent Nutrition Education Intervention: A Post-Intervention Qualitative Study Guided by Consolidated Framework for Implementation Research and the Social Ecological Model
AU  - Humaira Mahmood
AU  - Babar Tasneem Shaikh
AU  - Farrah Pervaiz
AU  - Azka Naseem
AU  - Mehvish Idrees
AU  - Abdul Momin Rizwan Ahmad
AU  - Yasir Waheed
AU  - Saleh A. Alsanie
PY  - 2026
DA  - 2026/11/03
JO  - Nutrients
DO  - 10.3390/nu18213652
UR  - https://www.mdpi.com/2072-6643/18/21/3652
AB  - Background/Objectives: School-based nutrition education provides a platform that could help in the promotion of healthy eating habits among adolescents. Nonetheless, information about the factors influencing the success of these interventions in low- and middle- income countries is still lacking. The objective of the study was to identify facilitators and barriers to effective implementation of school-based nutrition education by applying the Consolidated Framework for Implementation Research (CFIR) and interpreting findings across levels of the Social Ecological Model (SEM). Methods: A qualitative study was conducted after eight to ten weeks of nutrition education intervention in an urban school setting. Data were collected through two focus group discussions with sixteen students (eight students in each group), in-depth interviews with four teachers, six parents and key informant interviews with two school administrators. A semi-structured, CFIR- and SEM-based guide was used to conduct the data collection. Thematic analysis was conducted following Braun and Clarke’s six-phase approach, with deductive and inductive coding conducted independently by two researchers and reconciled through consensus. Results: Five themes were aligned with CFIR domains, including intervention characteristics, outer setting, inner setting, character of individuals, and implementation process. In general, the stakeholders agreed to the importance of relevance and contextualization of the intervention and the use of multi-mediums (classroom-based and online) to deliver the intervention, which they perceived to support improved knowledge of nutrition among adolescents. Implementation of the programme faced challenges arising from the incongruence between messages delivered in classrooms and those served in the school canteens, economic hurdles from home, cultural practices related to food consumption, social influence on peers and media, lack of time among staff, and largely passive parent participation. Conclusions: Nutrition education was perceived as inadequate on its own to support sustainable behaviour related dietary change. Factors that may influence whether nutrition messages can be translated into practice were identified by the study participants and include the school food environment (canteen), the development of the curriculum, policy integration, and shift in parental participation from passive learning to active collaboration.
SN  - 2072-6643
ER  -