Barriers and Facilitators to Implementation of the EU School Fruit and Vegetables Scheme: Cross Country Study.

The European Union (EU) School Fruit and Vegetables Scheme is a nutrition policy program. It has three actions: delivery of fruit and vegetables in schools, accompanying educational and information measures. The aim of this study is to identify barriers and facilitators to the implementation of the Scheme as perceived by implementers at government level. This work is a qualitative, exploratory study using the Consolidated Framework for Implementation Research (CFIR) to guide data collection and analysis. Twenty-three semi-structured interviews were conducted with representatives (n = 29) from agriculture, health and education, across 10 EU member states and the EU. Qualitative data were coded inductively. Themes were mapped to constructs of the CFIR. We found content in regard to 19 out of 26 constructs of the CFIR. Some example constructs are: adaptability, external policy and incentives, networks and communications, knowledge and beliefs and executing. Flexibility in how the scheme is designed and implemented and newly established cooperation between implementing ministries are facilitators. However, the timing of the yearly budget allocation is a barrier. Taking EU funding for granted is a potential disincentive to improvement, although the EU funding facilitates sustainability. Despite agreement on what the overall goals of the Scheme are, there is ambiguity as to what the perceived primary goal is, which may be a barrier. Some goal ambiguity may be useful at the supranational level, enabling politically acceptable framing and continuation of the financing of the Scheme, but this translates into a potential barrier to design and implementation at country and school level.