Unraveling the "black box" of school tobacco policy implementation: A mixed-methods study at Danish vocational schools informed by Normalization Process Theory.

ABSTRACT:

Background

Smoke-free policies are often poorly implemented in schools. The Smoke-Free Vocational Schools intervention aimed to support the routine implementation of a comprehensive school tobacco policy at Danish vocational schools and took place across seven schools. This study aimed to assess and understand the mechanisms-that is, reasoning and behavior change-that shaped if and how policy implementation outcomes occurred.

Method

We applied a convergent mixed-methods design informed by Normalization Process Theory (NPT). The quantitative strand employed a repeated cross-sectional design, assessing implementation mechanisms-Coherence, Cognitive Participation, Collective Action, Reflexive Monitoring-and implementation outcomes at two time points: 5+ months post-policy (T1)

SUBMITTER: Hjort AV 

PROVIDER: S-EPMC12511714 | biostudies-literature | 2025 Jan-Dec

REPOSITORIES: biostudies-literature