Understanding key implementation determinants for a school-based universal prevention intervention: a qualitative study

2021 ◽  
Author(s):  
Andria B Eisman ◽  
Sarah Kiperman ◽  
Laney A Rupp ◽  
Amy M Kilbourne ◽  
Lawrence A Palinkas
Keyword(s):  
School Health ◽  
Teaching Style ◽  
Implementation Strategies ◽  
Universal Prevention ◽  
Design Quality ◽  
Implementation Outcomes ◽  
School Based ◽  
Prevention Curriculum ◽  
Intervention Context ◽  
Health Objectives

Abstract This study examined how teachers discuss various factors as impacting their ability to execute with fidelity the Michigan Model for Health (MMH), an evidence-based health universal prevention curriculum widely adopted throughout Michigan. Researchers have found a robust relationship between fidelity and participant outcomes, including in schools. While previous studies have identified barriers that inhibit fidelity, few have focused on identifying key barriers and deepening our understanding of how these factors influence intervention fidelity. We conducted a thematic analysis using the reflexive thematic approach to identify key barriers and facilitators and deepen our understanding of how these factors influence MMH implementation. Guided by the Consolidated Framework for Implementation Research (CFIR) and the Implementation Outcomes Framework, we conducted semistructured interviews with 23 high school health teachers across Michigan. Teachers identified intervention characteristics (e.g., design quality, packaging, and program adaptability), student needs (e.g., trauma exposure, substances), and the fit between the intervention and the context as factors that contributed to acceptability. They also discussed the curriculum and its alignment with their teaching style and/or experiences as contributing to fidelity. Teachers shared how they would often go “off protocol” to improve intervention-context fit and meet students’ needs. Our results identified acceptability, a perceptual implementation outcome, as demonstrating an important role in shaping the relationship between CFIR factors and fidelity. Results provide guidance for systematically designing implementation strategies that address key barriers to improve acceptability, enhance fidelity, and ultimately achieve desired public health objectives.

scholarly journals Together, We Inspire Smart Eating (WISE): An Examination of Implementation of a WISE Curriculum for Obesity Prevention in Children 3 to 7 Years

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986981
Author(s):  
Leanne Whiteside-Mansell ◽  
Taren Swindle ◽  
James P. Selig
Keyword(s):  
Elementary Schools ◽  
Obesity Prevention ◽  
Low Income ◽  
Perceived Barriers ◽  
Convenience Sample ◽  
Low Income Children ◽  
School Year ◽  
Implementation Outcomes ◽  
School Based ◽  
Prevention Curriculum

This study examined the implementation of a school-based, obesity prevention curriculum, Together, We Inspire Smart Eating (WISE), targeting 3- to 7-year-old low-income children. Survey data from a convenience sample were collected from educators and parents (N = 73, N = 188, respectively) at the beginning and end of a school year in which WISE was implemented. Educators also reported on lessons weekly. Measures to evaluate the success of the implementation were conceptually distinct implementation outcomes (Educators: Perceived Barriers, Appropriateness, Acceptability, Feasibility, Fidelity; Parents: Adoption, Appropriateness). WISE was successfully implemented in 33 target classrooms representing 7 preschool centers and 2 elementary schools. Based on educator report, perceived barriers were reduced. Educators rated Appropriateness, Acceptability, and Feasibility high. Evidence of Fidelity was mixed. Parents reported indicators of Adoption and Appropriateness high. The study provided support for WISE in preschools and elementary schools serving young children from low-resource homes.

scholarly journals Specifying and reporting implementation strategies used in a school-based prevention efficacy trial

2021 ◽  
Vol 2 ◽  
pp. 263348952110478
Author(s):  
Stephanie A. Moore ◽  
Kimberly T. Arnold ◽  
Rinad S. Beidas ◽  
Tamar Mendelson
Keyword(s):  
Research Team ◽  
Implementation Strategies ◽  
Implementation Process ◽  
School Staff ◽  
Routine Practice ◽  
Efficacy Trial ◽  
Community Members ◽  
Implementation Outcomes ◽  
School Based ◽  
Trauma Informed

Background The implementation strategies used to enhance the implementation of interventions during efficacy and effectiveness studies are rarely reported. Tracking and reporting implementation strategies during these phases has the potential to improve future research studies and real-world implementation. We present an exemplar of how this might be executed by specifying and reporting the implementation strategies that were used during a school-based efficacy trial, Project POWER, which tested a trauma-informed prevention program delivered by a university research team, community members, and school staff facilitators in 29 schools. Methods Following the conclusion of the 4-year trial, core Project POWER research team members identified the implementation strategies that supported intervention delivery during the trial using an established taxonomy of school-based implementation strategies. The actors, actions, action targets, temporality, dose, and implementation outcomes were specified using established implementation strategies reporting guidelines. Results The research team identified 37 implementation strategies that were used during the Project POWER trial. Most strategies fell within the categories of Train and Educate Stakeholders, Use Evaluative and Iterative Strategies, and Develop Stakeholder Interrelationships. Actors included members of the research team and partner schools. Strategies were used multiple times during the preparation and implementation phases. Action targets were most often characteristics of individuals, implementation process, and characteristics of the inner setting. Strategies predominantly targeted the implementation outcomes of fidelity, acceptability, feasibility, and adoption. Conclusions This study provided evidence that implementation strategies are used and can be identified in efficacy research using a retrospective approach. Identifying and specifying implementation strategies used during the initial phases of the translational research pipeline can inform the implementation strategies that are carried forward, adapted, or discontinued in future trials and routine practice to improve implementation and effectiveness outcomes. Plain Language Abstract Intervention development and testing often occurs separately from implementation planning. However, evaluating an intervention without considering how it will be subsequently used in real-world settings is a major factor contributing to the research-to-practice gap. During the rigorous testing of interventions, research teams invest significant effort and resources to ensure their program is delivered as intended and so that beneficial outcomes can be assessed. However, the methods or techniques used to support implementation (i.e., implementation strategies) are often not measured or specified to be used and evaluated during later research or included with intervention materials that are distributed to stakeholders; this is a missed opportunity. This study identifies and describes the implementation strategies used during a large school-based research trial of a universal trauma-informed prevention program delivered by a university research team, community members, and school staff. In collaboration with the trial’s research team, we identified 37 implementation strategies that were used during the trial and defined how each strategy was used, including: the actions (i.e., things done), people who carried out the strategies, the targets of the actions, when and how often during the implementation process the strategies were used, and which implementation outcome(s) the strategy was expected to impact. Explicating implementation strategies during early phases of intervention research in schools can inform which implementation supports to carry forward, adapt, or discontinue in future studies and routine practice.

Administrasi Layanan Khusus

2020 ◽  
Author(s):  
Haisya Hamini
Keyword(s):  
Learning Process ◽  
Teaching And Learning ◽  
School Health ◽  
Service Management ◽  
Educational Goals ◽  
Guidance And Counseling ◽  
School Based ◽  
Special Services ◽  
School Cafeterias

This article describes the administration of special services. The teaching and learning process requires the support of facilities that are not directly used in the classroom. Facilities that do not directly include school libraries, school cooperatives, school health businesses and school cafeterias. Management of special services in schools is effective and efficient School Based Management (SBM). School is one of the facilities that can be used to improve the quality of Indonesia's population. Schools not only have responsibilities and duties to carry out the learning process in developing science and technology, but must maintain and improve students' physical and spiritual health.Special service management in schools is basically defined and organized to facilitate or facilitate learning, and can meet the special needs of students at school. Special services are provided in schools with a view to facilitating the implementation of teaching in the context of achieving educational goals in schools. Special services include guidance and counseling, libraries, laboratories, school health efforts (uks), canteens, school cooperatives, and transportation.

Adaptation in Dissemination and Implementation Science

2017 ◽  
Author(s):  
Ana A. Baumann ◽  
Leopoldo J. Cabassa ◽  
Shannon Wiltsey Stirman
Keyword(s):  
Implementation Science ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Dissemination And Implementation ◽  
Research And Practice ◽  
Implementation Outcomes ◽  
Dissemination And Implementation Science ◽  
Dissemination And Implementation Research

This chapter focuses on adaptations in the context of dissemination and implementation research and practice. Consistent with the existing literature, the authors recommend that adaptations be proactively and iteratively determined, strongly informed by a variety of stakeholders, and that efforts be made to carefully describe and document the nature of the adaptations and evaluate their impact on desired service, health, and implementation outcomes. While this chapter focuses on adaptations to interventions and the context of practice, the authors also note that adaptations may need to be made to implementation strategies. Following the call by Proctor and colleagues for further precision in defining and operationalizing implementation strategies, and based on evidence that scholars are not necessarily reporting what and how they are adapting the interventions, scholars are urged to define and evaluate the adaptations they are making not only to the interventions and context of practice but also to the implementation strategies.

scholarly journals Strategies to Integrate Genomic Medicine into Clinical Care: Evidence from the IGNITE Network

2021 ◽  
Vol 11 (7) ◽  
pp. 647
Author(s):  
Nina R. Sperber ◽  
Olivia M. Dong ◽  
Megan C. Roberts ◽  
Paul Dexter ◽  
Amanda R. Elsey ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Program Implementation ◽  
Clinical Care ◽  
Genomic Medicine ◽  
Implementation Strategies ◽  
Clinical Decision ◽  
Implementing Change ◽  
Implementation Outcomes ◽  
Planning Framework

The complexity of genomic medicine can be streamlined by implementing some form of clinical decision support (CDS) to guide clinicians in how to use and interpret personalized data; however, it is not yet clear which strategies are best suited for this purpose. In this study, we used implementation science to identify common strategies for applying provider-based CDS interventions across six genomic medicine clinical research projects funded by an NIH consortium. Each project’s strategies were elicited via a structured survey derived from a typology of implementation strategies, the Expert Recommendations for Implementing Change (ERIC), and follow-up interviews guided by both implementation strategy reporting criteria and a planning framework, RE-AIM, to obtain more detail about implementation strategies and desired outcomes. We found that, on average, the three pharmacogenomics implementation projects used more strategies than the disease-focused projects. Overall, projects had four implementation strategies in common; however, operationalization of each differed in accordance with each study’s implementation outcomes. These four common strategies may be important for precision medicine program implementation, and pharmacogenomics may require more integration into clinical care. Understanding how and why these strategies were successfully employed could be useful for others implementing genomic or precision medicine programs in different contexts.

scholarly journals A systematic review of school health policy measurement tools: implementation determinants and outcomes

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Gabriella M. McLoughlin ◽  
Peg Allen ◽  
Callie Walsh-Bailey ◽  
Ross C. Brownson
Keyword(s):  
Health Policy ◽  
Policy Implementation ◽  
School Health ◽  
School Policy ◽  
Implementation Processes ◽  
Implementation Outcomes ◽  
Policy Measurement ◽  
Measurement Tools ◽  
School Health Policy ◽  
Health Policy Implementation

Abstract Background Governments in some countries or states/provinces mandate school-based policies intended to improve the health and well-being of primary and secondary students and in some cases the health of school staff. Examples include mandating a minimum time spent per week in programmed physical activity, mandating provision of healthy foods and limiting fat content of school meals, and banning tobacco products or use on school campuses. Although school health researchers have studied whether schools, districts, or states/provinces are meeting requirements, it is unclear to what extent implementation processes and determinants are assessed. The purposes of the present systematic review of quantitative measures of school policy implementation were to (1) identify quantitative school health policy measurement tools developed to measure implementation at the school, district, or state/provincial levels; (2) describe the policy implementation outcomes and determinants assessed and identify the trends in measurement; and (3) assess pragmatic and psychometric properties of identified implementation measures to understand their quality and suitability for broader application. Methods Peer-reviewed journal articles published 1995–2020 were included if they (1) had multiple-item quantitative measures of school policy implementation and (2) addressed overall wellness, tobacco, physical activity, nutrition, obesity prevention, or mental health/bullying/social-emotional learning. The final sample comprised 86 measurement tools from 67 peer-review articles. We extracted study characteristics, such as psychometric and pragmatic measure properties, from included articles based on three frameworks: (1) Implementation Outcomes Framework, (2) Consolidated Framework for Implementation Research, and (3) Policy Implementation Determinants Framework. Results Most implementation tools were developed to measure overall wellness policies which combined multiple policy topics (n = 35, 40%) and were in survey form (n = 75, 87%). Fidelity was the most frequently prevalent implementation outcome (n = 70, 81%), followed by adoption (n = 32, 81%). The implementation determinants most assessed were readiness for implementation, including resources (n = 43, 50%), leadership (n = 42, 49%), and policy communication (n = 41, 48%). Overall, measures were low-cost and had easy readability. However, lengthy tools and lack of reported validity/reliability data indicate low transferability. Conclusions Implementation science can contribute to more complete and rigorous assessment of school health policy implementation processes, which can improve implementation strategies and ultimately the intended health benefits. Several high-quality measures of implementation determinants and implementation outcomes can be applied to school health policy implementation assessment. Dissemination and implementation science researchers can also benefit from measurement experiences of school health researchers.

Health education for deaf Romanian children: parents’ opinions

2019 ◽  
Vol 119 (5/6) ◽  
pp. 341-349
Author(s):  
Laura Ionescu ◽  
Lacramioara Ursache ◽  
Adelina Nicolae ◽  
Adriana Conea ◽  
Cristian Potora ◽  
...  
Keyword(s):  
Health Education ◽  
Communication Technology ◽  
School Health ◽  
Healthy Lifestyle ◽  
Smoking Prevention ◽  
Educational Activities ◽  
Content Type ◽  
North West ◽  
School Based ◽  
School Health Education

Purpose The purpose of this paper is to focus on parents of children with hearing disabilities from Romania and has three objectives. First, it assesses their characteristics regarding use of communication technology. Second, it investigates their opinions regarding the importance of school-based education for healthy lifestyle promotion among their children. Third, it evaluates the availability for their involvement in educational activities using face-to-face approach and communication technology dedicated to helping parents to promote healthy lifestyle among their children, as well as factors which influence this availability. Design/methodology/approach The study was performed in October–November 2015 in two schools deserving children with hearing disabilities from North-West part of Romania. Anonymous questionnaire were filled in by 182 parents. Findings The majority of parents recognize the importance of school-based health education and more than 77 per cent totally agree that it should include issues regarding healthy nutrition, promotion of physical activity and smoking prevention. In total, 80.2 per cent of the parents declared that they are interested to participate in educational activities organized periodically at school and 66.5 per cent declared their interest in educational activities developed through communication technology in order to help them to stimulate the adoption of healthy lifestyle among their children. The availability was influenced by residence, educational level, understanding the importance of parents’ involvement, characteristics regarding the use of communication technology. Originality/value This represents the first study from Romania investigating the opinions and availability for their involvement with regard to school health education among parents of children with hearing deficiencies. The results have several implications for health education among children with hearing deficiencies and their parents.

scholarly journals Students’ Satisfaction with e-Learning Systems During the COVID-19 Pandemic—An International Comparative Study

2021 ◽  
Author(s):  
Shahrokh Nikou ◽  
◽  
Seongcheol Kim
Keyword(s):  
University Students ◽  
Structural Equation ◽  
Course Design ◽  
Teaching Style ◽  
Learning Systems ◽  
Educational Institutions ◽  
Design Quality ◽  
Related Factors ◽  
E Learning ◽  
Students Satisfaction

t In response to the global COVID-19 situation, quarantine measures have been implemented at the educational institutions around the world. This paper aims to determine the antecedent factors predicting the university students’ satisfaction with e-learning systems during the COVID-19 situation. We used structural equation modelling (SEM) and evaluated a conceptual model on the basis of a sample of university students from Finland (n = 131) and South Korea (n = 114). The SEM results showed that the COVID-19 related factors, i.e., COVID19 awareness, perceived challenges during COVID-19 and the educational institutions’ preparedness indirectly influence the satisfaction with e-learning systems. Moreover, we found a statistically significant moderating effect of course design quality, and instructor’s teaching style between the COVID-19 related factors and the satisfaction with e-learning systems. The implications of these results for the management of e‐learning systems are discussed.

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