What question did this study set out to answer?

The study aims to evaluate the effectiveness of the Healthy School Recognized Campus initiative on student health and the role of a mentoring strategy in implementation.

February 8, 2026Implementation Science0 citationsOpen Access

Healthy school recognized campus: design and methodology of a hybrid type 2 implementation-effectiveness cluster randomized trial

ASAllyson SchaefersMitchell Institute CBCassandra M. BeattieBaylor University GMGabrielli Thais De MelloMitchell Institute

Key Points

The study aims to evaluate the effectiveness of the Healthy School Recognized Campus initiative on student health and the role of a mentoring strategy in implementation.
Conduct a hybrid type 2 implementation-effectiveness trial with 500 students from 20 public schools.
Randomize schools to either HSRC intervention or waitlist control.
Use BMI z-score, physical activity via accelerometer, and skin carotenoids as primary and secondary outcomes.
Randomize 200 program implementers to assess a school-to-school mentoring strategy.
Employ a mixed-methods approach for assessing program acceptability and feasibility.
The study will measure effectiveness outcomes related to HSRC and implementation outcomes for the mentoring strategy.
It is expected to show significant improvements in health behaviors, reducing obesity and chronic disease risk factors among participating youth.

Abstract

Abstract Background About one-third of U.S. youth are overweight and most have at least one risk factor that increases their chance of developing cardiovascular or other chronic diseases. School- and research-based physical activity and healthy eating programs can reduce obesity and improve health outcomes; however, schools face many implementation challenges. Healthy School Recognized Campus (HSRC) bundles school- and researched-based programs to improve their implementation and student health outcomes. This paper describes the protocol for a hybrid type 2 implementation-effectiveness, cluster dual randomized controlled trial that evaluates the (aim 1) effectiveness of the HSRC initiative for improving health behaviors and (aim 2) the impact of an implementation strategy – school-to-school mentoring – on HSRC’s delivery. Methods Students in 4th through 9th grade ( n = 500) at public schools ( n = 20) across East and Central Texas will be randomized at the school level to determine the effectiveness of HSRC (vs. waitlist control condition) on BMI z-score (primary outcome), physical activity measured via accelerometer, and skin carotenoids (i.e., fruit and vegetable intake; secondary outcomes). Assessments will occur at the start and end of one school year. Program implementers ( n = 200) at schools will be randomized to assess the impact of the school-to-school mentoring strategy (vs. standard implementation) on HSRC’s acceptability, appropriateness, and feasibility (co-primary outcomes). Assessments will occur at the start, middle, and end of one school year. The assessment at the end of the school year will also include a concurrent mixed-methods approach (QUAL + QUAN), guided by the Consolidated Framework for Implementation Research (CFIR), to evaluate the school-to-school mentoring strategy. For quantitative outcomes, a generalized linear model framework will be used to evaluate HSRC and the school-to-school mentoring strategy. Discussion This study’s innovative dual randomized design allows for rigorous assessment of HSRC on effectiveness outcomes and the evaluation of a school-to-school mentoring implementation strategy on implementation outcomes. If both HSRC and the school-to-school mentoring strategy have their hypothesized effect, we will be well positioned to address cardiovascular and other chronic disease risk factors among youth using a scalable, widely used approach within one of the largest health educator networks in the country. Trial registration Clinicaltrials.gov on July 1, 2025 (NCT07079995).

Demander à l'IA

Bookmark

View Full Paper