Christina Kien is a postdoctoral research fellow at the University for Continuing Education in Krems. She is interested in improving the quality of health promotion interventions and in providing research results to bridge the research-practice gap. In her research, she also focuses on implementation outcomes.
Programme theory can guide evaluation of programmes and streamline the implementation of programmes by different providers. We aimed at developing and applying a systematic process to elucidate and foster a common understanding of the programme theory and focussing on the functions of core elements involving relevant stakeholders of the programme. The health promotion programme follows the WHO health promoting school approach guidelines and aims at enabling representatives of different schools to create a healthy school environment in Lower Austria.
We conducted seven qualitative interviews with relevant stakeholders (i.e., programme’s providers and lead). Furthermore, we interviewed twelve middle school teachers being responsible for the implementation of the programme in their schools. Two researchers analysed the results applying a thematic analysis . We focused especially on the definition of the functions of the core elements of the programme. These core elements’ functions were then used in a Delphi process involving the same stakeholders. The Delphi process involved four different steps: 1) presentation and clarification of the functions, 2) rating of the functions’ relevance, 3) second rating of the functions’ relevance based on the results of the first rating, and 4) discussion and clarification of remaining functions with stakeholders.
Overall, the modified Delphi process enabled to identify 41 relevant out of 107 defined functions for 14 core elements of the programme. In five out of 14 core elements and core roles, the functions could be selected within the second round. The third round resulted only in finalizing one more core element. And only the final discussion enabled to select the further 8 core elements. The results of the participants ratings were considered in the discussion and served as a base for the decision.
This process enabled a fruitful discussion between the programme’s providers and lead about the programme theory. Furthermore, it sharpened the programme theory by focusing on core elements and their most relevant functions. Based on these results, the programme theory was finalised. Applying a Delphi technique for selecting functions of core elements was a fruitful approach. It aided in specifying a programme theory with different providers of an already existing programme.