In another reminder of how indispensable the Centers for Disease Control & Prevention (CDC) is to public health – despite recent national political headlines – the esteemed agency published an invaluable study evaluating the implementation of the renowned BOKS program (a before school physical activity program for children) in three schools located in a low-resource, racially/ethnically and socioeconomically diverse, urban area.

Very often, a study focuses on the results of an intervention and often overlooks or provides only scant details about how the intervention was actually implemented. This study, however, amounts to a blueprint for implementation that should be reviewed and considered by any organization attempting to create physical activity opportunities for children in similar areas. in my opinion. the study is a treasure of wisdom for public health and physical activity advocates.

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Key considerations include:

Cost: The cost of the program was covered by a grant from Massachusetts General Hospital. The program was free for all participants.

Logistics: Each school location was responsible for managing the program location, dates, and times; participant enrollment; and trainer recruitment.

Trainers: Trainers were recruited by each school and trained by BOKS, which increased capacity to lead within each school community.

Community Engagement: Prior to the intervention, the research team met with local community health leaders, school principals and BOKS staff to align the program and evaluation priorities.

Site Selection: Participating schools were selected by school administrators.

Coordination: Each site had a grant-funded coordinator to assist the school and coordinate with BOKS.

Communication with Parents: Recruitment materials for parents were available in four languages.

Adaptability: The program was appropriately adapted, as necessary. Although fidelity to the BOKS program was optimal, the reality of applying the program required adaptations consistent with practicability.

Important to remember for any intervention: Implementation is a balancing act between uniform implementation and real-world application.

These are just a handful of the golden nuggets found in the study.

I highly recommend reading through the whole study – it’s loaded with wisdom, it won’t take long to read and, unlike some very esoteric studies, it won’t give you a headache.

Why It Matters

Low-resource communities experience disproportionately high rates of physical inactivity and chronic disease. Addressing these disparities is notoriously challenging. This study offers practical guidance, based on hard earned experience, to make a significant impact in communities of need.