Haughton Jessica, Takemoto Michelle L, Schneider Jennifer, Hooker Steven P, Rabin Borsika, Brownson Ross C, Arredondo Elva M
Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA 92123 USA.
ServiceNow, 3260 Jay St, Santa Clara, CA USA.
Implement Sci Commun. 2020 Jun 8;1:51. doi: 10.1186/s43058-020-00043-3. eCollection 2020.
Community engagement is critical to the acceleration of evidence-based interventions into community settings. Harnessing the knowledge and opinions of community leaders increases the likelihood of successful implementation, scale-up, and sustainment of evidence-based interventions. () is an evidence-based -led physical activity program designed to increase moderate-to-vigorous physical activity among churchgoing Latina women.
We conducted in-depth interviews using a semi-structured interview guide based on the Consolidated Framework for Implementation Research (CFIR) at various Catholic and Protestant churches with large Latino membership in San Diego County, California to explore barriers and facilitators to implementation of and identify promising implementation strategies for program scale-up and dissemination. We interviewed 22 pastors and church staff and analyzed transcripts using an iterative-deductive team approach.
Pastors and church staff described barriers and facilitators to implementation within three domains of CFIR: characteristics of individuals (lack of self-efficacy for and knowledge of physical activity; influence on churchgoers' behaviors), inner setting (church culture and norms, alignment with mission and values, competing priorities, lack of resources), and outer setting (need for buy-in from senior leadership). From the interviews, we identified four promising implementation strategies for the scale-up of faith-based health promotion programs: (1) health behavior change training for pastors and staff, (2) tailored messaging, (3) developing community collaborations, and (4) gaining denominational support.
While churches can serve as valuable partners in health promotion, specific barriers and facilitators to implementation must be recognized and understood. Addressing these barriers through targeted implementation strategies at the adopter and organizational level can facilitate improved program implementation and lead the way for scale-up and dissemination.
社区参与对于将循证干预措施加速引入社区环境至关重要。利用社区领袖的知识和意见可增加循证干预措施成功实施、扩大规模及持续开展的可能性。（某项目名称）是一项以循证为导向的体育活动项目，旨在增加去教堂做礼拜的拉丁裔女性的中等到剧烈体育活动量。
我们在加利福尼亚州圣地亚哥县拥有大量拉丁裔成员的不同天主教和新教教堂，使用基于实施研究综合框架（CFIR）的半结构化访谈指南进行了深入访谈，以探讨（某项目名称）实施的障碍和促进因素，并确定项目扩大规模和传播的有前景的实施策略。我们采访了22名牧师和教会工作人员，并采用迭代演绎团队方法分析了访谈记录。
牧师和教会工作人员在CFIR的三个领域描述了实施的障碍和促进因素：个体特征（缺乏体育活动的自我效能感和知识；对礼拜者行为的影响）、内部环境（教会文化和规范、与使命和价值观的契合度、相互竞争的优先事项、资源匮乏）和外部环境（需要获得高层领导的支持）。通过访谈，我们确定了扩大基于信仰的健康促进项目规模的四个有前景的实施策略：（1）对牧师和工作人员进行健康行为改变培训，（2）量身定制信息，（3）发展社区合作，（4）获得教派支持。
虽然教会可以成为健康促进中有价值的合作伙伴，但必须认识和理解实施过程中的具体障碍和促进因素。通过在采用者和组织层面采取有针对性的实施策略来解决这些障碍，可以促进项目实施得到改善，并为扩大规模和传播铺平道路。
