Slemming Wiedaad, Drysdale Roisin, Richter Linda M
Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
Front Public Health. 2021 Jan 8;8:589870. doi: 10.3389/fpubh.2020.589870. eCollection 2020.
The study (HPHB) augments a routine service (pregnancy ultrasound) with information about fetal and infant development and the importance of parent wellbeing and infant care, to assess whether it will improve child development and growth, parent-infant attachment, parental wellbeing and routine clinic attendance. This paper outlines the process of intervention development and implementation in a complex environment with multiple stakeholders. Study participants were recruited from pregnant women attending fetal ultrasound (US) at Chris Hani Baragwanath Hospital (CHBH), Soweto, South Africa. Partners were invited to attend all sessions. The HPHB intervention, a novel combination of a health and a parenting intervention that augments a routine service (US), is being tested through a randomized controlled trial with outcome assessments at 6 weeks and 6 months follow-up. The current study outlines the process of moving from intervention design to full implementation in a high-risk clinical setting. Formative research informed the design and content of the intervention materials. Implementation is monitored through weekly reports and team meetings as well as formal and informal feedback received from staff and participants. Close collaborations with clinicians enhanced recruitment practices and provided clinical oversight of the trial procedures. Ongoing stakeholder engagement informed intervention procedures and strategies to address challenges that arise during implementation. This study emphasizes the importance of dynamic, inclusive and interactive approaches to intervention development and implementation, as well as the purposeful use of varied information from diverse sources in decision-making for effective implementation.
“健康亲子关系促进项目”（HPHB）在常规服务（孕期超声检查）基础上，增加了有关胎儿及婴儿发育以及父母健康和婴儿护理重要性的信息，以评估其是否能改善儿童发育与成长、亲子依恋关系、父母健康状况以及常规门诊就诊率。本文概述了在一个有多个利益相关者的复杂环境中进行干预措施开发与实施的过程。研究参与者从南非索韦托克里斯·哈尼·巴拉格瓦纳特医院（CHBH）接受胎儿超声检查（US）的孕妇中招募。其伴侣也被邀请参加所有环节。“健康亲子关系促进项目”干预措施是一种将健康干预与育儿干预相结合的创新方式，它强化了常规服务（超声检查），目前正通过一项随机对照试验进行测试，在6周和6个月随访时进行结果评估。本研究概述了在高风险临床环境中从干预设计到全面实施的过程。形成性研究为干预材料的设计和内容提供了依据。通过每周报告、团队会议以及从工作人员和参与者那里收到的正式和非正式反馈来监测实施情况。与临床医生的密切合作改进了招募工作，并为试验程序提供了临床监督。持续的利益相关者参与为干预程序和应对实施过程中出现的挑战的策略提供了信息。本研究强调了采用动态、包容和互动的方法进行干预开发与实施的重要性，以及在决策以实现有效实施时，有目的地利用来自不同来源的各种信息的重要性。
