Dataset Information

A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start.

ABSTRACT: OBJECTIVE:To identify positive and negative deviant cases using quantitative fidelity data from a previous implementation of a nutrition intervention, Together, We Inspire Smart Eating (WISE), and to determine barriers and facilitators to fidelity by conducting qualitative interviews with deviant cases. DESIGN:Explanatory sequential mixed methods. SETTING:Head Start Program agencies in 2 southern US states. PARTICIPANTS:Quantitative fidelity data were collected in 42 Head Start classrooms. Recruitment for qualitative interviews prioritized those who were positive or negative deviants across fidelity components (African American, n?=?21; white, n?=?19; and Hispanic, n?=?3). INTERVENTION:WISE introduces children to fruits and vegetables using evidence-based practices of role modeling, positive feeding, mascot use, and hands-on exposure. ANALYSIS:A directed content analysis approach informed by the integrated Promoting Action on Research Implementation in Health Service framework. PHENOMENON OF INTEREST:Barriers and facilitators to WISE evidence-based practices implementation. RESULTS:Qualitative analyses identified themes of culture, leadership support, and mechanisms for embedding change as key contextual factors. Key findings related to recipient characteristics were beliefs about what works, personalized strategies to use WISE, and classroom management. Primary themes for the innovation construct were time and preparation, degree of fit, and WISE advantage. Finally, findings relative to the construct of facilitation included trainer support and desire for additional training. CONCLUSIONS AND IMPLICATIONS:The study of cases at the extreme ends of the fidelity spectrum can provide unique perspectives on barriers and facilitators to implementation of interventions.

SUBMITTER: Swindle T

PROVIDER: S-EPMC6788974 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start.

Swindle Taren T Johnson Susan L SL Davenport Karen K Whiteside-Mansell Leanne L Thirunavukarasu Thirosha T Sadasavin Gireesh G Curran Geoffrey M GM

Journal of nutrition education and behavior 20190724 9

<h4>Objective</h4>To identify positive and negative deviant cases using quantitative fidelity data from a previous implementation of a nutrition intervention, Together, We Inspire Smart Eating (WISE), and to determine barriers and facilitators to fidelity by conducting qualitative interviews with deviant cases.<h4>Design</h4>Explanatory sequential mixed methods.<h4>Setting</h4>Head Start Program agencies in 2 southern US states.<h4>Participants</h4>Quantitative fidelity data were collected in 42 ...[more]

PMID: 31350198

Similar Datasets

Project description:Childhood obesity is a growing global health concern. Although mobile health apps have the potential to deliver behavioural interventions, their impact is commonly limited by a lack of sufficient engagement. The purpose of this study was to explore barriers and facilitators to engagement with a family-focused app and its perceived impact on motivation, self-efficacy, and behaviour. Parents with at least one child under 18 and healthcare professionals working with children were recruited; all participants were allocated to use the NoObesity app over a 6-month period. The mixed-methods design was based on the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks. Qualitative and quantitative data were gathered through semi-structured interviews, questionnaires, and app use data (logins and in-app self-reported data). 35 parents were included in the final analysis; quantitative results were analysed descriptively and thematic analysis was conducted on the qualitative data. Key barriers to engagement were boredom, forgetting, and usability issues and key barriers to potential impact on behaviours were accessibility, lack of motivation, and family characteristics. Novelty, gamification features, reminders, goal setting, progress monitoring and feedback, and suggestions for healthy foods and activities were key facilitators to engagement with the app and behaviours. A key observation was that intervention strategies could help address many motivation and capability barriers, but there was a gap in strategies addressing opportunity barriers. Without incorporating strategies that successfully mitigate barriers in all three determinants of behaviour, an intervention is unlikely to be successful. We highlight key recommendations for developers to consider when designing the features and implementation of digital health interventions. Trial Registration: ClinicalTrials.gov (NCT05261555).

Project description:BackgroundThe World Health Organization recommends use of multiple approaches to control malaria. The integrated approach to malaria prevention advocates the use of several malaria prevention methods in a holistic manner. This study assessed perceptions and practices on integrated malaria prevention in Wakiso district, Uganda.MethodsA clustered cross-sectional survey was conducted among 727 households from 29 villages using both quantitative and qualitative methods. Assessment was done on awareness of various malaria prevention methods, potential for use of the methods in a holistic manner, and reasons for dislike of certain methods. Households were classified as using integrated malaria prevention if they used at least two methods. Logistic regression was used to test for factors associated with the use of integrated malaria prevention while adjusting for clustering within villages.ResultsParticipants knew of the various malaria prevention methods in the integrated approach including use of insecticide treated nets (97.5%), removing mosquito breeding sites (89.1%), clearing overgrown vegetation near houses (97.9%), and closing windows and doors early in the evenings (96.4%). If trained, most participants (68.6%) would use all the suggested malaria prevention methods of the integrated approach. Among those who would not use all methods, the main reasons given were there being too many (70.2%) and cost (32.0%). Only 33.0% households were using the integrated approach to prevent malaria. Use of integrated malaria prevention by households was associated with reading newspapers (AOR 0.34; 95% CI 0.22 -0.53) and ownership of a motorcycle/car (AOR 1.75; 95% CI 1.03 - 2.98).ConclusionAlthough knowledge of malaria prevention methods was high and perceptions on the integrated approach promising, practices on integrated malaria prevention was relatively low. The use of the integrated approach can be improved by promoting use of multiple malaria prevention methods through various communication channels such as mass media.

Project description:BackgroundApp-based treatment for urinary incontinence is a proven effective and cost-effective alternative to care as usual, but successful implementation requires that we identify and address the barriers and facilitators associated with app use.ObjectiveThe goal of the research was to explore the factors influencing app-based treatment for urinary incontinence and identify which barriers or facilitators are associated with treatment success or failure.MethodsWe used a sequential explanatory mixed methods design to connect the results of a randomized controlled trial with data from semistructured interviews. This previous RCT had shown the noninferiority of app-based treatment compared with care as usual for urinary incontinence over 4 months. Participants who reported success or failure with app-based treatment, as measured by the change in International Consultation on Incontinence Modular Questionnaire Urinary Incontinence Short Form symptom score, were selected for telephone interview by purposive sampling (n=17). This study reports mainly on the qualitative component of our mixed methods study. Qualitative analyses were conducted in two ways. First, we analyzed the qualitative data of all interviewed participants and discussed the relationships between the main themes. Second, the experiences between the success (n=9) and failure group (n=8) were compared and contrasted to explore factors that were positively or negatively associated with the quantitative effect of app-based treatment. These factors were then interpreted as barriers to and facilitators of successful app-based treatment.ResultsFour interrelated themes were identified as affecting the app based treatment effect: adherence, personal factors, app factors, and awareness. Qualitative analyses of the relationships between the themes showed that adherence-related factors directly influenced treatment effect in both a positive and negative matter. In turn, adherence was also positively and negatively influenced by the other 3 themes. Additionally, awareness was positively influenced by the treatment effect. Within these themes, several factors were identified that acted as barriers (eg, unrealistic expectation of time investment and interfering personal circumstances), facilitators (eg, strict integration of exercises and prior pelvic floor muscle therapy), or both (eg, personality traits and increased awareness of symptoms).ConclusionsThis study shows that the effect of app-based treatment for urinary incontinence is mainly influenced by adherence, which in turn is affected by personal factors, app-based factors, and awareness. The identified factors could function as both facilitators and barriers depending on the user and interaction with other themes. Insight into these facilitators and barriers could lead to improved implementation and increased treatment effectiveness by targeting women most likely to benefit and through further development of the app.International registered report identifier (irrid)RR2-10.1002/nau.23507.

Dataset Information

A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start.

Publications

A Mixed-Methods Exploration of Barriers and Facilitators to Evidence-Based Practices for Obesity Prevention in Head Start.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets