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Multidisciplinary Approach to Obesity Management: A Case Report
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A Dissemination Strategy to Identify Communities Ready to Implement a Pediatric Weight Management Intervention in
Caitlin A Golden1, Jennie L Hill2, Kate A Heelan3
1University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198-4365.
Insights
A fund and contract strategy successfully engaged rural Nebraska communities for a pediatric weight management program. Communities showed high readiness, but implementation plans need strengthening for successful adoption.
Area of Science:
- Public Health
- Health Services Research
- Community Health
Background:
- Pediatric obesity is a significant public health concern, particularly in rural and underserved areas.
- Effective dissemination strategies are crucial for implementing evidence-based interventions in diverse community settings.
Purpose of the Study:
- To test the feasibility of a fund and contract dissemination strategy to engage rural communities in adopting a pediatric weight management program.
- To identify communities with the resources and motivation for successful intervention implementation and sustainability.
Main Methods:
- A competitive application process was used, including a request for applications distributed statewide.
- Quantitative data included organizational readiness to change assessment (ORCA) scores and community advisory board ratings.
- Qualitative data were gathered from community narratives and application reviews.
Main Results:
- The fund and contract strategy successfully reached 8 communities across Nebraska.
- Organizational readiness to change scores were high across evidence, context, and facilitation domains.
- Lower application scores were linked to weak implementation and sustainability plans.
Conclusions:
- A fund and contract dissemination strategy is feasible for engaging rural communities in pediatric weight management programs.
- Community readiness is high, but strengthening implementation and sustainability plans is essential for successful program translation.
- Findings offer guidance for disseminating interventions in medically underserved geographic areas.
Purpose And Objectives:
We developed a competitive application process to test the feasibility of a fund and contract dissemination strategy to identify and engage communities that demonstrated the necessary resources and motivation to adopt, implement, and sustain a pediatric weight management intervention, Building Healthy Families, in rural and micropolitan (<50,000 residents) communities in Nebraska.
Intervention Approach:
From April through December 2019, a community advisory board with representation from rural and micropolitan clinical, public health, education, and recreational organizations collaboratively developed a request for applications, as a fund and contract dissemination strategy, to encourage community adoption of Building Healthy Families.
Evaluation Methods:
Quantitative assessments included determining the distribution of requests for applications, evaluating organizational readiness to change assessment (ORCA) ratings (on a scale of 1 to 5, from strongly disagree to strongly agree that the organization is ready to change), and reviewing community advisory board member ratings of applications. We gathered qualitative data from community narratives provided in response to the request for applications and community advisory board reviews of the applications.
Results:
The request for applications was distributed to all 93 counties in Nebraska. Of the 8 communities that submitted a letter of intent, 7 submitted a community narrative. Across the 8 communities, 31 ORCAs were completed by the organizational decision makers (n = 15) and staff members (n = 16) who would be responsible for screening, recruiting, or implementing the intervention. Overall mean ORCA scores varied by ratings of evidence (4.1-4.6), context (4.2-4.9), and facilitation (4.3-4.8), indicating a high degree of readiness. Community advisory board ratings of applications ranged from 2.3 to 3.4 of 4 points. Qualitative data indicated that lower community narrative scores were primarily caused by weak implementation and sustainability plans.
Implications For Public Health:
Findings provide guidance for translating pediatric weight management programs in medically underserved geographic areas by maximizing the probability of successful adoption and implementation through a fund and contract dissemination strategy.
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