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Published on: February 2, 2017
Testing Implementation Strategies for a Family Healthy Weight Program: Results From the Nebraska Childhood Obesity
Jennie L Hill1, Kate A Heelan2, Bryce M Abbey2
1Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.
Background:
Building Healthy Families (BHF) is an adapted family healthy weight program (FHWP) designed for and implemented in rural areas. To increase the likelihood of the broad dissemination and implementation of BHF to other rural communities, the Nebraska Childhood Obesity Research Demonstration 3.0 project developed the BHF Online Training Resources and Program Package (BHF Program Resources). The BHF Program Resources is a "turn-key" online platform that includes a train-the-trainer system, program materials, and a data portal for use by community-based implementation teams.
Methods:
A community-randomized type 3 hybrid effectiveness-implementation pilot study tested the BHF Program Package only (BHF-PO) with and without an action learning collaborative (BHF-LC) to determine relative implementation fidelity and effectiveness among community-based implementation teams. RE-AIM was used for planning and reporting outcomes.
Results:
The BHF-LC communities demonstrated higher implementation fidelity during the core sessions (90.6% vs. 75.8%, p = 0.076), with greater contact hours (17.8 vs. 14.8, p = 0.096). Adoption and Maintenance were successfully achieved but did not differ by the study condition. Children in the BHF-LC communities attended significantly more sessions (79% vs. 69%, p < 0.05, Reach) and showed a greater change in the BMI z-score (-0.15 ± 0.14 vs. -0.08 ± 0.16, p < 0.05, Effectiveness) by 3 months.
Conclusions:
Rural communities can implement the BHF program with fidelity using online resources; however, adding a learning collaborative may improve early implementation quality and child engagement. These findings warrant further testing in a larger trial.
