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Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study

BACKGROUND: The purpose of this paper is to report on the implementation of an evidence-based model, VIVA, which was developed to translate physical activity (PA) recommendations to rural environments and was scaled-up to 12 rural communities across New Mexico. Our longitudinal qualitative research...

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Autores principales: Hess, Julia Meredith, Davis, Sally M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088558/
https://www.ncbi.nlm.nih.gov/pubmed/37056648
http://dx.doi.org/10.3389/fpubh.2023.1032662
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author Hess, Julia Meredith
Davis, Sally M.
author_facet Hess, Julia Meredith
Davis, Sally M.
author_sort Hess, Julia Meredith
collection PubMed
description BACKGROUND: The purpose of this paper is to report on the implementation of an evidence-based model, VIVA, which was developed to translate physical activity (PA) recommendations to rural environments and was scaled-up to 12 rural communities across New Mexico. Our longitudinal qualitative research describes processes of planned adaptation in the rural context with an exploration of inner and outer context adaptations that consider important implementation constructs including leadership, partnership and collaboration. MATERIALS & METHODS: An enhanced version of the RE-AIM framework was used to formulate community-level engagement and process questions essential to implementation science. Qualitative methods, using a thematic approach that included both inductive and deductive coding with attention to processes, was used to explore adaptation at the community level. Data included semi-structured interviews with 17 community leaders at baseline and 10 at follow-up, fieldnotes, and technical assistance tracking forms. Analysis was conducted with NVivo qualitative data analysis software. RESULTS: Analysis demonstrated how planned adaptation of the implementation model was critical to dissemination in rural communities. Understanding and adapting to local context—including geography, culture, economics—is essential for implementation. Inner context constructs, recognized as important across implementation models, including leadership, partnerships and political engagement were found to be key to implementation success. Moreover, we provide concrete examples of the range and complexity of these issues in rural communities, and how these shaped implementation uptake and success. DISCUSSION: Studying processes of planned adaptation in rural contexts will further implementation science efforts to move evidence into practice. It is essential to incorporate planned adaptation to local, community contexts to create models which are simple to encourage adoption, are evidence-based, and are adaptable to local conditions without compromising the integrity of the evidence-based model.
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spelling pubmed-100885582023-04-12 Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study Hess, Julia Meredith Davis, Sally M. Front Public Health Public Health BACKGROUND: The purpose of this paper is to report on the implementation of an evidence-based model, VIVA, which was developed to translate physical activity (PA) recommendations to rural environments and was scaled-up to 12 rural communities across New Mexico. Our longitudinal qualitative research describes processes of planned adaptation in the rural context with an exploration of inner and outer context adaptations that consider important implementation constructs including leadership, partnership and collaboration. MATERIALS & METHODS: An enhanced version of the RE-AIM framework was used to formulate community-level engagement and process questions essential to implementation science. Qualitative methods, using a thematic approach that included both inductive and deductive coding with attention to processes, was used to explore adaptation at the community level. Data included semi-structured interviews with 17 community leaders at baseline and 10 at follow-up, fieldnotes, and technical assistance tracking forms. Analysis was conducted with NVivo qualitative data analysis software. RESULTS: Analysis demonstrated how planned adaptation of the implementation model was critical to dissemination in rural communities. Understanding and adapting to local context—including geography, culture, economics—is essential for implementation. Inner context constructs, recognized as important across implementation models, including leadership, partnerships and political engagement were found to be key to implementation success. Moreover, we provide concrete examples of the range and complexity of these issues in rural communities, and how these shaped implementation uptake and success. DISCUSSION: Studying processes of planned adaptation in rural contexts will further implementation science efforts to move evidence into practice. It is essential to incorporate planned adaptation to local, community contexts to create models which are simple to encourage adoption, are evidence-based, and are adaptable to local conditions without compromising the integrity of the evidence-based model. Frontiers Media S.A. 2023-03-28 /pmc/articles/PMC10088558/ /pubmed/37056648 http://dx.doi.org/10.3389/fpubh.2023.1032662 Text en Copyright © 2023 Hess and Davis. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Hess, Julia Meredith
Davis, Sally M.
Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study
title Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study
title_full Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study
title_fullStr Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study
title_full_unstemmed Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study
title_short Planned adaptation and implementation of the Community Guide recommendations for increasing physical activity in rural community settings: A qualitative study
title_sort planned adaptation and implementation of the community guide recommendations for increasing physical activity in rural community settings: a qualitative study
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088558/
https://www.ncbi.nlm.nih.gov/pubmed/37056648
http://dx.doi.org/10.3389/fpubh.2023.1032662
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