Applying Principles from Prevention and Implementation Sciences to Optimize the Dissemination of Family Feeding Interventions

Because families are the primary food socialization agent for children, they are a key target for nutrition interventions promoting healthy eating development. Although researchers and clinicians have developed and tested successful family nutrition interventions, few have gained widespread dissemination. Prevention and implementation science disciplines can inform the design, testing, and dissemination of feeding interventions to advance the goals of widespread adoption and population health impact. We review concepts and frameworks from prevention science and dissemination and implementation (D&I) research that are useful to consider in designing, implementing, and evaluating feeding interventions. Risk and protective factor frameworks, types of translation processes, and implementation dimensions are explained. Specifically, we address how research–practice partnerships can reduce time to dissemination, how designing for modularity can allow for contextual adaptation, how articulating core components can strengthen fidelity and guide adaptation, and how establishing technical assistance infrastructure supports these processes. Finally, we review strategies for building capacity in D&I research and practice for nutrition professionals. In sum, the research and knowledge bases from prevention and implementation sciences offer guidance on designing and delivering family interventions in ways that maximize the potential for their broad dissemination, reducing time to translation and optimizing interventions for real-world settings.

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“Replanning” a Statewide Walking Program Through the Iterative Use of the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework

Journal of Physical Activity and Health ◽

10.1123/jpah.2021-0034 ◽

2021 ◽

pp. 1-8

Author(s):

Laura E. Balis ◽

Samantha M. Harden

Keyword(s):

Physical Activity ◽

Physical Activity Intervention ◽

Physical Activity Promotion ◽

Health Impact ◽

Activity Levels ◽

Implementation Quality ◽

Walking Program ◽

Activity Promotion ◽

Core Components ◽

Iterative Evaluation

Background: Interventions undergo adaptations when moving from efficacy to effectiveness trials. What happens beyond these initial steps—that is, when the “research” is over—is often unknown. The degree to which implementation quality remains high and impacts remain robust is underreported as these data are often less valued by community entities. Comprehensive and iterative evaluation is recommended to ensure robust outcomes over time. Methods: The reach, effectiveness, adoption, implementation, and maintenance framework was used within an assess, plan, do, evaluate, report process to determine the degree to which a statewide physical activity promotion program aligned with evidence-based core components, assess who was reached and impacts on physical activity behaviors, and make decisions for future iterations. Results: Walk Across Arkansas was adopted by a majority of delivery agents and was effective at increasing physical activity levels postprogram, but those effects were not maintained after 6 months. Future decisions included recruitment strategies to reach a more diverse population and a blueprint document to reduce program drift. Conclusions: This article details the process of “replanning” a community-based physical activity intervention to understand public health impact and make decisions for future iterations. Pragmatic reach, effectiveness, adoption, implementation, and maintenance questions were useful throughout the assess, plan, do, evaluate, report process.

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Dissemination, implementation, and quality improvement research within the HMO Cancer Research Network.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.215 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 215-215

Author(s):

Brian S. Mittman ◽

James W. Dearing ◽

Kathleen Mazor ◽

James Nutter ◽

Keyword(s):

Cancer Research ◽

Quality Improvement ◽

Cancer Care ◽

Technical Assistance ◽

Care Quality ◽

Research Network ◽

Dissemination And Implementation ◽

Decision Makin ◽

Cancer Research Network ◽

Quality Improvement Research

215 Background: The HMO Cancer Research Network, funded by the National Cancer Institute, provides infrastructure support to facilitate cancer research in non-profit integrated healthcare delivery systems. A key CRN goal to improve quality and outcomes through research and research-based methods for accelerating implementation of innovations in cancer care. Methods: The CRN is led by a Steering Committee and an Executive Committee. CRN Scientific Working Groups support activity within distinct areas; the CRN Communication and Dissemination Scientific Working Group (C&D SWG) supports the design, conduct and reporting of research on (1) communication and decision makin in cancer care and (2) dissemination and implementation of cancer research findings and best practices. C&D SWG activities include monthly calls presenting C&D research resources, project ideas and funding opportunities; individual consultation and technical assistance to support CRN researchers developing funding applications and conducting research in relevant areas; and mentorship for CRN Scholars. General CRN resources to facilitate research to improve cancer care quality include a multi-institution Virtual Data Warehouse with accompanying query tools to facilitate preparatory-to-research and collaborative research studies and specific cancer-related data items; funding for Developmental and Pilot Studies; and an Outreach and External Collaborations Core to facilitate research collaborations among (a) CRN institution-based scientists, (b) scientists at other institutions, and (c) clinical and operations partners. Results: The CRN C&D SWG continues to stimulate increased awareness and interest in conducting dissemination and implementation studies and quality improvement research in cancer care, and to support the development of new project ideas and funding applications and the successful completion and publication of such studies. Conclusions: CRN activities facilitate innovative multi-site, multi-disciplinary cancer studies in the integrated delivery system setting, and motivate continued evolution of CRN institutions as the nation's premier learning health care systems. Supported by U24 CA171524.

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National and International Adaptations of the Children’s Aid Society Model

Community Schools in Action ◽

10.1093/oso/9780195169591.003.0028 ◽

2005 ◽

Author(s):

Janice Chu-Zhu

Keyword(s):

New York ◽

Technical Assistance ◽

The United States ◽

Culturally Sensitive ◽

Community Schools ◽

Community Based ◽

Program Fidelity ◽

Wide Range ◽

Core Components ◽

The One

When the CAS community schools first opened in New York City in 1992, they attracted many visitors interested in learning about and adapting our model. In response CAS created its National Technical Assistance Center for Community Schools (NTACCS) in 1994 to handle the increasing number of requests for information, coordinate the large number of visitors to the schools, and provide technical assistance in the process and operations involved in creating a community school. People who wish to adapt our model can now tour the various components of our program and meet with our staff to ask questions and learn about the implementation of our program. This chapter will explore the core components of the CAS model and how adaptation sites in the United States and other countries have been able to incorporate elements that represent their signature style and reflect the needs of their individual communities. An immediate dilemma occurs when program planners seek to learn from the experience of others—should they try to replicate the model precisely or should they try to adapt it to their own local circumstances? Replicators often speak of the importance of “program fidelity,” while adaptors talk about differing needs among various communities and populations. The National Institute of Mental Health (NIMH) astutely assesses the dilemma: “While individual tailoring may account for success at a given location, there is pressing need for theoretically grounded interventions that will be effective in a wide range of communities. Therein lies a challenge. On the one hand, ‘replication’ implies fidelity to the original while, on the other hand, ‘community-based and culturally sensitive’ implies expectation of variation and sensitivity to that variation. The need to vary interventions is widely accepted, but systematically developed and articulated only occasionally.” The NIMH study found two key components that improved the effectiveness of HIV prevention programs as they were implemented in multiple sites around the country. One component was that they were “community-based,” designed with the input and skills of the particular communities in which they were implemented. The second was that the programs were “culturally sensitive”—that is, they reflected the needs and cultures of the individuals expected to participate in the intervention and used media and messages relevant to those individuals and their lives.

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Assessing the effectiveness of nutrition interventions implemented among US college students to promote healthy behaviors: A systematic review

Nutrition and Health ◽

10.1177/0260106018785528 ◽

2018 ◽

Vol 24 (3) ◽

pp. 171-181 ◽

Cited By ~ 7

Author(s):

Andrea M Brace ◽

Fernanda CD De Andrade ◽

Bobbi Finkelstein

Keyword(s):

College Students ◽

Healthy Eating ◽

Protective Factor ◽

Dietary Habits ◽

Overweight And Obesity ◽

Healthy Weight ◽

Methodological Issues ◽

Nutrition Interventions ◽

Healthy Behaviors

Background: Nutrition interventions are used to increase knowledge, change attitudes and beliefs about healthy eating, to increase skills, and promote healthy eating. Aims: To review the effectiveness of published nutrition interventions implemented among college students to promote healthy behaviors. Methods: The authors explored multiple electronic databases, such as ERIC, Science Direct, and EBSCOhost. Search criteria included nutritional interventions implemented among students attending US colleges, written in English, and published in peer-reviewed journals between 2000 and 2015. The authors conducted a systematic search of 1413 articles, and an in-depth review of 30 articles. The authors evaluated the following: (a) participants; (b) research design; (c) assessment instruments; (d) outcome measures; (e) results; and (f) methodological issues. Results: Short-term interventions showed promise in promoting positive dietary changes, which can serve as a protective factor for developing overweight and obesity. Methodological issues related to lack of comparison groups and minimal long-term follow-up do not allow researchers to determine if the interventions were the cause of the change, or if these changes are sustained over time. Studies that have a comparison group, use visual displays, or have longer durations, may maximize outcomes, improving long-term effects. Conclusions: Nutrition interventions can effectively change dietary habits among college students. This can lead to healthy weight management and reduce the risk for overweight and obesity. Future research should consider the highlighted methodological issues to improve the quality of nutrition interventions.

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Assessing the Public Health Impact of Developmental Origins of Health and Disease (DOHaD) Nutrition Interventions

Annals of Nutrition and Metabolism ◽

10.1159/000365024 ◽

2014 ◽

Vol 64 (3-4) ◽

pp. 226-230 ◽

Cited By ~ 20

Author(s):

Maria Luisa Garmendia ◽

Camila Corvalan ◽

Ricardo Uauy

Keyword(s):

Public Health ◽

Health Impact ◽

Public Health Impact ◽

Developmental Origins ◽

Nutrition Interventions ◽

The Public ◽

Health And Disease

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SIPsmartER delivered through rural, local health districts: adoption and implementation outcomes

BMC Public Health ◽

10.1186/s12889-019-7567-6 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Kathleen J. Porter ◽

Donna Jean Brock ◽

Paul A. Estabrooks ◽

Katelynn M. Perzynski ◽

Erin R. Hecht ◽

...

Keyword(s):

Implementation Strategy ◽

Implementation Strategies ◽

Health Impact ◽

Dissemination And Implementation ◽

High Fidelity ◽

Local Health ◽

Implementation Outcomes ◽

Phone Calls ◽

Adoption And Implementation ◽

Health Districts

Abstract Background SIPsmartER is a 6-month evidenced-based, multi-component behavioral intervention that targets sugar-sweetened beverages among adults. It consists of three in-person group classes, one teach-back call, and 11 automated phone calls. Given SIPsmartER’s previously demonstrated effectiveness, understanding its adoption, implementation, and potential for integration within a system that reaches health disparate communities is important to enhance its public health impact. During this pilot dissemination and implementation trial, SIPsmartER was delivered by trained staff from local health districts (delivery agents) in rural, Appalachian Virginia. SIPsmartER’s execution was supported by consultee-centered implementation strategies. Methods In this mixed-methods process evaluation, adoption and implementation indicators of the program and its implementation strategy (e.g., fidelity, feasibility, appropriateness, acceptability) were measured using tracking logs, delivery agent surveys and interviews, and fidelity checklists. Quantitative data were analyzed with descriptive statistics. Qualitative data were inductively coded. Results Delivery agents implemented SIPsmartER to the expected number of cohorts (n = 12), recruited 89% of cohorts, and taught 86% of expected small group classes with > 90% fidelity. The planned implementation strategies were also executed with high fidelity. Delivery agents completing the two-day training, pre-lesson meetings, fidelity checklists, and post-lesson meetings at rates of 86, 75, 100, and 100%, respectively. Additionally, delivery agents completed 5% (n = 3 of 66) and 10% (n = 6 of 59) of teach-back and missed class calls, respectively. On survey items using 6-point scales, delivery agents reported, on average, higher feasibility, appropriateness, and acceptability related to delivering the group classes (range 4.3 to 5.6) than executing missed class and teach-back calls (range 2.6 to 4.6). They also, on average, found the implementation strategy activities to be helpful (range 4.9 to 6.0). Delivery agents identified strengths and weakness related to recruitment, lesson delivery, call completion, and the implementation strategy. Conclusions In-person classes and the consultee-centered implementation strategies were viewed as acceptable, appropriate, and feasible and were executed with high fidelity. However, implementation outcomes for teach-back and missed class calls and recruitment were not as strong. Findings will inform the future full-scale dissemination and implementation of SIPsmartER, as well as other evidence-based interventions, into rural health districts as a means to improve population health.

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Oral Health Impact Profile Scale Applied to Periodontal Disease: Relationship with Sociodemographic Variables in General Population and Clinic Samples from Monterrey, Mexico

The Open Dentistry Journal ◽

10.2174/1874210601812011152 ◽

2018 ◽

Vol 12 (1) ◽

pp. 1152-1161

Author(s):

Norma Idalia Rodríguez Franco ◽

José Moral de la Rubia

Keyword(s):

Oral Health ◽

General Population ◽

Periodontal Disease ◽

Marital Status ◽

Discriminant Validity ◽

Protective Factor ◽

Health Impact ◽

Oral Health Impact Profile ◽

Sociodemographic Variables ◽

Two Samples

Background:The Oral Health Impact Profile applied to Periodontal Disease (OHIP-14-PD) shows good metric properties and great potential for its application in research and clinical practice.Objective:To evaluate OHIP-14-PD capability to detect associations with sociodemographic variables, to verify whether the OHIP-14-PD can differentiate between a General Population Sample (GPS) and a Dental Clinic Sample (DCS), and to establish whether there are interaction effects between the two samples and sociodemographic variables.Methods:The OHIP-14-PD was applied to two non-probability samples of 249 dental patients and 256 general adult population from Monterrey, Mexico. A validation study was done with a non-experimental cross-sectional design.Results:Occupation and age were related to OHIP-14-PD, although this last variable was redundant with the first one. In the GPS, the subjective socioeconomic status had a negative correlation with the OHIP-14-PD, but not in the DCS. The marital status showed significant association in DCS and significant interaction with the samples. Being married acted as a risk factor in the DCS, but as a protective factor in the GPS. Sex and education level were independent of the OHIP-14-PD. The expectation of discriminant validity of the OHIP-14-PD between the two samples was confirmed.Conclusion:We conclude that the OHIP-14-PD presented evidence of discriminant validity. Its relation to sociodemographic variables was limited, being more related to occupation and marital status.

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The Canadian 24-Hour Movement Guidelines for Children and Youth: Implications for practitioners, professionals, and organizations

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0086 ◽

2016 ◽

Vol 41 (6 (Suppl. 3)) ◽

pp. S328-S335 ◽

Cited By ~ 13

Author(s):

Amy E. Latimer-Cheung ◽

Jennifer L. Copeland ◽

Jonathon Fowles ◽

Lori Zehr ◽

Mary Duggan ◽

...

Keyword(s):

Public Health ◽

Service Provision ◽

Interdisciplinary Collaboration ◽

Vigorous Physical Activity ◽

Implementation Strategies ◽

Health Impact ◽

Children And Youth ◽

Dissemination And Implementation ◽

Evaluation Plan

The new Canadian 24-Hour Movement Guidelines for Children and Youth emphasize the integration of all movement behaviours that occur over a whole day (i.e., light, moderate, and vigorous physical activity, sedentary behaviour, and sleep). These guidelines shift the paradigm away from considering each behaviour in isolation. This concept of the “whole day matters” not only calls for a change in thinking about movement but also for redevelopment of dissemination and implementation practice. Past guideline launch activities largely have aimed to create awareness through passive dissemination strategies (e.g., Website posts, distribution of print resources). For the integrated guidelines to have public health impact, we must move beyond dissemination and raising of awareness to implementation and behaviour change. Shifting this focus requires new, innovative approaches to intervention, including interdisciplinary collaboration, policy change, and refocused service provision. The purpose of this paper is to identify practitioners, professionals, and organizations with potential to disseminate and/or implement the guidelines, discuss possible implementation strategies for each of these groups, and describe the few resources being developed and those needed to support dissemination and implementation efforts. This discussion makes readily apparent the need for a well-funded, comprehensive, long-term dissemination, implementation, and evaluation plan to ensure uptake and activation of the guidelines.

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