Department of Health and Kinesiology, Texas A&M University, 4243 TAMU, College Station, TX, 77843, USA.
Thrive: Sexual Collective for Youth, 3000 United Founders Blvd #247, Oklahoma City, OK, 73112, USA.
BMC Public Health. 2022 Jan 10;22(1):57. doi: 10.1186/s12889-021-12482-1.
The teenage birth rate in the USA has considerably decreased in recent decades; however, more innovative, collaborative approaches are needed to promote adolescent health and prevent teenage pregnancy at the community level. Despite literature on the promising results of the collective impact (CI) model for health promotion, there is limited literature on the model's ability to reduce teenage pregnancies in a community. The Central Oklahoma Teen Pregnancy Prevention Collaboration is applying the CI model to foster collaboration among multiple stakeholders with the goal of increasing community and organizational capacity to improve adolescent health outcomes. This paper reports the findings from the initiative's implementation evaluation, which sought to understand whether the CI model improved collaboration among organizations and understand barriers and facilitators that affected program delivery.
Program implementers and evaluators jointly developed research questions to guide the intervention and evaluation design. The Consolidated Framework for Implementation Research (CFIR) was used to assess program components including the intervention characteristics, organization setting, community setting, facilitator characteristics, and the process of implementation. Primary sources of data included performance measures, meeting observations (n = 11), and semi-structured interviews (n = 10). The data was thematically analyzed using CFIR constructs, community capacity domains, and the five constructs of CI.
Key findings include the need for shortened meeting times for meaningful engagement, opportunities for organizations to take on more active roles in the Collaboration, and enhanced community context expertise (i.e., those with lived experience) in all Collaboration initiatives. We identified additional elements to the core constructs of CI that are necessary for successful implementation: distinct role identification for partner organizations and incorporation of equity and inclusivity into collaboration processes and procedures.
Results from this implementation evaluation provide valuable insights into implementation fidelity, participant experience, and implementation reach of an innovative, systems-level program. Findings demonstrate the context and requirements needed to successfully implement this innovative program approach and CI overall. Additional core elements for CI are identified and contribute to the growing body of literature on successful CI initiatives.
美国的青少年生育率在最近几十年大幅下降；然而，需要更具创新性和协作性的方法，在社区层面促进青少年健康并预防青少年怀孕。尽管有关于集体影响（CI）模式促进健康的有希望结果的文献，但关于该模式在社区中减少青少年怀孕的能力的文献有限。中美洲俄克拉荷马州青少年怀孕预防合作组织正在应用 CI 模式，促进多个利益相关者之间的合作，旨在增强社区和组织能力，改善青少年健康结果。本文报告了该倡议实施评估的结果，该评估旨在了解 CI 模式是否改善了组织之间的合作，并了解影响项目交付的障碍和促进因素。
项目实施者和评估人员共同制定了研究问题，以指导干预和评估设计。使用实施研究综合框架（CFIR）评估了计划的组成部分，包括干预措施的特征、组织背景、社区背景、促进者特征以及实施过程。主要数据来源包括绩效指标、会议观察（n=11）和半结构访谈（n=10）。使用 CFIR 结构、社区能力领域和 CI 的五个结构对数据进行主题分析。
主要发现包括需要缩短会议时间以进行有意义的参与、为组织提供更多机会在合作中发挥更积极的作用、以及增强社区背景专业知识（即有生活经验的人）在所有合作倡议中的作用。我们确定了 CI 的核心结构的其他要素，这些要素对于成功实施是必要的：合作组织的明确角色识别以及将公平性和包容性纳入合作过程和程序。
这项实施评估的结果提供了有关创新系统层面计划的实施保真度、参与者经验和实施范围的宝贵见解。研究结果展示了成功实施这种创新计划方法和总体 CI 所需的背景和要求。确定了 CI 的其他核心要素，并为成功的 CI 倡议的不断发展的文献做出了贡献。
