School of Education, University of Colorado Boulder, 1134 CO-93, Boulder, CO, United States of America.
, Present Address: 3077 S Jasmine St, Denver, CO, 80222, United States of America.
Health Res Policy Syst. 2018 Jan 15;16(1):2. doi: 10.1186/s12961-017-0262-0.
This article reports on the development of a systematic approach to assess for community readiness prior to implementation of a behavioural intervention for childhood obesity. Using the Consolidated Framework for Implementation Research (CFIR), we developed research tools to evaluate local community centres' organisational readiness and their capacity to implement the intervention.
Four community Parks and Recreation centres from different states expressed interest in piloting an approach for dissemination and implementation of an evidence-based obesity prevention program for families with young children (Healthier Families). We conducted a mixed methods pre-implementation evaluation using the CFIR to evaluate the alignment of organisational priorities with the Healthier Families programme. Written surveys assessed organisational readiness for change amongst organisational leaders, recreation programmers, and staff (N = 25). Key informant interviews were conducted among staff to assess organisational readiness and with community members to assess community readiness (N = 64). Surveys were analysed with univariate statistics. Interviews were transcribed, coded and analysed using inductive and deductive methods of analysis.
Mixed-methods analysis led to the identification of three key domains on which to assess the organisational readiness to adopt a childhood obesity intervention, namely the physical infrastructure, the knowledge infrastructure, and the social infrastructure. The most critical measure of compatibility was the social infrastructure, since obstacles in the knowledge and physical infrastructures could be overcome by the strength of social resources, including the staff's ingenuity and commitment to a healthier community. This approach guided an assessment of organisational readiness prior to community organisations adopting and preparing to disseminate an obesity prevention community-based program in a wide-range of social and environmental contexts.
Using a comprehensive pre-implementation assessment of the knowledge, physical and social infrastructures in a community is an essential step in effective dissemination for community-based behavioural interventions. Our research found that, when evaluating readiness and alignment, a responsive social infrastructure could provide the capacity to overcome potential barriers to implementation in either the knowledge or physical infrastructures.
本文报告了在实施儿童肥胖行为干预之前，评估社区准备情况的系统方法的发展。我们使用整合实施研究框架（CFIR）开发了研究工具，以评估当地社区中心的组织准备情况及其实施干预的能力。
来自不同州的四个社区公园和娱乐中心对试点一种方法来传播和实施针对有幼儿家庭的循证肥胖预防计划（健康家庭）表现出了兴趣。我们使用 CFIR 进行了混合方法的实施前评估，以评估组织优先事项与健康家庭计划的一致性。书面调查评估了组织领导者、娱乐节目制作人和工作人员的组织变革准备情况（N=25）。对工作人员进行了关键知情人访谈，以评估组织准备情况，并对社区成员进行了访谈，以评估社区准备情况（N=64）。对调查进行了单变量统计分析。对访谈进行了转录、编码和分析，采用了归纳和演绎的分析方法。
混合方法分析确定了评估组织准备采用儿童肥胖干预措施的三个关键领域，即物理基础设施、知识基础设施和社会基础设施。最关键的兼容性衡量标准是社会基础设施，因为知识和物理基础设施中的障碍可以通过社会资源的力量来克服，包括员工的创造力和对更健康社区的承诺。这种方法指导了社区组织在采用和准备在广泛的社会和环境背景下传播基于社区的肥胖预防计划之前，对组织准备情况进行评估。
在社区中使用对知识、物理和社会基础设施的全面实施前评估是社区为基础的行为干预有效传播的必要步骤。我们的研究发现，在评估准备情况和一致性时，响应性强的社会基础设施可以提供克服知识或物理基础设施中潜在实施障碍的能力。
