Division of Pediatric Health Outcomes Research, MassGeneral Hospital for Children, Boston, MA, USA.
Division of Gastroenterology and Nutrition, MassGeneral Hospital for Children, Boston, MA, USA.
Child Obes. 2021 Sep;17(S1):S48-S54. doi: 10.1089/chi.2021.0177.
Although proven effective interventions for childhood obesity exist, there remains a substantial gap in the adoption of recommended practices by clinicians. The aims are to: (1) package implementation and training supports to facilitate the adoption of the evidence-based Pediatric Weight Management Intervention (PWMI) (based on three previous effectiveness trials); (2) pilot and evaluate the packaged PWMI; and (3) develop a sustainability and dissemination plan. We used the Consolidated Framework of Implementation Research constructs to create an Implementation Research Logic Model that defined the facilitators and barriers of the PWMI. We linked these constructs to implementation strategies and mechanisms. Packaging and design will be informed by the core essential components and functions of the PWMI along with stakeholder engagement. Once the package is complete, we will pilot the PWMI by using a Type III effectiveness-implementation hybrid design. Implementation outcomes will be evaluated by using the RE-AIM framework. We will create an integrated, multisystems level package for national dissemination. The package will include training and a suite of resources for primary care physicians and healthy weight clinic staff, including: patient and caregiver facing videos, patient and caregiver handouts, group curriculum guide, online provider trainings, and access to a virtual learning collaborative. The results will highlight the extent to which the package of the PWMI facilitates the adoption of effective strategies for treating childhood obesity. Lessons learned will inform modifications to the PWMI and strategies for future scaling.
尽管已经有了经过验证的有效干预儿童肥胖的方法,但临床医生在采用推荐实践方面仍存在很大差距。其目的是:(1) 整合实施和培训支持,以促进基于证据的儿科体重管理干预 (PWMI) 的采用(基于之前的三项有效性试验);(2) 试点和评估包装后的 PWMI;(3) 制定可持续性和推广计划。我们使用实施研究综合框架的构建来创建一个实施研究逻辑模型,该模型定义了 PWMI 的促进因素和障碍。我们将这些结构与实施策略和机制联系起来。包装和设计将由 PWMI 的核心基本组成部分和功能以及利益相关者的参与来提供信息。一旦包装完成,我们将使用 III 型有效性-实施混合设计来试点 PWMI。将使用 RE-AIM 框架评估实施结果。我们将创建一个集成的、多系统层面的全国推广包。该包装将包括培训和一系列针对初级保健医生和健康体重诊所工作人员的资源,包括:面向患者和照顾者的视频、患者和照顾者的讲义、小组课程指南、在线提供者培训以及访问虚拟学习协作。结果将突出显示 PWMI 包在多大程度上促进了有效治疗儿童肥胖策略的采用。所吸取的经验教训将为 PWMI 的修改和未来的扩展提供信息。