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

Swindle, Taren; Johnson, Susan L.; Davenport, Karen; Whiteside-Mansell, Leanne; Thirunavukarasu, Thirosha; Sadasavin, Gireesh; Curran, Geoffrey M.

doi:10.1016/j.jneb.2019.06.019

Cited by 21 publications

(20 citation statements)

References 70 publications

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“…Results from this study indicate organizational factors like turnover and communication amongst staff may be important influencers of parent engagement. Staff turnover is a recognized barrier to program implementation in ECE settings and beyond (Swindle et al, 2019). Results from the present study invite consideration of effects of turnover beyond program implementation.…”

Section: Discussionmentioning

confidence: 99%

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Barriers and Facilitators of Parent Engagement With Health Promotion in Child Care: A Mixed-Methods Evaluation

2020

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Background Early care and education providers cite lack of parent engagement as a central barrier to promoting healthy behaviors among young children. However, little research exists about factors influencing parent engagement with promoting healthy eating and activity behaviors in the this setting. Aims This study aimed to address this gap by examining low and high parent engagement with the Healthy Me, Healthy We campaign to identify barriers and facilitators of parent engagement with the intervention. Method This comparative case study used an explanatory sequential mixed-methods approach. We created center-level parent engagement scores using process evaluation data from the effectiveness trial of Healthy Me, Healthy We. Recruitment focused on centers with the five lowest and five highest scores. Twenty-eight adults (7 directors, 9 teachers, 12 parents) from seven centers (3 low engagement, 4 high engagement) completed semistructured interviews and the Family and Provider/Teacher Relationship Quality measure. Analytic approaches included descriptive statistical analyses for surveys and a framework-informed thematic analysis for interviews. Results Prominent contrasts between low- and high-engagement groups involved center culture for parent engagement and health promotion, practices for fostering networks and communication within centers, and communication between centers and parents. Personal attributes of providers (e.g., attitudes) also differentially influenced practices for engaging parents. Discussion and Conclusion Organizational characteristics and individual practices can facilitate or impede parent engagement with health promotion efforts. Assessing organizational context, gaining input from all stakeholders, and conducting capacity-building interventions may be critical for laying the foundation for positive relationships that support parent engagement in implementation of health promotion programs and beyond.

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Section: Discussionmentioning

confidence: 99%

“…It may also affect communication and relationship-building processes that are fundamental for high-quality parent engagement. Workforce development and administrative support may be important strategies for reducing staff turnover (Hale-Jinks et al, 2006; Swindle et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Barriers and Facilitators of Parent Engagement With Health Promotion in Child Care: A Mixed-Methods Evaluation

2020

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“…More recently, mixed methodology has been used to gain further understandings from nutrition trials undertaken in ECEC services. Swindle and colleagues undertook a mixed-method analysis with early childhood educators to understand the barriers and facilitators to the implementation fidelity of a nutrition intervention in ECEC services in the US [ 105 ]. The study employed semi-structured interviews and a directed content analysis approach informed by the integrated Promoting Action on Research Implementation in Health Service framework [ 105 , 106 ].…”

Section: Resultsmentioning

confidence: 99%

An Overview of Research Opportunities to Increase the Impact of Nutrition Intervention Research in Early Childhood and Education Care Settings According to the RE-AIM Framework

Yoong

Jones

Pearson

et al. 2021

IJERPH

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Objective: To highlight opportunities for future nutrition intervention research within early childhood and education care (ECEC) settings, with a focus on generating evidence that has applicability to real-world policy and practice. Methods: An overview of opportunities to progress the field was developed by the authors using a collaborative writing approach and informed by recent research in the field. The group developed a list of recommendations aligned with the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Pairs of authors drafted individual sections of the manuscript, which were then reviewed by a separate pair. The first and senior author consolidated all sections of the manuscript and sought critical input on the draft iterations of the manuscript. Results: Interventions that employ digital platforms (reach) in ECEC settings, as well as research in the family day care setting (effectiveness) were identified as areas of opportunities. Research understanding the determinants of and effective strategies for dissemination (adoption), the implementation of nutrition programs, in addition to de-implementation (implementation) of inappropriate nutrition practices, is warranted. For maintenance, there is a need to better understand sustainability and the sustainment of interventions, in addition to undertaking policy-relevant research. Conclusions: The ECEC setting is prime for innovative and practical nutrition intervention research.

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“…Hospitals with an average score over 4 will be categorized as high implementers, while hospitals with an average score less than or equal to 4 will be categorized as low implementers. Similar to previous research, these cutoff points were determined based on minimally accepted practices derived from discussion and consensus within the research group (Swindle et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Implementation of a Calorie Menu Labeling Policy in Public Hospitals: Study Protocol for a Multiple Case Study

Kerins

Houghton

McHugh

et al. 2019

International Journal of Qualitative Methods

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Background: Promotion of good nutrition is essential for reducing the risk of chronic disease and premature death. Evidence shows menu labeling interventions should be implemented in workplaces as part of a comprehensive approach to improve employees’ dietary habits; however, implementation challenges have arisen. This article describes a protocol for a multiple case study to explore the factors that impact on implementation of a calorie menu labeling policy in Irish public hospitals. Methods: Using a multiple case study design, comprising four Irish acute public hospitals, this study will draw on multiple perspectives and sources of evidence (observations followed by interviews, focus groups, and documentary analysis) to allow for a comprehensive depth and breadth of inquiry. Data collection and analysis will be guided by the Consolidated Framework for Implementation Research, bringing together constructs from implementation theories to understand the complexity of implementing policies. Hospitals will be categorized into high and low implementers of the policy based on quantitative data obtained from structured observations. Using framework analysis, within- and cross-case analyses will be performed to identify factors influencing policy implementation and to identify distinguishing patterns across high and low implementers and across hospital direct and indirect stakeholders. Strategies will be employed to ensure rigorous case study research, for example, triangulation, audit trail, reflexivity, and thick descriptions. An integrated knowledge translation approach, where researchers work with stakeholders throughout the research process, will be adopted to facilitate the translation of research into policy and practice. Discussion: This protocol highlights methodological insights in utilizing case study research to gain a greater understanding of the menu labeling implementation process. Study findings will be relevant to policy makers and other stakeholders involved in the rollout of such interventions and will provide a foundation to select and tailor implementation strategies to assist with scale-up of calorie menu labeling across the health service.

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

Cited by 21 publications

References 70 publications

Barriers and Facilitators of Parent Engagement With Health Promotion in Child Care: A Mixed-Methods Evaluation

Barriers and Facilitators of Parent Engagement With Health Promotion in Child Care: A Mixed-Methods Evaluation

An Overview of Research Opportunities to Increase the Impact of Nutrition Intervention Research in Early Childhood and Education Care Settings According to the RE-AIM Framework

Implementation of a Calorie Menu Labeling Policy in Public Hospitals: Study Protocol for a Multiple Case Study

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