Objectives and Design. There is growing recognition of the need for effective behaviour change interventions to prevent chronic diseases that are feasible and sustainable and can be implemented within routine health care systems. Focusing on implementation from the outset of intervention development, and incorporating multiple stakeholder perspectives to achieve this, is therefore essential. This study explores the development of the Choosing Healthy Eating for Infant Health (CHErIsH) childhood obesity prevention intervention and implementation strategy to improve infant feeding behaviours.Methods. Five qualitative and quantitative evidence syntheses, two primary qualitative studies, and formal/informal consultations were conducted with practice, policy, Results. The CHErIsH intervention targets parent-level behaviour change and comprises (1) brief verbal messages and (2) trustworthy resources, to be delivered by health care professionals (HCPs) during routine infant vaccination visits. The implementation strategy targets HCP-level behaviour change and comprises (1) a local opinion leader, (2) incentivized training, (3) HCP resources and educational materials, (4) electronic delivery prompts, (5) awareness-raising across all primary care HCPs, and (6) local technical support.Conclusions. This study provides a rigorous example of the development of an evidence-based intervention aimed at improving parental infant feeding behaviours, alongside an evidence-based behaviour change strategy to facilitate implementation and sustainability in primary care. This approach demonstrates how to systematically incorporate multiple stakeholder perspectives with existing literature and move from multiple evidence sources to clearly specified intervention components for both the intervention and implementation strategy. Statement of ContributionWhat is already known?Incorporating insights from practice, policy, and public/patient stakeholders plays a key role in developing behaviour change interventions that are feasible and sustainable and can be implemented within routine health care systems. However, there are limited examples that provide in-depth guidance of how to do this using a systematic approach.

Purpose Dementia is a complex, progressively degenerative condition. It results in loss of cognitive and functional capabilities, along with a significant increase in the level of dependency. A reduction in the use of pharmacological interventions correlates with an increased in good quality non-pharmacological interventions in dementia care. The purpose of this study is to examine the impact of 14-session face-to-face cognitive stimulation therapy (CST) and Sonas group interventions on individuals living with dementia with moderate cognitive impairment, from pre-intervention to post-intervention in terms of their cognition, communication, neuropsychiatric symptoms, activities of daily living and quality of life. Design/methodology/approach A pilot single blind prospective controlled trial evaluated two group intervention approaches, cognitive stimulation therapy (CST) and Sonas, with 28 participants with moderate dementia. Pseudorandomisation and single blinding were implemented. CST has a solid evidence base. Sonas is a widely used multi-sensory intervention in Ireland with an emerging evidence base. Participants were recruited from a mental health service. Participants who had a formal diagnosis of dementia, moderate cognitive impairment and some ability to communicate and understand communication were included. Findings Results supported CST to a greater extent than Sonas. The CST group showed significant changes in cognition (p = 0.032) and communication (p = 0.006). Both groups had significant changes in carer quality of life (CST, p = 0.019; Sonas, p = 0.035). Results support the recommendations for a future definitive trial. Research limitations/implications Rehabilitation potential of individuals living with moderate dementia was demonstrated. This study suggests that group interventions like these impact on the trajectory of dementia. Practical implications Rehabilitation interventions impact on the trajectory of dementia. CST and Sonas have no impact on activities of daily living. Future studies with larger sample sizes, 16 weeks intervention period and control groups are required. Social implications This pilot study supports CST over Sonas interventions for individuals living with moderate dementia. Multiple outcome measures demonstrated trends towards significance for both interventions. Future definitive trials may detect a significant effect of both interventions. Originality/value A dementia diagnosis is devastating and generally creates negative perceptions and associations (Alvira, 2014). In contrast, the outcomes of this study are positive. This study provides evidence that occupational therapist intervention can impact on the trajectory of the condition with people with dementia demonstrating that they do have rehabilitation potential by responding to treatment and improving and maintaining their abilities as they progress through the condition.

Objective: This study aims to (1) investigate current practice regarding ‘weaning workshops’ to support complementary infant feeding delivered within Irish primary care, (2) explore the experiences and opinions of community dietitians regarding optimal content and modes of delivery of weaning workshops and (3) identify the key factors to be considered in the development and implementation of weaning workshops delivered within primary care. Design: Cross-sectional survey. Setting: Irish primary care. Participants: Forty-seven community-based dietitians. Results: Sixteen dietitians reported that workshops were run in their area with variable frequency, with ten reporting that workshops were never run in their area. Participants reported that mostly mothers of medium socio-economic status (SES) attended weaning workshops when infants were aged between 4 and 7 months, and that feedback from workshop attendees was predominantly positive. Dietitians identified that key factors to be considered in future development and delivery of weaning workshops are (1) workshop characteristics such as content, timing and venue, (2) organisational characteristics such as availability of resources and multidisciplinary involvement and (3) attendee characteristics such as SES. Conclusions: This study highlights substantial variability regarding provision of weaning workshops in Ireland, and a lack of standardisation regarding the provider, content and frequency of workshops where workshops are being delivered. The study also provides unique insights into the experiences and opinions of primary care community dietitians regarding the development and delivery of weaning workshops in terms of optimal content and delivery options. These perspectives will make a valuable contribution given the dearth of evidence in this area internationally.

ObjectiveThis study aims to 1) investigate current practice regarding ‘weaning workshops’ to support complementary infant feeding delivered within Irish primary care, 2) explore the experiences and opinions of community dietitians regarding optimal content and modes of delivery of weaning workshops, and 3) identify the key factors to be considered in the development and implementation of weaning workshops delivered within primary care.DesignCross-sectional surveySettingIrish primary careParticipants47 community-based dietitiansResultsSixteen dietitians reported that workshops were run in their area with variable frequency, with ten reporting that workshops were never run in their area. Participants reported that mostly mothers of medium socioeconomic status attended weaning workshops when infants were aged between 4-7 months, and that feedback from workshop attendees was predominantly positive. Dietitians identified that key factors to be considered in future development and delivery of weaning workshops are 1) workshop characteristics such as content, timing and venue, 2) organisational characteristics such as availability of resources and multidisciplinary involvement, and 3) attendee characteristics such as socioeconomic status.ConclusionsThis study highlights substantial variability regarding provision of weaning workshops in Ireland, and a lack of standardisation regarding the provider, content, and frequency of workshops where workshops are being delivered. The study also provides unique insights into the experiences and opinions of primary care community dietitians regarding the development and delivery of weaning workshops in terms of optimal content and delivery options. These perspectives will make a valuable contribution given the dearth of evidence in this area internationally.