Table 2 Facilitating and hindering factors for the implementation and maintenance of SuperFIT in the preschool setting

Characteristics of the innovation: SuperFIT

- Training off-the-job, in particular to share experiences with other teachers and experts.

- Coaching on-the-job.

‘It is nice that you can share experiences like “how do you handle that?” … and it was nice that [the coach] came here to observe and give tips.’ (PT)

- Incongruence with current practice.

‘It is nice to hear, but then if you cannot apply it at your own preschool, I think that’s a shame.’ (PT)

- Enthusiasm of the implementers.

‘I liked it a lot, that you can use the expertise of others who are enthusiastic about their profession and you also get a piece of the pie.’ (PT)

- No changes in the outdoor play area (e.g., provision of fixed outdoor play materials).

‘I had hoped for more things for outside, the design … Our playgrounds are so boring.’ (PT)

- Supportive materials to implement changes within the preschool location (e.g., the water tap).

‘We started with the tap. Let them tap water themselves … and not one child has asked for lemonade since.’ (PT)

- Limited appropriateness for preschoolers (e.g., cards too difficult to understand, too exotic F&V).

‘But passion fruit, with the seeds and all, and the papaya was also hardly eaten and then I think … this may be too much’. (PT)

- Ready-made activities (e.g., delivery of materials/F&V).

‘If you do not have to put in that much effort, like the F&V delivery, then it is easy to implement’. (M)

- Predominantly top-down development of the intervention.

‘I thought it would have been good if a small group of preschool teachers discussed things together, some cooperation or consultation’. (M)

- Long overall duration of the programme.

‘It has to sink in, you have to experiment a bit and then you see that you changed your approach into something that works … this does not happen after the first training’. (PT)

- Lack of innovativeness (content of SuperFIT) for the preschool staff.

‘I was not really inspired. I felt like much of the ideas that arose, that we already do that. It was not new to me.’ (PT)

Characteristics of the user: preschool teacher

- Preschool staff’s previous experience with PA, through training or work experience.

‘You have to be creative with it, that’s something you learn with experience.’ (PT)

- Preschool staff’s initial negative attitude towards the programme and lack of motivation to participate.

‘I also thought that everyone was a bit hesitant, like, let’s wait and see what’s coming at us, does this suit us?’ (PT)

- Awareness among staff about the purpose of the intervention.

‘Eventually, we learned that it’s the little things that matter and then it is possible to integrate it.’ (PT)

- Low outcome expectations of the preschool staff to change children’s EBRBs due to expected lack of cooperation of the children.

‘I mean, we try, but they won’t even taste it and then I think: “what did we achieve?”’ (PT)

- Low self-efficacy of staff due to other tasks, and characteristics of their location or group.

‘At the beginning I thought “Do we get something extra to do again? We already have so little time … ”’ (PT)

Characteristics of the inner setting: preschool organisation

- Health promotion (PA and healthy nutrition) was part of the organisational vision.

‘We were already thinking of promoting a healthy lifestyle within our organisation before SuperFIT, but we hadn’t started yet, so it [SuperFIT] was right up our alley.’ (M)

- Characteristics of the preschool location (e.g., limited space, crowded arrangement of the room, and limited availability of an outdoor play area).

‘[The room] is already full, it is too small.’ (PT)

- Support for SuperFIT within the organisation.

‘It was always nice that some managers or even the director were present [at the training sessions for teachers] to see what was going on.’ (PT)

- Limited time available with the children (i.e., limited opening hours).

‘I need more time if I want to do everything and if I want to add this [SuperFIT] too, then I just need more time at the preschool.’ (PT)

- Group composition and characteristics of the children (e.g., language difficulties or age differences).

‘It really depends on the group. Sometimes you can do everything and sometimes you can do nothing, that’s typical for preschoolers, right?’ (M)

- Lack of information provision from the organisation.

‘I had hoped that [the organization] would have put more effort in making the preschool teachers enthusiastic about SuperFIT at the start … Preschool teachers did not know what SuperFIT was about.’ (I)

Characteristics of the outer setting

- Preschool situated within primary school building that also supported health promotion.

‘Because we’re part of a primary school that’s a “healthy school”, we’re also kind of obliged [to serve only water].’ (PT)

- Limited access to the gym, due to requirements of the primary school.

‘Look, it’s a cooperation with the primary school, we used to use the gym more often … now it has become a larger school, so we can do less.’(PT)

- Current attention for healthy nutrition and physical activity in society.

‘A healthy lifestyle is increasingly being put on the societal agenda, it’s considered increasingly important, also due to the increasing prevalence of overweight.’(I)

- Low perceived support from parents for healthy nutrition and PA within the preschool setting.

‘It is a pity that you receive little feedback from parents, not only on this topic but also more in general.’(PT)

- Strict rules and regulations of the Community Health Authority, e.g., regarding safety or hygiene, limiting PA.

‘Just this morning I was playing on the floor, but the floor isn’t that clean. And I started to think “What would the Community Health Service think about this?”’ (PT)

Characteristics of the innovation: SuperFIT

- Congruence with current practice.

‘Then we realised that you could also look at it differently and indeed can integrate it in your normal routines, by doing things just a bit different. Then it is possible to integrate it.’ (PT)

- Predominantly perceived top-down approach.

‘The idea of SuperFIT was still conceived behind a desk … it’s not the result of a need from the staff. They didn’t state “we think our community needs to be healthier”. (M)

- Relevance for the preschools.

‘I think that the things the preschool teachers are taught about how to be physically active with the children, are concrete things they can use.’ (M)

Characteristics of the user: preschool teacher

- Positive attitude towards creating a healthy environment for preschoolers.

‘Then I think, at least they got that bit here … because we have a varied offer [of F&V], they can taste different things, that’s what we can give them.’ (PT)

- Low outcome expectations of only changing the preschool setting, particularly the home setting should also be addressed.

‘To what extent can you influence it? If it doesn’t address the home situation, then things won’t change.’ (PT)

- The promotion of healthy nutrition and PA was regarded as part of the job.

‘As I see it, now we’re just doing it, because it’s become part of our daily schedule, it’s become routine.’ (PT)

- Some beliefs about not wanting to ‘go over the top’ with promoting healthy behaviour, in particular related to healthy nutrition (e.g., healthy treats or other celebrations).

‘I don’t believe it’s good to withhold everything from the children … a child’s birthday is a celebration and you should be allowed to give some sweets or a small biscuit. I think that should stay.’ (PT)

- High motivation to work on healthy nutrition and PA for preschoolers.

‘There are other locations that can’t wait to start working with it, who say “give me those cards and materials and I’ll start with it!”’ (M)

- Self-efficacy to be able to integrate SuperFIT activities into daily practice.

‘At the beginning we thought: “How are we going to do this?” but eventually, yes, you have to look at it differently and then you are able to do it.’ (PT)

Characteristics of the inner setting: preschool organisation

- Organisational vision on healthy nutrition and PA.

‘We have made it [healthy lifestyle] one of the spearheads of our organisation.’ (M)

- High workload and competition between the different tasks across the organisation.

‘I think we can do much more with it [SuperFIT] if you get the time and space to work on it... now you have to do it in-between other things and then you can’t implement it properly.’ (M)

- Formulation/reformulation of organizational policies related to nutrition and PA.

‘What we formulated in our vision three years ago is now in black and white in our policy: that we want to promote a healthy lifestyle.’ (M)

- Availability of resources such as time and money.

‘Do we have money for it? That discussion is being held now.’ (M)

- Training of managers and ‘Healthy Childcare Coach’.

‘We talk about “healthy childcare” now, there is a plan of action regarding “healthy childcare”, and there was some training regarding “healthy childcare”’. (M)

- Group composition and characteristics of the children (e.g., language difficulties or age differences within the group).

‘It may influence the integration of SuperFIT: if everyone speaks the same language it’s a lot easier, compared to a group of 16 children with 10 different nationalities.’ (M)

Characteristics of the outer setting

- Current societal views on healthy nutrition and PA.

‘If you look at society, then everything is healthy this and healthy that.’(PT)

- Low perceived support from parents for healthy nutrition and PA within the preschool setting.

‘Parents do influence [implementation], if you want to do a lot and parents keep saying: “we don’t want that”, that has its influence.’ (M)

- Much attention towards healthy nutrition and PA within ECE setting.

‘You just have to open a trade journal and it’s all about physical activity and healthy lifestyle, in that way it’s in tune with the spirit of the times.’ (M)

- Lack of cooperation between the primary school and the preschool in health-promoting initiatives.

‘Well, the primary school is renovating the playground, but they did not consult us … so I don’t know what it’s going to look like. It’s a shame they didn’t cooperate with [preschool organisation].’ (PT)

- Alignment of policies and activities between preschool and primary school.

‘We are often located within primary school buildings and you follow the policy of the primary school. So, if birthday treats are not allowed at primary school it is easier to implement such a policy in preschool.’ (M)