Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program

BMC Public Health, Aug 2016

Background While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT), an obesity prevention program for parents with infants aged 3–18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers. Methods Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4), policy makers (n = 2) and implementers (n = 22), contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking. Results Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however balancing this with program fidelity was a critical issue. The lack of ongoing funding to support translation activities was a barrier for researchers continued involvement in community implementation. Conclusion Policy makers, researchers and practitioners have important and complementary roles to play in supporting the translation of effective research interventions into practice. New avenues need to be explored to strengthen partnerships between researchers and end users to support the integration of effective public health research interventions into practice.

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Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program

Laws et al. BMC Public Health Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program R. Laws 0 1 K. D. Hesketh 1 K. Ball 0 1 C. Cooper 1 K. Vrljic K. J. Campbell 0 1 0 Centre for Obesity Management and Prevention Research Excellence in Primary Health Care (COMPaRE-PHC) , Sydney , Australia 1 Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University , Geelong, VIC , Australia Background: While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT), an obesity prevention program for parents with infants aged 3-18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers. Methods: Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4), policy makers (n = 2) and implementers (n = 22), contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking. Results: Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however balancing this with program fidelity was a critical issue. The lack of ongoing funding to support translation activities was a barrier for researchers continued involvement in community implementation. Conclusion: Policy makers, researchers and practitioners have important and complementary roles to play in supporting the translation of effective research interventions into practice. New avenues need to be explored to strengthen partnerships between researchers and end users to support the integration of effective public health research interventions into practice. Obesity prevention; Children; Infants; Implementation; Research translation; Dissemination Background It is widely accepted that the transfer of new knowledge from public health research into policy and practice is far from optimal. Government agencies, including the National Institute of Health in the USA emphasise the need for widespread dissemination of evidence-based interventions to help bridge the gap between research and practice [ 1 ]. There is a growing body of literature investigating the translation of public health research into practice [ 2–4 ]. Five main stages of building evidence in public health have been proposed: Stages one and two, Problem definition and Solution generation relate to program development; stage three, intervention testing, represents process and impact evaluation to determine program efficacy or effectiveness; and stage four, intervention replication, refers to subsequent studies in which effective programs are adapted for other settings to determine if and how similar outcomes can be achieved in different places and populations [ 5 ]. Finally stage five, intervention dissemination, focuses on the scaling up of an effective program to population level to maximise public health impact [ 5 ]. Translational research in public health has been defined as studies that focus on stages four and five, that is replication and scaling up of effective interventions [ 5 ]. Scaling up is the process by which health promotion interventions shown to be effective in controlled conditions or on a small scale are expanded into real world practice [ 6 ]. There is growing interest in the concept of ‘scaling up’; however existing literature to date has been limited in focus, for example, investigations of conceptual frameworks [ 6–8 ] or case studies of scaled up programs in low income countries [ 8–10 ]. There are relatively few examples of published studies reporting on the scaling up (...truncated)


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R. Laws, K. Hesketh, K. Ball, C. Cooper, K. Vrljic, K. Campbell. Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program, BMC Public Health, 2016, pp. 748, 16, DOI: 10.1186/s12889-016-3361-x