scholarly journals Barriers and Facilitators for the Implementation and Evaluation of Community-Based Interventions to Promote Physical Activity and Healthy Diet: A Mixed Methods Study in Argentina

2019 ◽  
Vol 16 (2) ◽  
pp. 213 ◽  
Author(s):  
Maria Belizan ◽  
R. Chaparro ◽  
Marilina Santero ◽  
Natalia Elorriaga ◽  
Nadja Kartschmit ◽  
...  
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Local Community ◽  
Project Evaluation ◽  
Political Support ◽  
Healthy Diet ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based

Background: Obesogenic environments promote sedentary behavior and high dietary energy intake. The objective of the study was to identify barriers and facilitators to the implementation and impact evaluation of projects oriented to promote physical activity and healthy diet at community level. We analyzed experiences of the projects implemented within the Healthy Municipalities and Communities Program (HMCP) in Argentina. Methods: A mixed methods approach included (1) in-depth semi-structured interviews, with 44 stakeholders; and (2) electronic survey completed by 206 individuals from 96 municipalities across the country. Results: The most important barriers included the lack of: adequate funding (43%); skilled personnel (42%); equipment and material resources (31%); technical support for data management and analysis (20%); training on project designs (12%); political support from local authorities (17%) and acceptance of the proposed intervention by the local community (9%). Facilitators included motivated local leaders, inter-sectorial participation and seizing local resources. Project evaluation was mostly based on process rather than outcome indicators. Conclusions: This study contributes to a better understanding of the difficulties in the implementation of community-based intervention projects. Findings may guide stakeholders on how to facilitate local initiatives. There is a need to improve project evaluation strategies by incorporating process, outcome and context specific indicators.

scholarly journals Physical activity promotion in primary care: Health professional and patient views on connecting primary care patients with community-based physical activity opportunities

2020 ◽  
Author(s):  
Sharon Ann Carstairs ◽  
Rayna H Rogowsky ◽  
Kathryn B Cunningham ◽  
Frank Sullivan ◽  
Gozde Ozakinci
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Local Community ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Community Based ◽  
Activity Promotion ◽  
Primary Care Patients ◽  
Potential Methods

Abstract Background Inconclusive evidence in support of referrals from health professionals to gym-based exercise programmes has raised a concern for the roll-out of such schemes and highlights the importance of developing and maintaining links between primary care settings and community-based opportunities to improve physical activity levels. This study aimed to identify methods of connecting primary care patients to community-based physical activity opportunities, using the example of jog scotland , and to explore what factors can facilitate this connection. Methods We conducted a qualitative exploratory study utilising semi-structured interviews with primary care patients (n=14) and health professionals (HP) (n=14) from one UK National Health Service (NHS) board. We analysed the transcripts separately for patients and HPs using thematic analysis and synthesised them for potential methods of connection. Sub-themes for patients and HPs were mapped onto relevant components of the capability, opportunity, motivation behavioural (COM-B) model and theoretical domains framework (TDF) to identify barriers and facilitators for connecting primary care to community jog scotland groups. Results Three potential methods of connecting patients to community-based jog scotland groups were identified: informal passive signposting, informal active signposting, and formal referral or prescribing. Barriers and facilitators to connecting patients to jog scotland groups fell into five TDF domains for HPs and two COM-B model components for patients. Conclusions Our findings suggest that for patients, the acknowledgement and raising of the topic of physical activity improvement by their HP can help to justify as well as facilitate and motivate action to change. The workload associated with connecting patients to community-based opportunities is central to the implementation by HPs. Resource solutions (e.g. intermediary person or community information hub) and social support opportunities for patients (e.g. meet and greet) can provide patients with a greater variety of physical activity options and the vital information and support for connecting with local community-based opportunities, such as jog scotland .

scholarly journals Connecting primary care patients to community-based physical activity: a qualitative study of health professional and patient views

BJGP Open ◽  
2020 ◽  
Vol 4 (3) ◽  
pp. bjgpopen20X101100
Author(s):  
Sharon Ann Carstairs ◽  
Rayna H Rogowsky ◽  
Kathryn B Cunningham ◽  
Frank Sullivan ◽  
Gozde Ozakinci
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Community Based ◽  
Healthcare Settings ◽  
Primary Care Patients ◽  
Exercise Programmes

BackgroundInconclusive evidence supporting referrals from health professionals to gym-based exercise programmes has raised concern for the roll-out of such schemes, and highlights the importance of developing links between healthcare settings and community-based opportunities to improve physical activity (PA) levels.AimThis study aimed to identify methods, and explore barriers and facilitators, of connecting primary care patients with PA opportunities from the perspectives of both health professionals (HPs) and patients, using the example of jogscotland.Design & settingAn exploratory study utilising semi-structured interviews with primary care patients (n = 14) and HPs (n = 14) from one UK NHS board was conducted.MethodPatient and HP transcripts were analysed separately using thematic analysis. Potential methods of connection were identified. The Capability, Opportunity, Motivation, behavioural (COM-B) model and theoretical domains framework (TDF) were employed to facilitate identification of barriers and facilitators for connecting primary care to community jogscotland groups.ResultsThree methods of connecting patients to community-based groups were identified: informal passive signposting, informal active signposting, and formal referral or prescribing. Barriers and facilitators for patient connection fell into five TDF domains for HPs and two COM-B model components for patients.ConclusionFor patients, HPs raising the topic of PA can help to justify, facilitate, and motivate action to change. The workload associated with connecting patients with community-based opportunities is central to implementation by HPs. Integrative resource solutions and social support for patients can provide a greater variety of PA options and the vital information and support for connecting with local opportunities, such as jogscotland.

scholarly journals Barriers and facilitators to implementing community-based physical activity interventions: a qualitative systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jemima Cooper ◽  
Joey Murphy ◽  
Catherine Woods ◽  
Femke Van Nassau ◽  
Aisling McGrath ◽  
...  
Keyword(s):  
Physical Activity ◽  
Implementation Strategies ◽  
Outcome Data ◽  
Barriers And Facilitators ◽  
Successful Implementation ◽  
Community Based Interventions ◽  
Community Based ◽  
Physical Activity Interventions ◽  
The Impact ◽  
Implementation Factors

Abstract Background Over the past decade several physical activity (PA) interventions have been shown to be efficacious in a controlled research setting, however there is a continued lack of evidence for how to successfully implement these PA interventions in real-world settings such as the community. This review aims to explore the barriers and facilitators that affect the implementation of community-based PA interventions and make recommendations to improve implementation from the included studies. Methods A systematic literature search of EBSCOhost, Scopus, PUBMED and Web of Science was conducted to identify articles that reported qualitative data on the implementation factors of community-based interventions where PA was a primary outcome. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) as a guide. Implementation factors and recommendations were then mapped onto the 5 domains of the CFIR and synthesised thematically. Results From 495 articles, a total of 13 eligible studies were identified, with 6 studies using a mixed methods approach, and 7 reporting qualitative methods only. There were 82 implementation factors identified, including 37 barriers and 45 facilitators, and a further 26 recommendations from the papers across all 5 domains of the CFIR. More barriers than facilitators were identified within the CFIR domain inner setting, in contrast to all other domains where facilitator numbers outweighed barriers. Conclusions This review identified many facilitators and barriers of implementing physical activity interventions in the community. A key finding of this review was the impact of implementation strategies on successful implementation of community PA interventions. From the evidence, it was clear that many barriers to implementation could have been negated or reduced by an implementation plan in which several strategies are embedded. The findings of this review also suggest more attention to individual’ skills and involvement is needed to improve self-efficacy and knowledge. The role of individuals across all organisational levels, from providers to leaders, can impact on the implementation of an intervention and its success. Trial registration PROSPERO - CRD42020153821.

scholarly journals The PROMISES study: a mixed methods approach to explore the acceptability of salivary progesterone testing for preterm birth risk among pregnant women and trained frontline healthcare workers in rural India

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040268
Author(s):  
Danielle Ashworth ◽  
Pankhuri Sharma ◽  
Sergio A Silverio ◽  
Simi Khan ◽  
Nishtha Kathuria ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Preterm Birth ◽  
Pregnant Women ◽  
Barriers And Facilitators ◽  
Rural India ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Thematic Framework

IntroductionIndia has an overall neonatal mortality rate of 28/1000 live births, with higher rates in rural India. Approximately 3.5 million pregnancies in India are affected by preterm birth (PTB) annually and contribute to approximately a quarter of PTBs globally. Embedded within the PROMISES study (which aims to validate a low-cost salivary progesterone test for early detection of PTB risk), we present a mixed methods explanatory sequential feasibility substudy of the salivary progesterone test.MethodsA pretraining and post-training questionnaire to assess Accredited Social Health Activists (ASHAs) (n=201) knowledge and experience of PTB and salivary progesterone sampling was analysed using the McNemar test. Descriptive statistics for a cross-sectional survey of pregnant women (n=400) are presented in which the acceptability of this test for pregnant women is assessed. Structured interviews were undertaken with ASHAs (n=10) and pregnant women (n=9), and were analysed using thematic framework analysis to explore the barriers and facilitators influencing the use of this test in rural India.ResultsBefore training, ASHAs’ knowledge of PTB (including risk factors, causes, postnatal support and testing) was very limited. After the training programme, there was a significant improvement in the ASHAs’ knowledge of PTB. All 400 women reported the salivary test was acceptable with the majority finding it easy but not quick or better than drawing blood. For the qualitative aspects of the study, analysis of interview data with ASHAs and women, our thematic framework comprised of three main areas: implementation of intervention; networks of influence and access to healthcare. Qualitative data were stratified and presented as barriers and facilitators.ConclusionThis study suggests support for ongoing investigations validating PTB testing using salivary progesterone in rural settings.

scholarly journals Homeless on Main Street: Using Photovoice to Highlight Older Adults Among the Hidden Homeless

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 728-728
Author(s):  
H Shellae Versey
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Meaning Making ◽  
Small Towns ◽  
Photo Elicitation ◽  
Service Agency ◽  
Structured Interviews ◽  
Community Based Interventions ◽  
Community Based ◽  
Formerly Homeless

Abstract Homelessness is a reality for a growing number of Americans living in small towns and rural areas. However, unlike in cities, housing instability may be less visible. Using a photo-elicitation method (i.e., Photovoice), this study explores the meaning of place and obscured visibility to currently and formerly homeless older adults living in a small town in central Connecticut. Participants (N = 27) were recruited from a local service agency, given cameras and asked to photograph areas around town that were meaningful to them. Photographs were developed and followed by in-person, semi-structured interviews with participants in which photos and experiences during the project were discussed. Primary themes included belonging, generativity, social isolation, and place-making as meaning-making. The study culminated in a community photography exhibition in which photographs from the project were displayed in public spaces around town. Implications for community-based interventions to reach homeless groups in rural areas are discussed. Part of a symposium sponsored by the Qualitative Research Interest Group.

scholarly journals A Mixed Methods Study on the Barriers and Facilitators of Physical Activity Associated with Residential Relocation

2018 ◽  
Vol 2018 ◽  
pp. 1-12
Author(s):  
Grazia Salvo ◽  
Bonnie M. Lashewicz ◽  
Patricia K. Doyle-Baker ◽  
Gavin R. McCormack
Keyword(s):  
Physical Activity ◽  
Mixed Methods ◽  
Statistical Significance ◽  
Mixed Methods Study ◽  
Barriers And Facilitators ◽  
Residential Relocation ◽  
Quantitative Phase ◽  
Neighbourhood Walkability ◽  
Perceived Change ◽  
Leisure Physical Activity

Despite evidence suggesting that neighbourhood characteristics are associated with physical activity, very few mixed methods studies investigate how relocating neighbourhood, and subsequent changes in the built environment, influences physical activity. This sequential mixed methods study estimates associations between changes in overall physical activity and transportation walking and cycling and changes in objectively assessed neighbourhood walkability (quantitative phase) and describes perceived barriers and facilitators to physical activity following residential relocation (qualitative phase). During the quantitative phase, self-reported changes in transportation walking, transportation cycling, and overall physical activity following residential relocation were measured using a 5-point scale: (1) a lot less now, (2) a little less now, (3) about the same, (4) a little more now, and (5) a lot more now. Walkability improvers reported a slight increase in transportation walking (mean = 3.29, standard deviation (SD) = 0.87), while walkability decliners reported little or no perceived change in their transportation walking after relocation (mean = 2.96, SD = 1.12). This difference approached statistical significance (p=0.053). Furthermore, walkability decliners reported a slight decrease in transportation cycling (mean = 2.69, SD = 0.96), while walkability improvers reported little or no perceived change in their transportation cycling after relocation (mean = 3.02, SD = 0.84). This difference was statistically significant (p<0.05). Change in walkability resulting from relocation was not significantly associated with perceived change in overall physical activity. Our qualitative findings suggest that moving to a neighbourhood with safe paths connecting to nearby destinations can facilitate transportation walking and cycling. Some participants describe adjusting their leisure physical activity to compensate for changes in transportation walking and cycling. Strong contributors to neighbourhood leisure physical activity included the presence of aesthetic features and availability of recreational opportunities that allow for the creation of social connections with community and family.

scholarly journals An Examination of Rural Homestay Operations through the Lens of the Sustainable Livelihood Framework: A Case Study of Phou Khao Khouay National Park Community-Based Tourism (PKK NP CBT), Lao PDR

2021 ◽  
Author(s):  
◽  
Khamsavay Pasanchay
Keyword(s):  
Qualitative Methodology ◽  
Local Community ◽  
Culture Shock ◽  
Primary Data ◽  
Sustainable Livelihood ◽  
Structured Interviews ◽  
Community Based ◽  
Sustainable Livelihood Framework ◽  
The Government

<p>In many developing countries, Community-Based Tourism (CBT) is regarded as a sustainable tourism development tool as well as a catalyst for rural community development through the involvement of local people and the improvement of the standard of living. To extend the involvement of the local community in CBT, homestay tourism is a form of operation unit and its concept aims to facilitate individual household social-cultural and economic benefit from CBT directly. Although homestays are widely regarded as providing better livelihoods directly to the homestay operators, it is not clear to what extent homestay operations actually contribute to the sustainable livelihood of homestay operators when considering the wider livelihood implications. This research seeks to explore this gap by analysing homestay operators through the lens of Sustainable Livelihood theory (Scoones, 1998). This research adopts a post-positivist paradigm with qualitative methodology. Taking a case study approach, semi-structured interviews and observations were employed to collect primary data from community leaders, heads and deputy heads of the tourist guides, and homestay operators themselves.  Results of the study found that although homestay tourism was initially established by the government. The study also found the main characteristics of the homestay operation are in a small size with a limitation of bedrooms, and a few family members involved in hosting tourists, which are husband, wife, and an adult child. All of these people are unpaid labour but receive benefits from the sharing of food and shelter. The study also uncovered that cash-based income, gender empowerment enhancement, and environmental enhancement were the positive impacts of homestay tourism on the livelihoods of the homestay operators, and these positive livelihood outcomes were in line with the original sustainable livelihood framework. In addition, cultural revitalisation was found as an emerged indicator of the sustainable livelihood outcomes, which was used to extend the revised framework. However, the study discovered that opportunity costs, culture shock, and conflict with villagers were negative implications affecting sustainable livelihood outcomes of the homestay operators. The revised Sustainable Livelihood Framework (SLF) suggests that if these negative implications are mitigated, the overall livelihood outcomes will be even greater. The results of this study are expected to provide a deeper understanding of how the impacts of homestay tourism on the sustainable livelihood of the homestay operators.</p>

scholarly journals Effect of a brief physical activity-based presentation by a former patient for men treated with radical prostatectomy for prostate cancer: a mixed methods pilot study

2020 ◽  
Vol 29 (1) ◽  
pp. 145-154
Author(s):  
Louis Fox ◽  
Theresa Wiseman ◽  
Declan Cahill ◽  
Louisa Fleure ◽  
Janette Kinsella ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Prostate Cancer ◽  
Mixed Methods ◽  
Pragmatic Trial ◽  
Behavioural Intervention ◽  
Structured Interviews ◽  
Exercise Specialist ◽  
Clinically Significant

Abstract Purpose Existing research indicates that physical activity (PA) is beneficial to men with prostate cancer (PCa). We examined the potential of a single-contact peer-support-based behavioural intervention to promote PA engagement in men treated for PCa. Methods A mixed methods design was employed, comprising a two-arm pragmatic trial and semi-structured interviews. The intervention was a 10-min PA-based presentation by a former patient, delivered in group seminars that are provided for patients as standard care. Seminars were alternately allocated to (a) cancer exercise specialist talk + patient speaker talk or (b) cancer exercise specialist talk only. Self-reported PA, exercise motivation, quality of life, fatigue and clinical and demographic characteristics were obtained from n = 148 (intervention: n = 69; control: n = 79) patients immediately prior to the seminar, and at follow-up ≈ 100 days later. Data were analysed using ANCOVA models and χ2 tests. Fourteen semi-structured interviews with intervention participants, which explored how the intervention was experienced, were analysed using a grounded theory-style approach. Results The intervention had no significant effect on quantitatively self-reported PA (p = 0.4). However, the intervention was statistically and clinically beneficial for fatigue (p = 0.04) and quality of life (p = 0.01). Qualitative analysis showed that the intervention was beneficial to psychological wellbeing and some participants had increased intention to engage in PA as a result of the intervention. Conclusions A brief one-off PA-based presentation for men with PCa, delivered by a former patient alongside cancer exercise specialist advice, may result in clinically significant benefits to quality of life and may influence PA intention in certain individuals.

A participatory mixed-methods evaluation of a falls awareness programme

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Megan Elliott ◽  
Hannah Watson ◽  
Amy Lewis ◽  
Carolyn Wallace
Keyword(s):  
Older Adults ◽  
Mixed Methods ◽  
General Health ◽  
Sheltered Housing ◽  
Methodological Issues ◽  
Community Based Interventions ◽  
Community Based ◽  
Content Type ◽  
Behaviour Changes ◽  
Awareness Programme

Purpose Falls are common in older adults and are associated with injuries and serious ongoing problems. This paper aims to present a participatory evaluation of a Falls Awareness Programme implemented in South Wales for older adults living in sheltered housing schemes or in the community. It identifies methodological issues and provides recommendations for evaluation design and methods for community-based interventions in the future. Design/methodology/approach A mixed-methods study combining a non-experimental pretest–posttest design with face-to-face focus groups. Findings Concerns about falling and self-reported general health at baseline were worse for participants living in sheltered housing schemes, compared to participants in the community. There was no statistically significant change between baseline and follow-up in general health or concerns about falling; however, the data suggesting the programme may be more effective for people in sheltered housing schemes. Participants reported making small, but sustainable behaviour changes following the programme and described unexpected outcomes from the programme, e.g. socialising and meeting new people. Originality/value This paper demonstrates the benefit of engaging older adults in research using a participatory approach, highlights key components of community-based interventions for older people and identifies some methodological issues when conducting evaluations in the community. Specifically, it highlights the importance of selecting appropriate measurement tools for data collection and the utility of continuous monitoring where programme participation is flexible and fluid.

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