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An early implementation assessment of Ontario's Healthy Kids Community Challenge: results from a survey of key stakeholders.

ABSTRACT: BACKGROUND:In Ontario Canada, the Healthy Kids Community Challenge (HKCC) is a program intended to reduce the prevalence and prevent childhood overweight and obesity through community-based initiatives to improve health behaviours. Guided by the RE-AIM framework and Durlak and DuPre's Ecological Framework for Understanding Effective Implementation, the evaluation focused on two objectives: 1) to describe the organization of the program at the community level; and, 2) to identify opportunities for improvement through an early assessment of factors contributing to implementation. METHODS:Participants (n?=?320) - members of the HKCC local steering committee, including the local project manager - completed a cross-sectional survey using SurveyMonkey and descriptive statistics were calculated. A sample (20%) of qualitative open-ended responses was thematically analyzed. RESULTS:Results indicated strong respondent agreement that the HKCC enhanced individual knowledge of access to health-promoting programs (88.3%) and messaging regarding healthy behaviours for healthy kids, with less for its effectiveness in reducing weight (53.1%). There was a high-level of adherence to HKCC social marketing messages and overall program structure, with few Local Project Manager reports of adaptations to theme one (9.2%) and theme two messages (15.4%). Fewer Local Project Managers (50%) reported the existence of private partnerships. While most respondents agreed they had the appropriate information to complete mandatory reporting, the usefulness of the HKCC online networking platform was in question (only 47% of Local Project Managers agreed that it was useful). Results reveal sufficient funding from the province to support program implementation, with a moderate level of local political commitment (63% of respondents). CONCLUSIONS:Results indicate that the HKCC was considered beneficial for enhancing access to health promoting programs, could be feasibly implemented with adherence to centrally-developed social marketing messages, and was amendable to local adaptation. Despite this, few private partnerships were reported. Going forward, there is opportunity to further evaluate factors contributing to HKCC program implementation, particularly as it relates to buy-in from intervention providers, and strategies for forming private sector partnerships to support long-term program sustainability.

SUBMITTER: Vine MM

PROVIDER: S-EPMC6880511 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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An early implementation assessment of Ontario's Healthy Kids Community Challenge: results from a survey of key stakeholders.

Vine Michelle M MM Jarvis Jocelyn W JW Chong Eunice E Laxer Rachel E RE Ladak Adam A Manson Heather H

BMC public health 20191127 1

<h4>Background</h4>In Ontario Canada, the Healthy Kids Community Challenge (HKCC) is a program intended to reduce the prevalence and prevent childhood overweight and obesity through community-based initiatives to improve health behaviours. Guided by the RE-AIM framework and Durlak and DuPre's Ecological Framework for Understanding Effective Implementation, the evaluation focused on two objectives: 1) to describe the organization of the program at the community level; and, 2) to identify opportun ...[more]

PMID: 31775742

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Project description:INTRODUCTION:The World Health Organisation recommends HIV self-testing as an alternative testing method to help reach underserved populations, such as men in sub-Saharan Africa. Successful implementation and scale-up of HIV self-testing (HIVST) in Rwanda relies heavily on relevant stakeholders' involvement. We sought to explore HIVST key stakeholders' perceptions of the implementation and scale-up of HIVST in Rwanda. METHOD:We conducted in-depth interviews with personnel involved in HIV response projects in Rwanda between September and November 2019. We purposively sampled and interviewed 13 national-level key stakeholders from the Ministry of Health, Rwanda Biomedical Center, non-governmental organizations and HIV clinics at tertiary health facilities in Kigali. We used a thematic approach to analysis with a coding framework guided by Consolidated Framework for Implementation Research (intervention characteristics, inner setting, outer setting, characteristics of individuals involved in the implementation and the implementation process). RESULTS:Key stakeholders perceived HIVST as a potentially effective initiative, which can be used in order to ensure that there is an improvement in uptake of testing services, especially for underserved populations in Rwanda. The following challenges for implementation and scale-up of HIVST were revealed: lack of awareness of the kits, high cost of the self-test kits, and concerns on results interpretation. Key stakeholders identified the following as prerequisites to the successful implementation and scale-up of HIVST in Rwanda; creation of awareness, training those involved in the implementation process, regulation of the selling of the self-test kits, reduction of the costs of acquiring the self-test kits through the provision of subsidies, and ensuring consistent availability of the self-test kits. CONCLUSIONS:Key stakeholders expressed confidence in HIVST's ability to improve the uptake of HIV testing services. However, they reported challenges, which need to be addressed to ensure successful implementation and scale-up of the HIVST. There is a need for further research incorporating lower level stakeholders to fully understand HIVST implementation and scale-up challenges and strategies to inform policy.

Project description:From 2008 to 2014, the Healthy Kids, Healthy Communities (HKHC) national program funded 49 communities across the United States and Puerto Rico to implement healthy eating and active living policy, system, and environmental changes to support healthier communities for children and families, with special emphasis on reaching children at highest risk for obesity on the basis of race, ethnicity, income, or geographic location. Evaluators designed a mixed-methods evaluation to capture the complexity of the HKHC projects, understand implementation, and document perceived and actual impacts of these efforts. Eight complementary evaluation methods addressed 4 primary aims seeking to (1) coordinate data collection for the evaluation through the web-based project management system (HKHC Community Dashboard) and provide training and technical assistance for use of this system; (2) guide data collection and analysis through use of the Assessment and Evaluation Toolkit; (3) conduct a quantitative cross-site impact evaluation among a subset of community partnership sites; and (4) conduct a qualitative cross-site process and impact evaluation among all 49 community partnership sites. Evaluators identified successes and challenges in relation to the following methods: an online performance-monitoring HKHC Community Dashboard system, environmental audits, direct observations, individual and group interviews, partnership and community capacity surveys, group model building, photographs and videos, and secondary data sources (surveillance data and record review). Several themes emerged, including the value of systems approaches, the need for capacity building for evaluation, the value of focusing on upstream and downstream outcomes, and the importance of practical approaches for dissemination. The mixed-methods evaluation of HKHC advances evaluation science related to community-based efforts for addressing childhood obesity in complex community settings. The findings are likely to provide practice-relevant evidence for public health.

Project description:Background:The demand for solid organ transplantation has spurred countries around the world to search for innovative policies and practices to increase the supply of organs. Spain has become a global reference point for organ donation with the highest transplantation rates. In Ontario, Canada the Ontario Trillium Gift of Life (TGLN) has sought to replicate some of the successes in Spain. In particular, TGLN's implementation of the Physician Leadership Model has been viewed as a promising strategy to improve donation conversion rates. Objective:The objective of this study was to evaluate the implementation of TGLNs (TGLN) Physician Leadership Model by examining critical implementation process variables (education/training, communication, satisfaction, participation and reach). Methods:This mixed-method implementation evaluation included data from all members of the Physician Leadership Model including the Chief Medical Officer, five Regional Medical Leads (RMLs), and the 52 Hospital Donation Physicians (HDPs). Social Network Analysis (SNA) surveys were sent to all 52 HDPs and yielded an 85% rate. Analysis included constructing sociograms and qualitatively analyzing interviews. Results:TGLN's PLM was poised for success by utilizing the existing RMLs' network as a foundation. The social network analysis measures, particularly participation and reach, indicated the PLM was quite dense (ie, the degree to which members are connected) at baseline. HDPs reported communication to be facilitated by their connections to their RMLs. Early evaluative data indicated that lack of education and training was viewed by HDPs as a barrier, and thus more capacity would need to be directed to this issue. Overall, HDPs reported that various intended outcomes were being met. Conclusion:We have demonstrated that an implementation evaluation helps us to understand which elements of the PLM were successful and which elements required immediate attention. This evaluation helped to highlight the successes and challenges in implementing the TGLN Physician Leadership Model in Ontario. Social network analysis of publicly funded capacity building systems has been identified as a promising area for health program evaluation to answer questions at a system level, such as identifying service provisions among information exchange networks and ultimately better health care.

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An early implementation assessment of Ontario's Healthy Kids Community Challenge: results from a survey of key stakeholders.

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An early implementation assessment of Ontario's Healthy Kids Community Challenge: results from a survey of key stakeholders.

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