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A stitch in time saves nine? A repeated cross-sectional case study on the implementation of the intersectoral community approach Youth At a Healthy Weight.

van der Kleij RM, Crone MR, Paulussen TG, van de Gaar VM, Reis R - BMC Public Health (2015)

Bottom Line: We advise multiple 'stitches in time'; tailoring implementation strategies to specific implementation phases and sectors using both the results from this study and a mutual adaptation strategy in which professionals are involved in the development of implementation strategies.The results of this study show that the implementation process of IACOs is complex and sustainable implementation is difficult to achieve.Moreover, this study reveals that the implementation process is influenced by predominantly sector and implementation phase specific (causal configurations of) determinants.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Postbus 9600 zone V-0-P 2300 RC, Leiden, The Netherlands. m.j.j.van_der_kleij@lumc.nl.

ABSTRACT

Background: The implementation of programs complex in design, such as the intersectoral community approach Youth At a Healthy Weight (JOGG), often deviates from their application as intended. There is limited knowledge of their implementation processes, making it difficult to formulate sound implementation strategies.

Methods: For two years, we performed a repeated cross-sectional case study on the implementation of a JOGG fruit and water campaign targeting children age 0-12. Semi-structured observations, interviews, field notes and professionals' logs entries were used to evaluate implementation process. Data was analyzed via a framework approach; within-case and cross-case displays were formulated and key determinants identified. Principles from Qualitative Comparative Analysis (QCA) were used to identify causal configurations of determinants per sector and implementation phase.

Results: Implementation completeness differed, but was highest in the educational and health care sector, and higher for key than additional activities. Determinants and causal configurations of determinants were mostly sector- and implementation phase specific. High campaign ownership and possibilities for campaign adaptation were most frequently mentioned as facilitators. A lack of reinforcement strategies, low priority for campaign use and incompatibility of own goals with campaign goals were most often indicated as barriers.

Discussion: We advise multiple 'stitches in time'; tailoring implementation strategies to specific implementation phases and sectors using both the results from this study and a mutual adaptation strategy in which professionals are involved in the development of implementation strategies.

Conclusion: The results of this study show that the implementation process of IACOs is complex and sustainable implementation is difficult to achieve. Moreover, this study reveals that the implementation process is influenced by predominantly sector and implementation phase specific (causal configurations of) determinants.

No MeSH data available.


Overview of the framework by Saunders et al. [27]
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Fig1: Overview of the framework by Saunders et al. [27]

Mentions: Research took place from the start of the campaign in December 2011 until its ending in July of 2014. As suggested by Saunders et al. [27] (Fig. 1), we first performed an inventory of the campaign’s setup (t0, research phase A) (Fig. 2). A blue print of the campaign design, setup and activities was then formulated. The implementation of the campaign was evaluated (research phase B, t1-t5) in five subsequent waves that coincided with ‘the booster months’ for either the water or fruit theme. For analytical purposes, we considered the first six months of campaigning as initial implementation, followed by mid-way implementation between 7–18 months, and continued implementation between 19–30 months. Thus, if an organization participated in the campaign from the start, initial implementation was assessed during t1, mid-way implementation during t2 and t3, and continued implementation during t4 and t5. A member check was obtained at t6 (research phase C).Fig. 1


A stitch in time saves nine? A repeated cross-sectional case study on the implementation of the intersectoral community approach Youth At a Healthy Weight.

van der Kleij RM, Crone MR, Paulussen TG, van de Gaar VM, Reis R - BMC Public Health (2015)

Overview of the framework by Saunders et al. [27]
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4597380&req=5

Fig1: Overview of the framework by Saunders et al. [27]
Mentions: Research took place from the start of the campaign in December 2011 until its ending in July of 2014. As suggested by Saunders et al. [27] (Fig. 1), we first performed an inventory of the campaign’s setup (t0, research phase A) (Fig. 2). A blue print of the campaign design, setup and activities was then formulated. The implementation of the campaign was evaluated (research phase B, t1-t5) in five subsequent waves that coincided with ‘the booster months’ for either the water or fruit theme. For analytical purposes, we considered the first six months of campaigning as initial implementation, followed by mid-way implementation between 7–18 months, and continued implementation between 19–30 months. Thus, if an organization participated in the campaign from the start, initial implementation was assessed during t1, mid-way implementation during t2 and t3, and continued implementation during t4 and t5. A member check was obtained at t6 (research phase C).Fig. 1

Bottom Line: We advise multiple 'stitches in time'; tailoring implementation strategies to specific implementation phases and sectors using both the results from this study and a mutual adaptation strategy in which professionals are involved in the development of implementation strategies.The results of this study show that the implementation process of IACOs is complex and sustainable implementation is difficult to achieve.Moreover, this study reveals that the implementation process is influenced by predominantly sector and implementation phase specific (causal configurations of) determinants.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Postbus 9600 zone V-0-P 2300 RC, Leiden, The Netherlands. m.j.j.van_der_kleij@lumc.nl.

ABSTRACT

Background: The implementation of programs complex in design, such as the intersectoral community approach Youth At a Healthy Weight (JOGG), often deviates from their application as intended. There is limited knowledge of their implementation processes, making it difficult to formulate sound implementation strategies.

Methods: For two years, we performed a repeated cross-sectional case study on the implementation of a JOGG fruit and water campaign targeting children age 0-12. Semi-structured observations, interviews, field notes and professionals' logs entries were used to evaluate implementation process. Data was analyzed via a framework approach; within-case and cross-case displays were formulated and key determinants identified. Principles from Qualitative Comparative Analysis (QCA) were used to identify causal configurations of determinants per sector and implementation phase.

Results: Implementation completeness differed, but was highest in the educational and health care sector, and higher for key than additional activities. Determinants and causal configurations of determinants were mostly sector- and implementation phase specific. High campaign ownership and possibilities for campaign adaptation were most frequently mentioned as facilitators. A lack of reinforcement strategies, low priority for campaign use and incompatibility of own goals with campaign goals were most often indicated as barriers.

Discussion: We advise multiple 'stitches in time'; tailoring implementation strategies to specific implementation phases and sectors using both the results from this study and a mutual adaptation strategy in which professionals are involved in the development of implementation strategies.

Conclusion: The results of this study show that the implementation process of IACOs is complex and sustainable implementation is difficult to achieve. Moreover, this study reveals that the implementation process is influenced by predominantly sector and implementation phase specific (causal configurations of) determinants.

No MeSH data available.