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Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation

BACKGROUND: To describe the identification, adaptation, and testing of an evidence-based pediatric weight management program for a health disparate community. METHODS: A community advisory board (CAB) of decision-makers and staff from local health care, public health, and recreation organizations en...

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Autores principales: Hill, Jennie L., Zoellner, Jamie M., You, Wen, Brock, Donna J., Price, Bryan, Alexander, Ramine C., Frisard, Madlyn, Brito, Fabiana, Hou, Xiaolu, Estabrooks, Paul A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352451/
https://www.ncbi.nlm.nih.gov/pubmed/30696420
http://dx.doi.org/10.1186/s12889-019-6450-9
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author Hill, Jennie L.
Zoellner, Jamie M.
You, Wen
Brock, Donna J.
Price, Bryan
Alexander, Ramine C.
Frisard, Madlyn
Brito, Fabiana
Hou, Xiaolu
Estabrooks, Paul A.
author_facet Hill, Jennie L.
Zoellner, Jamie M.
You, Wen
Brock, Donna J.
Price, Bryan
Alexander, Ramine C.
Frisard, Madlyn
Brito, Fabiana
Hou, Xiaolu
Estabrooks, Paul A.
author_sort Hill, Jennie L.
collection PubMed
description BACKGROUND: To describe the identification, adaptation, and testing of an evidence-based pediatric weight management program for a health disparate community. METHODS: A community advisory board (CAB) of decision-makers and staff from local health care, public health, and recreation organizations engaged with academic partners to select an evidence-based program (EBP) for local implementation. Three EBPs were identified (Traffic Light, Bright Bodies, Golan and colleagues Home Environmental Model) and each EBP was rated on program characteristics, implementation and adaptation, and adoptability. Following selection of the EBP that was rated highest, the POPS-CAB made adaptations based on the program principles described in peer-reviewed publications. The adapted intervention, iChoose, was then pilot tested in 3 iterative phases delivered initially by research partners, then co-delivered by research and community partners, then delivered by community partners. The RE-AIM framework was used to plan and evaluate the iChoose intervention across all waves with assessments at baseline, post program (3 months), and follow-up (6 months). RESULTS: Bright Bodies rated highest on program characteristics and adoptability (p’s < 0.05), while Home Environmental Model rated highest on implementation factors (p < 0.05). Qualitatively, the selection focused on important program characteristics and on matching those characteristics to the potential to fit within the community partner services. The adapted program—iChoose—had 18% reach and with participants that were representative of the target population on age, gender, ethnicity, and race. Effectiveness was demonstrated by modest, but significant reductions in BMI z-scores at post-program compared to baseline (M(Δ) = − 0.047; t = − 2.11, p = 0.046). This decrease returned to values similar to baseline 3 months (M(Δ) = 0.009) after the program was completed. Implementation fidelity was high and implementation fidelity did not differ between community or research delivery agents. CONCLUSION: The process to help organizations identify and select evidence-based programs appropriate for their community led to consensus on a single EBP. While iChoose was successful in initiating changes in BMI z-scores, could be implemented in a low resource community with fidelity, it was insufficient to lead to sustained child BMI z-scores. In response to these data, maintenance of program effects and delivery are the current focus of the CBPR team.
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spelling pubmed-63524512019-02-06 Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation Hill, Jennie L. Zoellner, Jamie M. You, Wen Brock, Donna J. Price, Bryan Alexander, Ramine C. Frisard, Madlyn Brito, Fabiana Hou, Xiaolu Estabrooks, Paul A. BMC Public Health Research Article BACKGROUND: To describe the identification, adaptation, and testing of an evidence-based pediatric weight management program for a health disparate community. METHODS: A community advisory board (CAB) of decision-makers and staff from local health care, public health, and recreation organizations engaged with academic partners to select an evidence-based program (EBP) for local implementation. Three EBPs were identified (Traffic Light, Bright Bodies, Golan and colleagues Home Environmental Model) and each EBP was rated on program characteristics, implementation and adaptation, and adoptability. Following selection of the EBP that was rated highest, the POPS-CAB made adaptations based on the program principles described in peer-reviewed publications. The adapted intervention, iChoose, was then pilot tested in 3 iterative phases delivered initially by research partners, then co-delivered by research and community partners, then delivered by community partners. The RE-AIM framework was used to plan and evaluate the iChoose intervention across all waves with assessments at baseline, post program (3 months), and follow-up (6 months). RESULTS: Bright Bodies rated highest on program characteristics and adoptability (p’s < 0.05), while Home Environmental Model rated highest on implementation factors (p < 0.05). Qualitatively, the selection focused on important program characteristics and on matching those characteristics to the potential to fit within the community partner services. The adapted program—iChoose—had 18% reach and with participants that were representative of the target population on age, gender, ethnicity, and race. Effectiveness was demonstrated by modest, but significant reductions in BMI z-scores at post-program compared to baseline (M(Δ) = − 0.047; t = − 2.11, p = 0.046). This decrease returned to values similar to baseline 3 months (M(Δ) = 0.009) after the program was completed. Implementation fidelity was high and implementation fidelity did not differ between community or research delivery agents. CONCLUSION: The process to help organizations identify and select evidence-based programs appropriate for their community led to consensus on a single EBP. While iChoose was successful in initiating changes in BMI z-scores, could be implemented in a low resource community with fidelity, it was insufficient to lead to sustained child BMI z-scores. In response to these data, maintenance of program effects and delivery are the current focus of the CBPR team. BioMed Central 2019-01-29 /pmc/articles/PMC6352451/ /pubmed/30696420 http://dx.doi.org/10.1186/s12889-019-6450-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hill, Jennie L.
Zoellner, Jamie M.
You, Wen
Brock, Donna J.
Price, Bryan
Alexander, Ramine C.
Frisard, Madlyn
Brito, Fabiana
Hou, Xiaolu
Estabrooks, Paul A.
Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
title Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
title_full Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
title_fullStr Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
title_full_unstemmed Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
title_short Participatory development and pilot testing of iChoose: an adaptation of an evidence-based paediatric weight management program for community implementation
title_sort participatory development and pilot testing of ichoose: an adaptation of an evidence-based paediatric weight management program for community implementation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352451/
https://www.ncbi.nlm.nih.gov/pubmed/30696420
http://dx.doi.org/10.1186/s12889-019-6450-9
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