Exploring meso- and macro-level contextual factors associated with inequalities in program adoption during statewide scale-up of TransformUs Primary, a whole-school physical activity intervention.

ABSTRACT:

Background

Contextual influences on program implementation exist across micro (individual), meso (organization), and macro (government/environment) system levels, yet macro factors are less frequently explored in implementation research. This retrospective study explored differences in adoption across meso- and macro-system levels using data from the 2018-2022 state-wide hybrid effectiveness-implementation trial of TransformUs Primary, a whole-school physical activity intervention. Aims were to: (1) assess differences in contextual characteristics between adopting and non-adopting schools and implications for equity, and (2) assess associations between macro-level events and dissemination events with program adoption over time.

Methods

Descriptive statistics (number and %) a

SUBMITTER: Ganakas E 

PROVIDER: S-EPMC12359990 | biostudies-literature | 2025 Aug

REPOSITORIES: biostudies-literature