"Cooking and Active Leisure" TAS Program, Spain: a Program Impact Pathways (PIP) analysis.

BACKGROUND The "Cooking and Active Leisure" Tu y Alícia por la Salud (CAL-TAS) Program is a school-based pilot that addresses healthy lifestyle needs of Spanish secondary school students with initiatives that research has proven to improve dietary and physical activity behaviors. OBJECTIVE The objectives were to perform a Program Impact Pathways (PIP) analysis to describe key activities and processes of the CAL-TAS Program, identify Critical Quality Control Points (CCPs), and identify a suite of common indicators of healthy lifestyles to be applied across participant schools. METHODS The CAL-TAS Program designers and implementation team developed this PIP analysis through an iterative process and presented the results for feedback at the seven-country Healthy Lifestyles Program Evaluation Workshop held in Granada, Spain, 13-14 September 2013, under the auspices of the Mondelēz International Foundation. RESULTS The team identified three PIP CCPs: teachers' motivation and training, changes in students' knowledge of healthy lifestyles, and changes in students' healthy lifestyle behavior. The selected indicators of the program's impact on healthy lifestyles are adequacy of food intake, level of knowledge of healthy lifestyles gained, and adequacy of physical activity level according to World Health Organization recommendations. A clear definition of impact indicators, as well as collection of accurate data on healthy lifestyle behaviors and knowledge, is essential to understanding the effectiveness of this program before it can be scaled up. CONCLUSIONS CAL-TAS is an effective secondary school-based program encouraging healthy lifestyles. The PIP analysis was instrumental in identifying CCPs to sustain and improve the quality of the program. The team hopes to sustain and improve the program through these program evaluation recommendations.