Application of implementation science frameworks to a community-based healthy eating and activity intervention: a...

To contribute to the growing literature applying implementation science frameworks, this study utilized the Consolidated Framework for Implementation Research (CFIR) and the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) frameworks. Our objectives were to (1) describe surveys used to assess CFIR context and RE-AIM implementation outcomes and (2) explore correlations between constructs within and across the frameworks in a community-based home-visiting organization.

This cross-sectional, baseline secondary analysis was conducted within a cluster-randomized trial partnered with parents as teachers (PAT), a national home-visiting, community-based organization. Guided by CFIR and RE-AIM, parent educators (provider level: seven scales, 26 items) and one leader per site (organization level: 11 scales, 56 items) completed surveys online before beginning the study. Standardized Cronbach coefficient alphas were calculated to reflect internal consistency reliability and intraclass correlation coefficients (ICCs) were used to reflect the agreement among parent educators within sites. Relationships between contextual factors (CFIR), antecedent outcomes (CFIR), and RE-AIM outcomes were calculated using Pearson correlations.

A total of 271 parent educators and 26 site leaders completed the demographic survey. Most parent educators (72.5%) were white and a third of parent educators identified as Hispanic or Latino. Alphas ranged from 0.70 to 0.92 and 0.47 to 0.95 for scales completed by parent educators and site leaders, respectively. There was limited agreement among parent educators within sites; ICCs ranged from 0 to 0.24. Correlations for constructs within CFIR and between CFIR context and CFIR antecedent outcomes were statistically significant, while few correlations with these constructs and those in RE-AIM were statistically significant.

This study demonstrates the application of CFIR, CFIR outcomes addendum, and RE-AIM. Investigators can use these findings to inform future studies incorporating implementation science in nutrition and physical activity research and to examine theoretical relationships between constructs and frameworks.