Strategies to support implementation of an intervention embedding healthy eating and activity content within community-based home visiting

Embedding evidence-based health interventions within community-based home visiting models offers opportunities to leverage the expertise of these organizations to support reach, trust, and sustainability. This is particularly the case for mothers facing barriers to healthcare access. This study used a Designing for Dissemination and Sustainability approach and the Implementation Strategies Applied in Communities (ISAC) compilation to describe implementation strategies and perspectives of these strategies to support a healthy eating and active living intervention (HEALTH) embedded within Parents as Teachers (PAT), a national community-based home visiting model serving families from pregnancy through early childhood.

Implementation determinants were informed by prior mixed-methods work and stakeholder engagement with the PAT National Center, affiliate staff (supervisors and parent educators), and annual conference participants. An anonymous 5-item survey administered at the 2025 PAT Annual Conference assessed stakeholder perceptions of proposed implementation strategies. Participants rated strategies on perceived impact and feasibility and reported role and community type. Descriptive analyses were conducted.

Forty-nine participants from 18 states completed the survey; most were parent educators. Across strategies, training on implementing the intervention and materials to support supervisors for reflexive supervision were rated as the most impactful and feasible. Communities of practice, parent educator team meetings, and resource connection supports were viewed as highly impactful but somewhat less feasible. Ratings were generally similar across rural and mixed or urban settings, and parent educators often rating strategies as more feasible than supervisors or leaders.

Findings suggest that leveraging existing organizational infrastructure, especially training, reflective supervision, and peer learning supports, may facilitate implementation of health-related interventions in community settings. Stakeholder input was essential for tailoring strategies to workforce role and context. These results can inform future implementation planning for HEALTH and similar interventions embedded in community-based organizations.