Evaluating the implementation and effectiveness of the switch–ms: An ecological, multi-component adolescent obesity prevention intervention

Senlin Chen, Richard R. Rosenkranz, Gabriella M. McLoughlin, Spyridoula Vazou, Lorraine Lanningham-Foster, Douglas A. Gentile, David A. Dzewaltowski

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: The purpose of this study was to evaluate the implementation and effectiveness of an ecological, multi-component adolescent obesity prevention intervention called School Wellness Integration Targeting Child Health–Middle School (SWITCH–MS). Methods: Following the effectiveness-implementation hybrid type 3 quasi-experimental design, seven middle schools (377 students) in Iowa, United States, were stratified into “experienced” (n = 3; 110 students) or “inexperienced” (n = 4; 267 students) groups to receive the 12-week SWITCH–MS intervention. To evaluate implementation, school informants (n = 10) responded to a survey and students completed behavioral tracking in the classroom on a website. For effectiveness evaluation, students in 6th, 7th, and 8th grades completed a validated questionnaire before and after intervention, to measure behaviors of physical activity (PA; “Do”), screen-based activity (“View”), and fruits and vegetable consumption (“Chew”). Results: The two groups of schools showed similar levels of implementation for best practices, awareness, and engagement. Behavioral tracking rate favored the experienced schools early on (47.5% vs. 11.7%), but differences leveled off in weeks 3–12 (sustained at 30.1–44.3%). Linear mixed models demonstrated significant time effects for “Do” (at school and out of school; p <0.01) and “View” behaviors (p = 0.02), after controlling for student-and schoollevel covariates. Conclusions: This study demonstrates that prior experience with SWITCH–MS may not be a prominent factor for implementation and effectiveness, although greater experience is associated with favorable behavioral tracking when the intervention is first launched.

Original languageEnglish (US)
Article number5401
Pages (from-to)1-12
Number of pages12
JournalInternational journal of environmental research and public health
Issue number15
StatePublished - Aug 1 2020


  • Healthy-living behaviors
  • Implementation science
  • Obesity prevention
  • Program evaluation
  • School wellness

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Pollution
  • Health, Toxicology and Mutagenesis


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