Table 2.

Quotes from attendance coordinators sorted by the elements of implementation.

Theme	Element	Quotes from Absenteeism Coordinators
The innovation	Procedural clarity	“This system distinctly shows how far everyone’s responsibility goes. The collaboration is clear-cut.” —2019
	Correctness	“We wonder if the criteria are too strict? (…) Actually, we know who the children with problems are. It’s still good to do, although I think we are lucky in our village as problems aren’t that big here.”—2018
	Completeness	“I always do it with you [meaning researcher & child and youth health care physician EP], we discuss the identified children and then get the ball rolling.”—2020
	Complexity	“One teacher categorises a dentist visit as a doctor’s visit, the other calls it other authorised absence, so we changed the options with [researcher] EP. Less choice in the registration system makes it easier to pick the right category.”—2020
		“I’ve noticed that our teachers find it difficult to talk to parents about absenteeism. I have to remind them (…) not to actually say ‘your child is absent far too often’.”—2019
	Compatibility	“For our school, identifying absenteeism every six to eight weeks is fitting. (…) With the possibility of more frequent checks when there are signs of increased absenteeism, but that’s up to the school to decide.”—2020
	Observability	“Teachers often think it’s authorised absenteeism, because they fill in that it’s this or that’, (…) When you ask parents, however, it may be confirmed, or it may be very different than what we thought. Knowing the problem makes it easy to tackle.”—2019
	Relevance for the client	“You tackle the problem earlier (…), before, a child had 40 periods of absence, but now, they’ve already been identified. That makes it easier to involve the teacher, and for the teacher to involve the parents. That’s an improvement.”
		“I believe that parents don’t recognise the necessity as of yet’ ‘Actually, I’ve noticed a difference between younger and older groups. (…) Parents are more focussed on absenteeism of their child in group 8, than in group 2’ ‘And the teacher does the same of course, saying ‘this can’t happen next year’.”—Two ACs 2019
The user	Personal benefits/drawbacks	“The whole trajectory (…) has given me insights, about talking to parents and even children. (…) I really appreciate that. It provides a kind of norm, a criterion that shows what is normal and what is excessive.”—2020
		“For me, it’s that you’re made aware so much earlier. The children are noticed so much sooner and you can start the conversation with parents in an earlier stage.”—2020
		“Sometimes, you’re kind of relieved that a few pupils are ill, it’s quiet.”—2018
	Outcome expectations	Minor remarks
	Professional obligation	“Teachers don’t see it as their job (…), they teach whoever is in the class. The absenteeism is the parents’ responsibility, the teacher is responsible for brushing up the knowledge once the child is back.”—Logbook
	Client/patient satisfaction	“When I talk to parents myself, I don’t get the impression that they mind. They seem to appreciate that absenteeism is identified and we care about it.”—2019
	Client/patient cooperation	“Sickness absence can sometimes seem an easy way to be able to go to a theme park (…), a five-year-old will blurt that out by the way.”—Logbook
		“As soon as we mention the CYHP or nurse, we see a drop in absenteeism. It makes parents think.”
	Social support	“What I do notice is some teachers are very enthusiastic and good at it. Some other teachers seem afraid that it will create more work for them, when in fact it doesn’t have to.”—2018
		“I am the only SNC on staff, so my communication with the teachers is easy (…). And I can see that they really care too. This was a team decision, because the teachers were also concerned about the children with high levels of absenteeism but we didn’t know exactly what to do (…), so MASS-PS is great.”—2019
	Descriptive norm	Not mentioned
	Subjective norm	Not mentioned
	Self-efficacy	“I notice that once a teacher had had a few conversations with parents [about absenteeism], they say ‘it’s easier than we thought’. Especially because you can use MASS, which gives peace of mind. You can hide behind the numbers and don’t have to jump to conclusions.”—2019
	Awareness of content of innovation	“Word of mouth around the village is that sickness absence is monitored now, and that has an effect on the absenteeism in school.”—Logbook
The organisation	Formal ramification by management	“When I look at myself, I have to ensure that I make time to monitor absenteeism. The issues of the day catch up to us all (…) My advice to starting schools would be: make it a recurring item on the agenda.”—2020
	Replacement when staff leave	“We need to keep explaining the program to teachers, (…) Because of changes in colleagues, or other changes in the teams, (…), it [the intervention] soon becomes less like the original.”—2020
	Staff capacity	“There are a few positions I can’t fill, my SNC is absent long-term for example and I’m missing an important link to use this intervention. (…) It changes too much, so I’ll try, but no guarantees.”—2018
	Financial resources	Not mentioned
	Time available	“It takes time, not that that’s bad or anything, time just has to be available.”—2018 “We only do it when the researcher comes, that’s disappointing isn’t it?”—logbook
	Material resources and facilities	“It’s a pity that the functionalities of the MASS-PS program aren’t implemented in the regular school registration software.”—2020
	Coordinator	“We’ve had a study day in September and I am kind of the driving force behind this intervention in school, together with the principal and special needs coordinators.”—2018
	Unsettled organisation	“I’ll be honest, it’s still something I want to implement properly in my school. It just hasn’t happened yet because of all the turbulence and busy schedules.”—2018
	Information accessible about use of innovation	Minor remarks
	Performance feedback	Not mentioned
The socio-political context	Legislation and regulations	“What is the role of the GDPR? (…). We’re not sure yet what is allowed and what isn’t.”—2018
	Pandemic	“Children with, for example, a serious intestinal disorder, who couldn’t be in school before the pandemic, (…) can now log in to the class from home and miss fewer lessons than before.”—2020
		“Now that the school lockdown is over, the sickness absence is skyrocketing again. You can’t blame people because you have to stay home with any symptoms of a cold, but because of that we’ve lost our grip on sickness absence again.”—2020
		“After Corona, sickness absence was lower than before. We’ve had no negative effect on absenteeism. (…) Yes, the occasional pupil goes for a test, is absent for a while, but nothing comes out of it.”—2020