A recently published article in Health Education Research explores the implementation of Familie+, a school-based intervention targeting childhood obesity in low socioeconomic status (SES) regions in Germany.
Childhood overweight and obesity remain significant public health challenges, particularly among families with lower SES. Schools are considered vital environments for reaching all children regardless of background over long periods. Because teachers play a pivotal role as the primary implementers of health programs, understanding their perceptions is essential. The Familie+ project was designed as a multi-component intervention to promote healthy nutrition, physical activity, reduced sedentary behavior, and improved sleep.
A sequential mixed-methods study design to evaluate the intervention’s implementation. Our study was guided by the Consolidated Framework for Implementation Research (CFIR) and Proctor’s implementation outcomes. The study focused on 3rd and 4th-grade teachers across nine primary schools in low SES regions in Germany. Teachers were asked to answer questionnaires at the start and after the intervention to assess delivery rates and implementation outcomes like acceptability and feasibility. Semi-structured interviews with teachers were applied to gain deeper insights into influencing factors.
The results were merged by presenting descriptive quantitative data alongside corresponding qualitative quotes and summaries to provide a holistic view of the implementation process.
Our study shows that for school-based obesity prevention to be successful, interventions must be flexible and adaptable to fit the local context of each school. We suggest not to view health programs in isolation, but rather as part of the school as complex social system. To improve long-term effects, we recommend prioritizing principal engagement, fostering teamwork within the school, and involving teachers in the co-production of materials to ensure they are practical for everyday use. Ultimately, integrating these programs into existing school systems is necessary to address health (in)equity effectively.
Butscher, F., Gebhard, D., Singer, M., & van Nassau, F. (2026). Exploring the implementation of the school-based obesity prevention Familie+ intervention: a pilot mixed-methods study of teachers’ perceptions. Health Education Research, 41(1). https://doi.org/10.1093/her/cyaf064