Teachers' experiences in co-creating an implementation plan for a public health intervention: a Health CASCADE study

When co-creating school-based public health interventions, it is crucial to involve teachers alongside students as they are often deliverers of the school-based intervention (components), and fulfil a key role in the implementation of the intervention. This study investigates teachers' experiences during the co-creation process of developing an implementation plan of a healthy sleep intervention.

Qualitative observational study.

Experiences of teachers involved in the action group (n = 6) were derived from transcripts of all co-creation sessions (n = 6) and one semi-structured focus group. Reflexive thematic analysis (RTA) in NVivo 14 was performed.

The co-creation process took place within the highly demanding school context, which influenced teachers' co-creation experience. Teachers preferred a guided process, to make efficient use of their time. Positive experiences were principal support, the ability to share their opinion, and decision-making power. Negative experiences were inter-role conflict, low group cohesion due to the high absence level, and lacking support of their fellow colleagues. In addition, misunderstanding the aim of the co-creation process impacted teachers' motivation, as they expected to focus on the health problem rather than developing an implementation plan to tackle the health problem among adolescents.

Since teachers are not trained as health promotors, co-creation processes for implementing school-based public health interventions should be guided by researchers. These processes should incorporate capacity-building activities to enhance teachers' knowledge and skills in the health topic and intervention implementation, while minimising time demands to facilitate their participation.