Community readiness assessment for obesity research: pilot implementation of the Healthier Families programme

Abstract

BackgroundThis article reports on the development of a systematic approach to assess for community readiness prior to implementation of a behavioural intervention for childhood obesity. Using the Consolidated Framework for Implementation Research (CFIR), we developed research tools to evaluate local community centres’ organisational readiness and their capacity to implement the intervention.MethodsFour community Parks and Recreation centres from different states expressed interest in piloting an approach for dissemination and implementation of an evidence-based obesity prevention program for families with young children (Healthier Families). We conducted a mixed methods pre-implementation evaluation using the CFIR to evaluate the alignment of organisational priorities with the Healthier Families programme. Written surveys assessed organisational readiness for change amongst organisational leaders, recreation programmers, and staff (N = 25). Key informant interviews were conducted among staff to assess organisational readiness and with community members to assess community readiness (N = 64). Surveys were analysed with univariate statistics. Interviews were transcribed, coded and analysed using inductive and deductive methods of analysis.ResultsMixed-methods analysis led to the identification of three key domains on which to assess the organisational readiness to adopt a childhood obesity intervention, namely the physical infrastructure, the knowledge infrastructure, and the social infrastructure. The most critical measure of compatibility was the social infrastructure, since obstacles in the knowledge and physical infrastructures could be overcome by the strength of social resources, including the staff’s ingenuity and commitment to a healthier community. This approach guided an assessment of organisational readiness prior to community organisations adopting and preparing to disseminate an obesity prevention community-based program in a wide-range of social and environmental contexts.ConclusionsUsing a comprehensive pre-implementation assessment of the knowledge, physical and social infrastructures in a community is an essential step in effective dissemination for community-based behavioural interventions. Our research found that, when evaluating readiness and alignment, a responsive social infrastructure could provide the capacity to overcome potential barriers to implementation in either the knowledge or physical infrastructures.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-017-0262-0) contains supplementary material, which is available to authorized users.

A rural community moves closer to sustainable obesity prevention - an exploration of community readiness pre and post a community-based participatory intervention

“…The Tri-ethnic Center for Prevention Research developed the first standard methodology (Community Readiness Tool (CRT)) for describing and assessing community readiness [11]. The CRT has been used to help communities address a range of public health problems including tobacco control [12], HIV [13] and obesity [14–16].…”

Application of an Implementation Science Framework to Policies on Immediate Postpartum Long-Acting Reversible Contraception

“…Teams in our study may have benefited from incorporating the CFIR earlier in the process, as with a recent study that applied the CFIR in a preimplementation assessment. 23 Examining facilitators, barriers, and strategies according to the CFIR domains may help states anticipate barriers for which facilitators or strategies have not been identified or may not apply to their context. In our study, the cost of immediate postpartum LARC devices was a major barrier for many states.…”

“…Teams in our study may have benefited from incorporating the CFIR earlier in the process, as with a recent study that applied the CFIR in a preimplementation assessment. 23…”

Using Implementation Science to Improve Transition for Adolescents and Young Adults with Sickle Cell Disease

“…12 The framework has been widely used to evaluate pre, post, and ongoing implementation processes. 13,14 It has been used across a wide variety of studies, settings, and units of analysis. 15 While the CFIR framework offers a comprehensive taxonomy of factors influencing intervention planning and implementation, a mixed deductive-inductive approach has been used to address the challenge that CFIR domains and constructs may not capture all emergent themes in qualitative assessment.…”