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Using coincidence analysis to understand implementation of a play-promotion program through a national learning
Rebecca L Emery Tavernier1, Kelly E Coates2, May Oo3
1Weitzman Institute, Moses Weitzman Health System, 1575 I Street NW Washington, DC 20005, USA; University of Minnesota Medical School, Duluth campus, 1035 University Dr, Duluth, MN 55812, USA.
Academic Pediatrics
|July 1, 2026
Summary
High learning session attendance and specific team structures are key for successful implementation of play-promotion programs in pediatric primary care. These factors ensure fidelity in programs like Prescription for Play (P4P).
Area of Science:
- Implementation Science
- Pediatric Primary Care
- Childhood Development
Background:
- Prescription for Play (P4P) is a program designed to enhance early childhood play through caregiver education.
- The P4P Learning Collaborative (LC) was established to facilitate P4P implementation via expert education and coaching.
Purpose of the Study:
- To identify the essential conditions for achieving implementation fidelity within the P4P Learning Collaborative.
- To utilize coincidence analysis (CNA) for identifying necessary and sufficient conditions for program implementation.
Main Methods:
- Twenty teams participated in a 6-month P4P Learning Collaborative.
- Coincidence analysis (CNA) was employed to link organizational characteristics and engagement factors to implementation fidelity.
- Data included team roles (site coordinator, provider champion), practice size, and attendance at learning sessions and coaching calls.
Main Results:
- Two pathways to achieving implementation fidelity were identified: high learning session attendance combined with either a provider champion in an administrative role or operation within a medium-to-large pediatric practice.
- Low learning session attendance was found to be a sufficient condition for not meeting fidelity criteria.
Conclusions:
- Sustained engagement in learning collaboratives and specific enabling factors are crucial for the successful implementation of play-promotion programs.
- Coincidence analysis (CNA) proves effective in pinpointing implementation pathways within pediatric primary care settings.
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