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Understanding the dynamics of implementing the Norwegian School Fruit Programme: integrating implementation science
Mahshid Zolfaghari1, Nanna Lien2, Caroline Løvik Brandvik2
1Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway. mahshid.zolfaghari@medisin.uio.no.
Implementation Science Communications
|December 10, 2025
Summary
Implementing the Norwegian School Fruit Programme (NPPP) requires aligning fruit offerings with student preferences and improving communication. Addressing implementation costs and stakeholder involvement are key to successful school nutrition interventions.
Area of Science:
- Public Health
- Nutrition Science
- Implementation Science
Background:
- School nutritional interventions face implementation challenges.
- Understanding the interplay of determinants in school food programs is crucial.
- The Norwegian School Fruit Programme (NPPP) and its No Parental Payment Programme (NPPP) context require system-level analysis.
Purpose of the Study:
- Investigate NPPP implementation dynamics in Norwegian schools.
- Analyze interactions between NPPP and school system structures.
- Understand the interplay of Consolidated Framework for Implementation Research (CFIR) determinants within the NPPP.
Main Methods:
- Qualitative system dynamics modelling using group model building (GMB) workshops.
- Facilitated discussions with school personnel and pupils to map implementation determinants.
- Compilation of individual school diagrams and mapping of CFIR onto a unified system diagram.
Main Results:
- Communication gaps, external food availability, and NPPP design hindered fruit consumption.
- Increased implementation costs (fruit waste, littering) led to adaptive strategies.
- Adaptive strategies' success was limited by NPPP design and school priorities, sometimes counterintuitively impacting fruit intake.
Conclusions:
- Qualitative system dynamics effectively investigated NPPP implementation.
- Recommendations include aligning NPPP with pupil preferences and monitoring fruit consumption.
- Involving internal (pupils, staff) and external (municipalities) stakeholders is vital for feedback and monitoring.
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