Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation
Abstract Background Connect for Health is an evidence-based weight management program with clinical- and family-facing components for delivery in pediatric primary care for families of children ages 2 to 12 years. We used the Consolidated Framework for Implementation Research (CFIR) to guide formati...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-020-00047-z |
| _version_ | 1818669162625499136 |
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| author | Meg Simione Holly M. Frost Rachel Cournoyer Fernanda Neri Mini Jackie Cassidy Cassie Craddock Jennifer Moreland Jessica Wallace Joshua Metlay Caroline J. Kistin Kerry Sease Simon J. Hambidge Elsie M. Taveras |
| author_facet | Meg Simione Holly M. Frost Rachel Cournoyer Fernanda Neri Mini Jackie Cassidy Cassie Craddock Jennifer Moreland Jessica Wallace Joshua Metlay Caroline J. Kistin Kerry Sease Simon J. Hambidge Elsie M. Taveras |
| author_sort | Meg Simione |
| collection | DOAJ |
| description | Abstract Background Connect for Health is an evidence-based weight management program with clinical- and family-facing components for delivery in pediatric primary care for families of children ages 2 to 12 years. We used the Consolidated Framework for Implementation Research (CFIR) to guide formative work prior to national implementation. The purpose of this study was to describe the process and results of stakeholder engagement and program adaptation. Methods We used mixed qualitative and quantitative methods to iteratively adapt and optimize the program by assessing needs and perspectives of clinicians and parents, as well as contextual barriers, facilitators, and organizational readiness for the uptake of the proposed program tools and implementation strategies. We conducted interviews with primary care clinicians from four health care organizations in Boston, MA; Denver, CO; and Greenville, SC, and used principles of immersion-crystallization for qualitative analyses. We also conducted surveys of parents of children with a body mass index ≥ 85th percentile. Results We reached thematic saturation after 52 clinician interviews. Emergent themes representing the CFIR domains of intervention characteristics, outer and inner setting, and process included (1) importance of evidence-based clinical decision support tools that integrate into the workflow and do not extend visit time, (2) developing resources that respond to family’s needs, (3) using multimodal delivery options for family resources, (4) addressing childhood obesity while balancing competing demands, (5) emphasizing patient care rather than documentation and establishing sustainability plans, and (6) offering multiple training methods that incorporate performance feedback. Of the parents surveyed (n = 400), approximately 50% were Spanish-speaking and over 75% reported an annual income < $50,000. Parents affirmed the importance of addressing weight management during well-child visits, being provided with referrals and resources, and offering multiple methods for resource delivery. Decisions about program modifications were made at the program and healthcare-system level and based on stakeholder engagement findings. Modifications included cultural, geographic, and target audience adaptations, as well as varied resource delivery options. Conclusions To ensure the fit between the Connect for Health program and national implementation settings, adaptations were systematically made through engagement of clinician and parent stakeholders to support adoption, sustainability, and health outcomes. Trial registration NCT04042493 |
| first_indexed | 2024-12-17T06:47:50Z |
| format | Article |
| id | doaj.art-26288ff8b8c7469996034218a419da44 |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-12-17T06:47:50Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-26288ff8b8c7469996034218a419da442022-12-21T21:59:42ZengBMCImplementation Science Communications2662-22112020-06-011111310.1186/s43058-020-00047-zEngaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementationMeg Simione0Holly M. Frost1Rachel Cournoyer2Fernanda Neri Mini3Jackie Cassidy4Cassie Craddock5Jennifer Moreland6Jessica Wallace7Joshua Metlay8Caroline J. Kistin9Kerry Sease10Simon J. Hambidge11Elsie M. Taveras12Division of General Academic Pediatrics, MassGeneral Hospital for ChildrenDenver HealthDivision of General Academic Pediatrics, MassGeneral Hospital for ChildrenDivision of General Academic Pediatrics, MassGeneral Hospital for ChildrenPrisma HealthPrisma HealthDenver HealthDenver HealthDivision of General Internal Medicine, Massachusetts General HospitalDepartment of Pediatrics, Boston Medical CenterPrisma HealthDenver HealthDivision of General Academic Pediatrics, MassGeneral Hospital for ChildrenAbstract Background Connect for Health is an evidence-based weight management program with clinical- and family-facing components for delivery in pediatric primary care for families of children ages 2 to 12 years. We used the Consolidated Framework for Implementation Research (CFIR) to guide formative work prior to national implementation. The purpose of this study was to describe the process and results of stakeholder engagement and program adaptation. Methods We used mixed qualitative and quantitative methods to iteratively adapt and optimize the program by assessing needs and perspectives of clinicians and parents, as well as contextual barriers, facilitators, and organizational readiness for the uptake of the proposed program tools and implementation strategies. We conducted interviews with primary care clinicians from four health care organizations in Boston, MA; Denver, CO; and Greenville, SC, and used principles of immersion-crystallization for qualitative analyses. We also conducted surveys of parents of children with a body mass index ≥ 85th percentile. Results We reached thematic saturation after 52 clinician interviews. Emergent themes representing the CFIR domains of intervention characteristics, outer and inner setting, and process included (1) importance of evidence-based clinical decision support tools that integrate into the workflow and do not extend visit time, (2) developing resources that respond to family’s needs, (3) using multimodal delivery options for family resources, (4) addressing childhood obesity while balancing competing demands, (5) emphasizing patient care rather than documentation and establishing sustainability plans, and (6) offering multiple training methods that incorporate performance feedback. Of the parents surveyed (n = 400), approximately 50% were Spanish-speaking and over 75% reported an annual income < $50,000. Parents affirmed the importance of addressing weight management during well-child visits, being provided with referrals and resources, and offering multiple methods for resource delivery. Decisions about program modifications were made at the program and healthcare-system level and based on stakeholder engagement findings. Modifications included cultural, geographic, and target audience adaptations, as well as varied resource delivery options. Conclusions To ensure the fit between the Connect for Health program and national implementation settings, adaptations were systematically made through engagement of clinician and parent stakeholders to support adoption, sustainability, and health outcomes. Trial registration NCT04042493https://doi.org/10.1186/s43058-020-00047-zChildhood obesityAdaptationsStakeholder engagementPre-implementationImplementation science |
| spellingShingle | Meg Simione Holly M. Frost Rachel Cournoyer Fernanda Neri Mini Jackie Cassidy Cassie Craddock Jennifer Moreland Jessica Wallace Joshua Metlay Caroline J. Kistin Kerry Sease Simon J. Hambidge Elsie M. Taveras Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation Implementation Science Communications Childhood obesity Adaptations Stakeholder engagement Pre-implementation Implementation science |
| title | Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation |
| title_full | Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation |
| title_fullStr | Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation |
| title_full_unstemmed | Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation |
| title_short | Engaging stakeholders in the adaptation of the Connect for Health pediatric weight management program for national implementation |
| title_sort | engaging stakeholders in the adaptation of the connect for health pediatric weight management program for national implementation |
| topic | Childhood obesity Adaptations Stakeholder engagement Pre-implementation Implementation science |
| url | https://doi.org/10.1186/s43058-020-00047-z |
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