Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study.
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ABSTRACT:
SUBMITTER: Palinkas LA
PROVIDER: S-EPMC3216853 | biostudies-literature | 2011 Sep
REPOSITORIES: biostudies-literature
Publications
Social networks and implementation of evidence-based practices in public youth-serving systems: a mixed-methods study.
Palinkas Lawrence A LA Holloway Ian W IW Rice Eric E Fuentes Dahlia D Wu Qiaobing Q Chamberlain Patricia P
Implementation science : IS 20110929
<h4>Background</h4>The present study examines the structure and operation of social networks of information and advice and their role in making decisions as to whether to adopt new evidence-based practices (EBPs) among agency directors and other program professionals in 12 California counties participating in a large randomized controlled trial.<h4>Methods</h4>Interviews were conducted with 38 directors, assistant directors, and program managers of county probation, mental health, and child welf ...[more]
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Project description:ObjectiveTo examine the relationship between public health system network density and organizational centrality in public health systems and public health governance, community size, and health status in three public health domains.Data sources/study settingDuring the fall and the winter of 2007-2008, primary data were collected on the organization and composition of eight rural public health systems.Study designMultivariate analysis and network graphical tools are used in a case comparative design to examine public health system network density and organizational centrality in the domains of adolescent health, senior health, and preparedness. Differences associated with public health governance (centralized, decentralized), urbanization (micropolitan, noncore), health status, public health domain, and collaboration area are described.Data collection/extraction methodsSite visit interviews with key informants from local organizations and a web-based survey administered to local stakeholders.Principal findingsGovernance, urbanization, public health domain, and health status are associated with public health system network structures. The centrality of local health departments (LHDs) varies across public health domains and urbanization. Collaboration is greater in assessment, assurance, and advocacy than in seeking funding.ConclusionsIf public health system organization is causally related to improved health status, studying individual system components such as LHDs will prove insufficient for studying the impact of public health systems.
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Project description:BackgroundOnly a few adolescents are meeting their daily vegetable requirement. At the same time, spicy food is increasingly popular and familiar across cultures.ObjectivesTo explore the implementation of spicy vegetables into school meals, the primary objective is to determine adolescents' preferred degree of hot spice on steamed broccoli. Secondary objectives include estimating the appropriateness and acceptability of spicy vegetables in the National School Lunch Program and identifying strategies to promote spicy vegetables within school meals.MethodsOne hundred participants between the age 11 and 17 y sampled 4 steamed broccoli florets with varying levels of a ground red and cayenne pepper spice blend (0, 0.9, 2.0, and 4.0 g). Participants rated their likeability of each broccoli sample on a 9-point hedonic scale and answered a survey assessing chili liking, chili consumption patterns, appropriateness, and acceptability. An interview assessed perspectives on spicy vegetables within school lunch.Regression analyses assessed relationships between participant attributes and sample ratings and survey outcomes. Agglomerative hierarchical cluster analysis was conducted to cluster together participants with similar sample liking ratings.ResultsSeventy-seven percent of participants reported that chili pepper makes food taste better, and 67% consumed spicy food weekly or daily. Chili likers (n = 41) were the dominant cluster group, compared with moderates (n = 31) and chili dislikers (n = 28). Thematic analysis results suggested that most participants support incorporating spicy vegetables into school lunch but mushy vegetable texture may undermine the impact of changing school vegetable spice levels.ConclusionsSpicy foods are commonly consumed by adolescents, and these findings support the inclusion of spicy vegetables in school lunch. Additional research is needed to identify policies and practices to improve the texture of vegetables in school meals and determine additional strategies to support cultural humility in child nutrition programs.
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Project description:BACKGROUND:Generating participant engagement in social media applications for health promotion and disease prevention efforts is vital for their effectiveness and increases the likelihood of effecting sustainable behavior change. However, there is limited evidence regarding effective strategies for engaging Latino immigrant youth using social media. As part of the Avance Center for the Advancement of Immigrant/Refugee Health in Washington, DC, USA, we implemented Adelante, a branded primary prevention program, to address risk factors for co-occurring substance use, sexual risk, and interpersonal violence among Latino immigrant adolescents aged 12 to 19 years in a Washington, DC suburb. OBJECTIVE:The objectives of this study were to (1) characterize Adelante participant Facebook reach and engagement and (2) identify post content and features that resulted in greater user engagement. METHODS:We established the Adelante Facebook fan page in October of 2013, and the Adelante social marketing campaign used this platform for campaign activities from September 2015 to September 2016. We used Facebook Insights metrics to examine reach and post engagement of Adelante Facebook page fans (n=743). Data consisted of Facebook fan page posts between October 1, 2013 and September 30, 2016 (n=871). We developed a 2-phased mixed-methods analytical plan and coding scheme, and explored the association between post content categories and features and a composite measure of post engagement using 1-way analysis of variance tests. P<.05 determined statistical significance. RESULTS:Posts on the Adelante Facebook page had a total of 34,318 clicks, 473 comments, 9080 likes or reactions, and 617 shares. Post content categories that were statistically significantly associated with post engagement were Adelante program updates (P<.001); youth achievement showcases (P=.001); news links (P<.001); social marketing campaign posts (P<.001); and prevention topics, including substance abuse (P<.001), safe sex (P=.02), sexually transmitted disease prevention (P<.001), and violence or fighting (P=.047). Post features that were significantly associated with post engagement comprised the inclusion of photos (P<.001); Spanish (P<.001) or bilingual (P=.001) posts; and portrayal of youth of both sexes (P<.001) portrayed in groups (P<.001) that were facilitated by adults (P<.001). CONCLUSIONS:Social media outreach is a promising strategy that youth programs can use to complement in-person programming for augmented engagement. The Latino immigrant youth audience in this study had a tendency toward more passive social media consumption, having implications for outreach strategies and engagement measurement in future studies. While study findings confirmed the utility of social marketing campaigns for increasing user engagement, findings also highlighted a high level of engagement among youth with posts that covered casual, day-to-day program activity participation. This finding identifies an underexplored area that should be considered for health messaging, and also supports interventions that use peer-to-peer and user-generated health promotion approaches.
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Project description:BackgroundOne goal of health systems seeking to evolve into learning health systems is to accelerate the implementation and sustainment of evidence-based practices (EBPs). As part of this evolution, the Veterans Health Administration (VHA) developed the Innovation Ecosystem, which includes the Diffusion of Excellence (DoE), a program that identifies and diffuses Gold Status Practices (GSPs) across facilities. The DoE hosts an annual "Shark Tank" competition in which leaders bid on the opportunity to implement a GSP with 6 months of implementation support. Over 750 diverse practices were submitted in cohorts 2 and 3 of Shark Tank; 23 were designated GSPs and were implemented in 31 VA networks or facilities. As part of a national evaluation of the DoE, we identified factors contributing to GSP implementation and sustainment.MethodsOur sequential mixed methods evaluation of cohorts 2 and 3 of Shark Tank included semi-structured interviews with at least one representative from 30/31 implementing teams (N = 78/105 people invited) and survey responses from 29/31 teams (N = 39/47 invited). Interviews focused on factors influencing implementation and future sustainment. Surveys focused on sustainment 1.5-2 years after implementation. The Consolidated Framework for Implementation Research (CFIR) informed data collection and directed content analysis. Ordinal scales were developed inductively to rank implementation and sustainment outcomes.ResultsOver 50% of teams (17/30) successfully implemented their GSP within the 6-month implementation period. Despite extensive implementation support, significant barriers related to centralized decision-making, staffing, and resources led to partial (n = 6) or no (n = 7) implementation for the remaining teams. While 12/17 initially successful implementation teams reported sustained use of their GSP, over half of the initially unsuccessful teams (n = 7/13) also reported sustained GSP use 1.5 years after the initial implementation period. When asked at 6 months, 18/27 teams with complete data accurately anticipated their future sustainability based on reported sustainment an average of 1.5 years later.ConclusionsMost teams implemented within 6 months and/or sustained their GSP 1.5 years later. High levels of implementation and sustainment across diverse practices and teams suggest that VHA's DoE is a successful large-scale model of diffusion. Team predictions about sustainability after the first 6 months of implementation provide a promising early assessment and point of intervention to increase sustainability.
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