What is it about?

Sustainability is important in achieving long-term health benefits within the population. As chronic diseases are responsible for 70% of all deaths globally, a number of effective public health programs have been introduced within schools and childcare settings to address the leading risk factors for chronic disease development early in life. However, previous research shows that public health programs in schools are not being sustained. Therefore it is important to understand what may either promote or prevent this in order to develop strategies to support their ongoing delivery. We found that the majority of the 59 barriers and 74 facilitators identified in 31 articles from high income countries were similar across school and childcare settings. Factors mostly relating to the readiness and resources available within the organisation, as well as organisational leadership and support present were viewed by 100% of childcare service staff and 95% of school staff as important to continued program delivery. We also found that the volume of research in this area conducted in childcare services compared to schools is severely lacking, with only 6% of articles conducted in the childcare setting.

Featured Image

Why is it important?

Recent research however has shown that over two years public health programs are not being sustained and suggests when support is withdrawn, the quality of program delivery may reduce or stop being delivered altogether, along with its impact on improving health outcomes. In order to protect the public health investments made and realise the long-term benefits of public health programs within children, then sustained delivery of these programs is needed. Despite its importance, there is little evidence regarding how to best support the sustained implementation of school-based public health interventions. Our findings build on the existing research around the sustainability of public health programs in schools and childcare services. Our results help inform the future planning, development, and testing of strategies to address barriers and promote the sustained delivery of public health programs, supporting positive, long-term health outcomes in children.


Writing this article was a great pleasure as it has co-authors with whom I have strengthened collaborations with. I hope this article makes people think about what may be needed to sustain public health programs within educational settings, and provoke some thought as to the barriers preventing this and what strategies may help support their continued delivery.

Mr Adam Shoesmith
University of Newcastle

Read the Original

This page is a summary of: Barriers and facilitators influencing the sustainment of health behaviour interventions in schools and childcare services: a systematic review, Implementation Science, June 2021, Springer Science + Business Media,
DOI: 10.1186/s13012-021-01134-y.
You can read the full text:




The following have contributed to this page