This qualitative case study addresses the problem of rising physical inactivity levels and the challenges that state and local agencies have in implementing, supporting, monitoring, and evaluating a comprehensive state physical activity plan. In 2010, statewide data collected for Nebraska using the Behavioral Risk Factor Surveillance System (BRFSS) indicated that, “nearly 2 in 3 adults were overweight or obese” and “nearly 1 in 3 adults did not meet recommended guidelines for physical activity” (DHHS, 2010). In 2011, statewide partners revised The Nebraska Physical Activity and Nutrition State Plan (NPANSP) as part of a long-term initiative to manage rising obesity levels in adults and youth. In an effort to provide evidence-based public health strategies to enhance the policy and built environment, the NPANSP was framed around the Center for Disease Control and Prevention (CDC)’s health priority goals and developed strategies using The Community Guide provided by the Community Prevention
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47). Using program theory (Weiss, 1998), the aim is to understand why did things happen, or not, by unpacking how the intervention is meant to work, thus connecting the process, content, and known outcomes. The process evaluation is framed from stakeholder attitudes, knowledge, and awareness of the key activities that were completed during the implementation process using semi-structured, in-depth interviews with key stakeholders accompanied by document analysis of the state plan. Findings suggest that the key mechanism for change (increasing the use of the state plan in the target population) is the role the Nutrition and Activity for Health (NAFH) team plays in the implementation process. The NAFH’s role is to build capacity in the target population. Implementation
47). Using program theory (Weiss, 1998), the aim is to understand why did things happen, or not, by unpacking how the intervention is meant to work, thus connecting the process, content, and known outcomes. The process evaluation is framed from stakeholder attitudes, knowledge, and awareness of the key activities that were completed during the implementation process using semi-structured, in-depth interviews with key stakeholders accompanied by document analysis of the state plan. Findings suggest that the key mechanism for change (increasing the use of the state plan in the target population) is the role the Nutrition and Activity for Health (NAFH) team plays in the implementation process. The NAFH’s role is to build capacity in the target population. Implementation