Purpose: Building Healthy Families (BHF), a Family Healthy Weight Program (FHWP) that is an adaptation of Epstein’s Traffic Light Diet (TLD) and has been implemented in a Midwestern micropolitan city and successfully achieved clinically and statistically significant reductions in child BMIz scores. FHWP’s reduce child weight status, but for families living in micropolitan cities (<50,000) and rural areas, the availability of inter-disciplinary healthcare teams recommended to deliver FHWPs is low—so adapted interventions with well packaged materials and training resources are necessary to fit the needs of families, and organizations interested in reducing obesity in these regions. The purpose of this project is to describe the development of BHF Online Training and Resource Program package for dissemination to community implementation teams across the US. Methods: We created the BHF Online Training Resources and Program package using a backward design approach to incorporate several instructional design features and adoption and implementation strategies to focus on effectiveness across all user groups. Online training modules were created for each implementation team role including program coordinator and nutrition, physical activity, lifestyle and recruitment coordinators. Additionally, the packaged program includes presentation materials, handouts, and lesson plans that increase the likelihood that the delivery of the program will be consistent across communities. A data portal was built to allow users to track local program effectiveness. Results: An overview video of “What is Building Healthy Families” along with stakeholder presentations and written documentations and contracts have been developed to explain the how and what is needed for implementation. Knowledge checks and self-rated implementation fidelity were high across seven pilot communities. Frequently asked questions and lessons learned from the design process will be discussed. Conclusion: Implementing a program and packaging a program for broad distribution for community implementation requires a different set of skills by the research team and partners. Including enough time for a backward design process increased the acceptability and utility of the platform for rural implementation teams.  Further, developing marketing materials and describing content and feasibility of the digital package is needed to recruit communities.

Purpose: To describe the development and testing of an action learning collaborative implementation strategy to facilitate cross community collaboration to address the reach, effectiveness, adoption, implementation, and maintenance of BHF Online Training Resources and Program Package with (BHF-LC) and without participation in an action learning collaborative (BHF-PO). The BHF-LC includes learning sessions and action periods consisting of activities grounded in evidence-based training principles, community action planning, and structured follow-up. Quarterly learning sessions were attended by all community implementation teams (CIT) and provided opportunities for learning/training, peer sharing, goal setting and planning as a team. Between learning sessions, action periods followed a ‘plan, do, study, and act’ cycle and the research team conducted at least one, 1:1 meeting with each CIT during the action period. 

Methods: Mixed methods process and outcome data were collected during the study. Direct observations were used to track implementation fidelity based on the number of sessions completed, participant attendance, CIT adherence to session activities and objectives, family engagement, and overall quality of implementation. In addition, knowledge checks were used as a proxy for CIT competence across sessions. Finally, child BMI z-scores were recorded using a research-grade scale and stadiometer at 3 months to determine effectiveness.

Results: Reach: Families in the BHF-LC (n=12) condition attended significantly more sessions (94.3%) than those in BHF-PO (n=14 families; 73.7%; p<0.05). Effectiveness: BHF-LC community children had a significantly higher BMI z-score change (-0.15±.08) when compared to those in BHF-PO communities (-0.09±0.11; p<0.05). Implementation: BHF-LC delivered more sessions (11.75/12 vs 10/12) and had stronger adherence to protocol based on objectives (84% vs 72%) and activities (91% vs 73%) by number of sessions completed. Maintenance: All 7 communities planned additional BHF cohorts. Adoption: 28 of 90 rural counties were within the recruitment areas of the 7 CITs identified through our bundled adoption strategy.  

Conclusions: Communities participating in the BHF learning collaborative had higher implementation fidelity, increased confidence in their ability to deliver BHF and increased capacity to sustain BHF.

Purpose: This presentation will provide a community perspective on using the Building Healthy Families (BHF) Online Training Resource and Program Package and participating in the BHF action learning collaborative. 

Rationale: North Platte, Nebraska, is a small regional city of approximately 23,000 people. Childhood obesity was identified as a regional health priority, but no local programs existed to help families with children who were experiencing obesity. To address this need, our community responded to a call for proposals for communities that were interested in delivering a childhood obesity program in small towns and rural areas across Nebraska. The North Platte application was accepted, and the community was provided access to the BHF resources and learning collaborative.

Methods: The North Platte community partners included an integrated healthcare network, the department of health, and school and other community-based organizations. The partnership was provided access to the BHF resources and participated in 9 action learning collaborative sessions over approximately 2 years.  

Results: After initial challenges due to the COVID-19 pandemic, community partners from the health department led the training and implementation of BHF.  Over, they delivered BHF to 2 cohorts of approximately 10 families. Challenges included developing a sustained partnership with leadership in the school district to assist with recruitment and needing to move cohorts back based on pandemic guidance. However, community partners expressed that the BHF Online Resources were easy to use and while the program was complex to implement it was one of the most impactful programs the community leaders had implemented. The action learning collaborative was also helpful to address unique recruitment and implementation challenges such as addressing children being raised in multiple households, address behavioral issues, and make positive adaptations (e.g., celebration when the group achieved 100-pound weight loss).

Conclusions: Having access to the BHF online resources and the action learning collaborative allowed this community to deliver a program it did not have the capacity to deliver previously. The connections with families and across organizations was a highly valued component of the program and North Platte has big plans to sustain BHF, even after the research is completed.