Managing the initiation and early implementation of health promotion interventions: a study of a parental support programme in primary care
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Published on: June 6, 2020
Anna Westerlund1, Rickard Garvare2, Monica E Nyström1,3
1Department of Public Health and Clinical Medicine, Epidemiology and Global health, Umeå University, Umeå, Sweden.
Insights
Implementing parental support programs like the International Child Development Programme (ICDP) requires understanding actor views on implementation factors. Clear strategies and context examination are crucial for successful adoption and effectiveness in child mental health prevention.
Area of Science:
- Child and Adolescent Mental Health
- Public Health Interventions
- Program Implementation Science
Background:
- Rising global child and adolescent mental health issues necessitate effective preventive interventions.
- Parental support programs are a key strategy, but adoption and sustainability remain challenges.
- Further research on implementation is vital to enhance program impact.
Purpose of the Study:
- To examine the initial implementation of the International Child Development Programme (ICDP) in primary care settings.
- To investigate stakeholders' perspectives on factors influencing ICDP implementation.
- To identify strategies used to manage implementation challenges.
Main Methods:
- A mixed-methods case study approach was employed, integrating quantitative and qualitative data.
- Data were collected through questionnaires and interviews with 82 professionals.
- Directed content analysis focused on perceived importance and manifestation of implementation factors.
Main Results:
- Professionals reported uncertainty in managing key implementation factors and vague change strategies.
- Discrepancies were noted between perceived importance and actual manifestation of factors like support, resources, and communication.
- Key manifested factors included a need for change, motivation, and program compatibility with existing practices.
Conclusions:
- Thorough pre-implementation analysis of the intervention and context is essential for successful parental support program rollout.
- Developing clear implementation strategies based on this examination can improve adoption and sustainability.
- Insights gained can enhance the effectiveness of health promotion programs in complex settings.
Background:
Mental health problems are increasing among children and adolescents worldwide, and parental support programmes have been suggested as one preventive intervention. However, the actual impact and low rates of adoption and sustainability of prevention programmes have proven to be a concern, and thus, further studies on their implementation are needed.
Aim:
This study focused on the initial implementation of the International Child Development Programme (ICDP) in primary care. The aim was to investigate the involved actors' views on factors likely to affect implementation and the strategies used to manage them.
Design:
A case study design with a mixed-methods approach combining quantitative and qualitative data from questionnaires and interviews was used.
Methods:
Eighty-two professionals at different positions in the involved organisations participated. Directed content analysis was used for analyses, focusing on perceived levels of importance and the manifestation of implementation factors.
Findings:
Interviews and questionnaires provided descriptions of factors influencing the initial ICDP implementation. Uncertainty on how to manage important factors and vague change strategies was reported. Discrepancies in the perceived levels of importance versus manifestation were found regarding several factors, including hands-on support, time and resources, communication and information, a comprehensive plan of action, follow-ups, and external and internal collaborations. Manifested factors were a need for change, motivation and the ICDP's compatibility with existing norms, values and practices.
Conclusions:
Implementing a parental support programme in a complex setting will benefit from being preceded by a thorough examination of the intervention and the target context and the development of clear implementation strategies based on the results of that examination. This study provides insights into how and by whom knowledge on implementation is applied during the launch of a health promotion programme, and these insights might help increase the rate of adoption and the use of such programmes and thereby increase their effectiveness.
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