Related Experiment Video
Updated: Jul 12, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Stakeholders' perception of factors influencing adoption of a pediatric weight management intervention: a qualitative
Desiree Sierra-Velez1, Anisha Gundewar2, Alicia Persaud3
1Division of Pediatric Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA, United States.
Insights
Adopting pediatric weight management interventions (PWMIs) requires understanding facilitators like positive learning climates and adaptable models. Addressing social determinants of health and adapting to challenges like COVID-19 are crucial for reaching at-risk children.
Area of Science:
- Implementation Science
- Public Health
- Pediatric Medicine
Background:
- Childhood obesity disproportionately affects minority and low-income communities, with disparities exacerbated by the COVID-19 pandemic.
- Effective pediatric weight management interventions (PWMIs) are needed, particularly those evaluated in diverse, low-income populations.
- The Healthy Weight Clinic PWMI, developed by the American Academy of Pediatrics and Massachusetts General Hospital, offers a tested, multidisciplinary approach.
Purpose of the Study:
- To identify factors influencing the successful adoption of the Healthy Weight Clinic PWMI.
- To understand necessary adaptations for implementing PWMIs in new settings.
- To inform strategies for nationwide dissemination of effective PWMIs.
Main Methods:
- Qualitative study involving interviews with 20 stakeholders from pre-implementation and maintenance-stage health centers.
- Interviews guided by the Consolidated Framework for Implementation Research (CFIR).
- Analysis using directed content analysis and Framework for Reporting Adaptations and Modifications-Expanded (FRAME) for pandemic-related adaptations.
Main Results:
- Facilitators for adoption include a positive learning climate, staff willingness to learn, valuing evidence-based care, and culturally sensitive staff.
- Social determinants of health pose barriers, but creative solutions can mitigate them.
- Intervention adaptability, telehealth, and modified content were key adaptations, especially during the COVID-19 pandemic.
Conclusions:
- Understanding adoption factors is key to successful PWMI implementation and adaptation.
- Tailored implementation strategies are essential for reaching at-risk populations.
- Nationwide dissemination of PWMIs can help address childhood obesity disparities.
Background:
Childhood obesity is highly prevalent in the United States and disproportionately impacts communities of color and low-income populations; these disparities have worsened during the COVID-19 pandemic. Adoption of effective pediatric weight management interventions (PWMIs) that have been evaluated among low-income diverse populations is needed. The Healthy Weight Clinic PWMI, a package co-developed by the American Academy of Pediatrics and Massachusetts General Hospital, helps health centers establish multidisciplinary Healthy Weight Clinics based on previous randomized controlled trials which demonstrated effectiveness. We sought to identify the factors influencing successful adoption of this PWMI and understand adaptations needed prior to implementation in new sites.
Methods:
We interviewed 20 stakeholders, 10 from two health centers in Mississippi where the Healthy Weight Clinic PWMI will be piloted (pre-implementation sites) and 10 from health centers that have previously implemented it (sites in maintenance stages). Separate interview guides informed by the Consolidated Framework for Implementation Research (CFIR) were developed for the pre-implementation sites and those in maintenance stages, including questions related to adaptations of the PWMI in response to the COVID-19 pandemic. Qualitative data analysis was conducted using directed content analysis based on CFIR constructs. Adaptations in response to the pandemic were categorized using Framework for Reporting Adaptations and Modifications-Expanded (FRAME).
Results:
In pre-implementation sites, an inner setting facilitator mentioned was a positive learning climate. Characteristics of individuals that can facilitate adoption include staff willingness to learn, valuing evidence-based care for childhood obesity, and culturally and weight-sensitive staff. In terms of patient needs and resources (outer setting), social drivers of health are barriers to adoption, but creative solutions were suggested to mitigate these. Other facilitators related to the intervention included its multidisciplinary model and adaptability. Similar themes were elicited from sites in maintenance stages; adaptations brought on by the pandemic, such as telehealth visits and content modification to align with distancing guidelines and the effects of social isolation were also described.
Conclusion:
Understanding the factors influencing adoption of an evidence-based PWMI informs necessary adaptations and implementation strategies required to facilitate nationwide dissemination of PWMIs, with the goal of reaching the populations most at-risk.
Related Concept Videos
01:29Assessment of the Gastrointestinal System II: Health Perception Pattern
Health Perception Patterns
Health perception patterns offer valuable insights into a patient's lifestyle habits and how they may impact their GI health. These patterns include:
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:23Influence of Parents and Peers on Identity
Parental Influence on Identity Development
Parents serve as primary guides and managers in an adolescent's life, offering support instrumental in decision-making and personal growth....
01:25Role of Communication in the Nursing Process II: Planning and Implementation
01:25Factors Affecting Perception
An illustrative example of a perceptual set is the scenario where an airline pilot told...
01:52Regression Toward the Mean