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An Iterative Process for Training Design and Implementation Increased Health Workers' Knowledge for Taking Nutrition Behavior Change to Scale.

ABSTRACT: BACKGROUND:The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. OBJECTIVE:The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. METHODS:The design and implementation of training followed a 5-phase process: situation analysis, formative research, large-scale feasibility study, redesign and scale up, and evaluation. We conducted document reviews, surveys, and focus groups during the first phases to inform and refine the training, as well as a pre- and posttraining telephone survey to evaluate change in knowledge. RESULTS:The initial phases of the design provided a clear understanding of the opportunities and challenges for promoting infant and young child feeding, as well as health workers' routines and practices, which informed training design. The feasibility study allowed tailoring and refinement of training. The vertical coherence and coordination between the federal and state levels during redesign and scale up facilitated compliance with training timeline and process. Evaluation results showed significant improvement in knowledge posttraining of up to 19 percentage points. CONCLUSIONS:The EsIAN training component for health providers was developed using a systematic approach to consolidate and generate relevant evidence, following an iterative process to test, learn, and improve both design and implementation. This process allowed for flexibility to take advantage of new opportunities and respond to findings from iterations. Garnering and ensuring political support allowed for continuity and sustainability of actions.

SUBMITTER: Gonzalez W

PROVIDER: S-EPMC6887730 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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An Iterative Process for Training Design and Implementation Increased Health Workers' Knowledge for Taking Nutrition Behavior Change to Scale.

Gonzalez Wendy W Bonvecchio Arenas Anabelle A García-Guerra Armando A Vilar-Compte Mireya M Villa de la Vega Alejandría A Quezada Laura L Rosas Cynthia C Lozada-Tequeanes Ana Lilia AL Hernández Amira A

The Journal of nutrition 20191201 Suppl 1

<h4>Background</h4>The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services.<h4>Objective</h4>The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific o ...[more]

PMID: 31793649

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Project description:BackgroundThere is currently no cogent set of standards to guide the design, implementation and evaluation of nutrition social and behavior change (SBC), including for nutrition-sensitive agriculture (NSA).ObjectivesWe aimed to capture, consolidate, and describe SBC core principles and practices (CPPs), reflecting professional consensus, and to offer programmatic examples that illustrate their application for NSA projects in low- and middle-income countries.MethodsWe conducted a narrative review following a 4-step iterative process to identify and describe SBC CPPs. We first reviewed general SBC frameworks and technical documents and developed a preliminary list of CPPs and their definitions. Following review and feedback from 8 content experts, we revised the CPPs, incorporating the panel's feedback, and conducted a more specific search of the peer-reviewed and gray literature. We presented a revised draft of the CPPs to 26 NSA researchers, practitioners, and implementers at the 2022 Agriculture, Nutrition and Health Academy annual conference. We then conducted a focused review of each CPP, and 3 content experts rereviewed the final draft.ResultsWe reviewed ∼475 documents and resources resulting in a set of 4 core principles: 1) following a systematic, strategic method in designing, implementing, and evaluating SBC activities; 2) ensuring design and implementation are evidence-based; 3) grounding design and implementation in theory; and 4) authentically engaging communities. Additionally, we identified 11 core practices and mapped these to the different stages in the SBC design, implementation, and evaluation cycle. Detailed descriptions, illustrative examples and resources for implementation are provided for each CPP.ConclusionsAn explicit set of CPPs for SBC can serve as a guide for design, research, implementation, and evaluation of nutrition and NSA programs; help standardize knowledge sharing and production; and contribute to improved quality of implementation. Broader consultation with SBC practitioners and researchers will further consensus on this work.

Dataset Information

An Iterative Process for Training Design and Implementation Increased Health Workers' Knowledge for Taking Nutrition Behavior Change to Scale.

Publications

An Iterative Process for Training Design and Implementation Increased Health Workers' Knowledge for Taking Nutrition Behavior Change to Scale.

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