Sustainability Requires Many Faces of Support.

Purpose: This study focused on the sustainability of a school-wide health behavior intervention in rural schools in the Southwestern US. Informed by the seven premises of Theories of Action with Merit, the purpose of this study was to investigate which portion(s) of a five-year, school-wide health behavior intervention were still in practice (i.e. sustainable), and why they were maintained following the removal of funding and resources for the program. Method: Teachers (N = 41) participated in individual, semi-structured interviews during which they shared what aspects of the original intervention were retained as part of personal classroom practices or of the school culture. Teachers reflected on facilitators and barriers to the sustainability of these practices. Data also included field notes from campus visits. To establish trustworthiness, data triangulation (interview transcripts, survey results, and field notes) provided multiple angles of analysis, and two researchers negotiated all themes. Results: Using the premises of the Theories of Action with Merit, teachers' comments often circulated around themes of administrative support and personal investment/interest in healthy behaviors. Additional themes of sustainability included feeling capable and physical activity being the "norm" at their school. Conclusions: Teachers' personal beliefs and self-efficacy in physical literacy held the highest importance in sustaining classroom healthy behavior practices as opposed to the district or state expectations for healthy behaviors. Administrator support was key to whole-school integration and sustainability of practices, however, teachers described evidence of support differently suggesting administrators need awareness of how messages of support are being translated.