Purpose: Implementation strategies – methods of moving research to practice – have primarily been developed and studied in clinical settings. As a result, researchers and practitioners in community settings are not fully utilizing implementation strategies to integrate primary prevention interventions (nutrition, physical activity, tobacco prevention). To address this gap, a new compilation of community setting implementation strategies for researchers and practitioners was recently developed. The goal of this work was to inform a dissemination plan for the compilation by understanding public health practitioners would prefer to receive this information.

Methods: This research was conducted as part of a qualitative study investigating implementation strategies used by public health researchers and practitioners in community settings. Purposive and snowball sampling was used to recruit practitioners working in seven settings: education, social services, city planning and transportation, workplaces, recreation/sport, faith-based, and public health. A portion of semi-structured virtual interview questions focused on preferred dissemination methods for practitioners following the Diffusion of Innovations theory regarding sources (who provides information) and channels (how information is provided). A rapid deductive approach was used to analyze findings using a coding matrix based on DOI in alignment with the interview guide. Two researchers coded each interview and resolved discrepancies.

Results: Practitioners (n=8) completed interviews; most (n=6) reported delivering interventions across multiple focus areas (e.g., both nutrition and physical activity) and working in public health (n=3) or multiple (n=3) community settings. Interviewees shared preferred dissemination channels (n=24) and sources (n=23). Webinars (n=6), listservs/newsletters (n=5), and conferences (n=3) were the most mentioned dissemination channels. National public health organizations (n=13; e.g., professional associations, accreditors, non-profit organizations) were the most mentioned dissemination sources.

Conclusions: Results reported here expand on past findings and suggest the involvement of broad-reaching public health organizations to disseminate implementation strategies to practitioners in diverse settings. Future work could equip researchers with the skills and strategies to leverage these channels in ways that influence practitioners’ uptake of implementation strategies to improve nutrition and physical activity intervention adoption, implementation, and sustainability.

Purpose

The Gus Schumacher Nutrition Incentive Program (GusNIP) Nutrition Incentive Training, Technical Assistance, Evaluation, and Information Center (NTAE) is charged with supporting implementation and evaluation of nutrition incentive (NI) and produce prescription (PPR) projects across the United States. Alongside NI and PPR grants, a Capacity Building and Innovation Fund (CBIF) is offered to grantees to expand capacity and innovation within their project. The purpose of this presentation is to systematically describe the CBIF mechanism, detail the needs of organizations applying from 2020-2022, and define technical assistance strategies to best support NI and PPR projects. This work can also be applied broadly to programs that seek to build organizational capacity to implement and disseminate projects that address public health nutrition and physical activity nationally and globally.

Methods

Each CBIF application from 2020-2022 was independently coded by two researchers from the Nutrition Incentive Program Training, Technical Assistance, Evaluation, and Information Center (NTAE) using document-based thematic content analysis methods. In addition, a pre-determined codebook was used to abstract quantitative data from the applications.

Findings

Applicants (N = 130) requested funds to build capacity and innovation around one or more domains: leadership and staffing (n = 72); communications (n = 67); diversity, equity, and inclusion (DEI; n = 57); and technology (n = 42). Three key qualitative themes emerged: “applicants need staffing and technology to streamline their projects;” “applicants need training, resources, and funding to enhance DEI within programs;” and, “opportunities exist for the NTAE to strengthen support of GusNIP grantees and strengthen the CBIF funding mechanism”. The NTAE has taken steps to respond to these findings by offering a DEI workshop for GusNIP grantees and their partners in 2022, given that almost half of the CBIF applications (43.8%) requested capacity building in this area.

Conclusions

Findings from this study can increase awareness about capacity building and innovation needs of organizations who implement NI and PPR projects, policymakers, and funders to consider when supporting healthy food incentive projects – further advancing the implementation and dissemination implications for innovative behavior change interventions that address public health nutrition and physical activity nationally and globally.

Purpose: Walking school bus (WSB) programs are among the most effective Safe Routes to School strategies for supporting walking to/from school and increasing daily physical activity. WSBs utilize adult route leaders to keep children safe during their commute to school. Despite their effectiveness, uptake of WSBs has been low in the U.S., largely due to challenges recruiting route leaders. This study investigated the types of route leaders existing WSB programs have successfully recruited.

Methods: Program coordinators from N=146 existing WSB programs from 34 U.S. states completed a questionnaire on school and program characteristics. Generalized mixed models examined whether programs with certain characteristics were more likely to be successful in recruiting 3 types of route leaders (school, outside organization, parents).

Results/findings: Programs experienced success recruiting route leaders from the school (79%; e.g., teachers, staff), outside organizations (79%; e.g., community organizations, universities), and parents (70%). Only 37% of programs were successful in recruiting all 3 types of route leaders. Programs were more successful in recruiting school route leaders if the coordinator was a school representative (OR=14.7, 95%CI=[3.0,72.1]), the school initiated the program (OR=7.5 [1.6,36.2]), or the school had a higher free/reduced lunch eligibility (OR=1.2 [1.0,1.4]). Programs were more successful in recruiting outside route leaders if the school had bussing (OR=3.5 [1.1, 11.1]), the coordinator was from a community organization (OR=10.1 [2.3,46.0]), or the program implemented multiple built environment activities (OR=1.3 [1.0,1.8]). No school or program factors were associated with successful recruitment of parent route leaders. Programs were more successful in recruiting multiple types of route leaders if the school had bussing (OR=3.4 [1.0,11.6]), the coordinator was from a community organization (OR=6.5 [1.3, 2.9]), or the program implemented multiple built environment activities (OR=1.8 [1.2,2.7]).

Conclusion: Across WSB programs, different types of route leaders have been successfully engaged. Future research should identify effective strategies for leveraging multiple types of route leaders within a program, as well as route leaders who are from a different source than the organizer (e.g., school route leaders within programs operated by outside organizations), given previous research emphasizes these factors’ importance in WSB sustainability.

Purpose: Learning collaborative (LC) is a broad term used to define structured activities to bring organizations with similar interests together. LC’s are used to support adoption and implementation of programming. This leaves a gap among program implementers on evaluation and maintenance to sustain and scale programming. The purpose of this presentation is to elucidate the evolution of developing a LC model to support community-based organizations in implementing and evaluating programming to support the nutrition and health needs of children.

Methods: Children’s Nebraska, the regions only full-service pediatric health system, provides funding to ten community partners biennially across Nebraska as part of their community benefit investments. Programs that promote positive health outcomes of children by addressing family-based needs where children live, learn, and play are of priority. Funding alongside opportunities to build capacity for sustained programming are provided to grantees. Starting in 2016, Children’s partnered with the Gretchen Swanson Center for Nutrition (GSCN), a non-profit research center with expertise in evaluation to provide LC's for grantees. The LC’s provide an opportunity for the grantees to collaborate, share best practices for implementation and evaluation, and build collective community-based capacity for sustainability.

Results: Throughout the 2017-2022 funding cycles, Children’s and GSCN have provided a total of 18 LC’s to 30 grantees. Topic areas included evaluation, data management and analysis, sustainability, and dissemination and reporting. During the first year, grantees suggested adding conversations on building and maintaining partnerships, opportunities to share lessons learned to address barriers, and shortening the requirement of six, three-hour sessions. Adaptations to the LC model include four group LC sessions instead of six, two individual evaluation-specific meetings with each grantee, a hybrid model, and setting a focus of health equity in the 2021-2022 funding cycle.

Conclusions: The LC model allows community-based organizations working to address nutrition and health of families in their communities to network, expand capacity and knowledge, as well as learn evidence-based approaches to evaluation and program sustainability. Children’s and GSCN continue to implement and adapt the LC model as a core component of technical assistance. Children’s incorporates lessons learned each year into their new call for proposals.

*Presenting author: Teresa Warne
*Corresponding author: Teresa Warne

Purpose: Turtle Island Tales-is an effective childhood obesity prevention intervention that was developed, using community-based participatory research methods, with and for Native American (NA) families. The purpose of this presentation is to describe an approach to scale up Turtle Island Tales for families who live in persistent poverty census tracts.

Methods: Turtle Island Tales is a home-based culturally adapted intervention delivered monthly over one year to facilitate family interaction and promote health. We used community engaged dissemination and implementation (CEDI) principles to identify and document strategies to improve scale up across 3 states and increase reach into NA families. Strategies were specified to include the actor, action, target of action, temporality, dose, and intended mechanism and outcome using the Consolidated Framework for Implementation Research, RE-AIM, and the Framework for Reporting Adaptations and Modifications to Evidence-Based Implementation Strategies.

Results/findings: Four primary strategies were identified to improve reach including (1) the development of a project steering committee with membership from potential delivery systems, key community partners, and the scientific team, (2) local community implementation teams focused on implementing strategies to increase reach, adoption, implementation quality, and program maintenance, (3) pursing and achieving recognition in an evidence-based intervention in the SNAP-ED intervention repository, and (4) creating a centralized distribution center to reduce the complexity of local program implementation. The project steering committee and the community implementation teams were designed to meet quarterly/monthly and contribute to the design, revision, and application of strategies specific to increasing program reach. Within these strategies, use of social media support for family recruitment (locally and project-level) and place-based recruitment strategies through community Head Start appear to be promising approaches to improve reach. Inclusion in the repository has also demonstrated initial success at increasing states and SNAP-Ed provider adoption of Turtule Island Tales. Finally, using centralized distribution facilitated ordering, packaging, and distribution to communities, though current concerns related to cost and scale are still being considered.

Conclusions: Identifying strategies to improve scale up of evidence-based interventions in persistent poverty areas and underserved communities—adoption and reach, in particular—has the potential to fast-track implementation and increase community impact.

Background: Children living in rural areas and small towns in the United States are at higher risk for obesity but have much lower access to evidence-based family healthy weight programs (FHWP). Developing local community capacity for implementation has the potential to leverage local resources to adopt, deliver, and sustain FHWPs. We developed the Building Healthy Families (BHF) Online Training and Resource Package to support rural community implementation capacity for BHF, an evidence based FHWP.
Purpose: To describe the characteristics of rural and micropolitan communities and implementation teams that participated in the BHF program in seven US communities.
Methods: Pilot communities were selected through a fund and contract process and submitted a brief application that described the community priorities, assets, and organizations that could assist with recruitment and implementation of the BHF program. Successful communities created a BHF implementation team to address the roles of program, nutrition, lifestyle modification, and physical activity coordination. Information such as level of education, place of work, and certifications were used to characterize the implementation personnel.
Results: Seven rural communities (populations ranged from 5,603 to 51,440 people) were successful in the fund and contract process and each community team involved an average of 3 partner organizations including healthcare, public health departments, schools, and parks and recreation. No two communities had identical organizational partners. Of those partners, 60% engaged in program implementation with the remainder addressing program support by contributing to recruitment or providing resources to the implementation team. Implementation personnel also varied with some teams consisting of members with experience in coordinator-specific roles (n=11; 44%). Over half of the implementation staff (n=13; 52%) were credentialed professionals including registered nurses and licensed medical nutrition therapists.
Conclusion: Community assets and implementation personnel vary in rural areas. Through partnership and collaboration, these communities were able to assemble community resources and implementation teams, with relevant experience or expertise, to deliver an evidence based FHWP to families in their communities.