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Application of an Implementation Framework Using Mixed Methods in Preschool Settings
Charlotte V Farewell1, Emily Bergling1, Emily Maiurro1
1University of Colorado Denver, Aurora, CO, USA.
Insights
Implementing obesity prevention programs in preschools requires understanding provider skills and program adaptability. These factors are key to the successful, long-term sustainability of policy, system, and environment changes.
Area of Science:
- Public Health
- Implementation Science
- Early Childhood Education
Background:
- Childhood obesity is a significant public health concern.
- Preschool settings are critical for early intervention.
- Dissemination and implementation (D&I) frameworks are essential for program success.
Purpose of the Study:
- To investigate factors influencing the implementation and sustainability of obesity prevention programs in preschools.
- To explore individual, organizational, and intervention-level determinants of policy, system, and environment (PSE) changes.
- To understand the role of mixed methods in evaluating D&I efforts.
Main Methods:
- Employed a simultaneous, exploratory, mixed-methods design.
- Studied 20 randomly selected preschool centers.
- Analyzed individual (provider attitudes/skills), organizational (staff/leadership engagement), and intervention (adaptability) factors.
Main Results:
- Provider attitudes and skills significantly correlated with the sustainability of PSE changes (r = .56, p < .01).
- Staff and leadership engagement positively impacted implementation and sustainability.
- Program adaptability was crucial for successful D&I.
Conclusions:
- Successful implementation and sustainability of preschool obesity prevention programs depend on multilevel factors.
- Provider-level factors, particularly attitudes and skills, are vital.
- Interventions must consider organizational support and program flexibility for lasting impact.
Abstract:
Research Findings. Application of mixed methods in a dissemination and implementation framework can give researchers a better understanding of the reach and delivery of early childhood obesity prevention programs in preschool settings, as well as potential facilitators and barriers related to implementation and sustainability. This study utilized a simultaneous, exploratory, mixed-methods design to investigate individual-, organizational-, and intervention-level factors that were related to the implementation and sustainability of policy, system, and environment (PSE) changes as part of a larger obesity prevention program in a randomly selected sample of preschool centers (n = 20). Individual-level factors, and specifically the attitudes and skills of preschool providers, were identified in both the qualitative and quantitative data as important factors related to the sustainability of PSE changes (r = .56, p < .01). Staff and leadership engagement and adaptability of the program were also identified as important factors related to the implementation and sustainability of PSE changes. Practice or Policy. These findings highlight the complexity of implementation success and suggest PSE obesity prevention interventions in preschool centers require the consideration of numerous, multilevel factors to ensure programming is impactful and sustained over time.
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