Implementing an Injury Prevention Briefing to aid delivery of key fire safety messages in UK children’s centres: qualitative study nested within a multi-centre randomised controlled trial

BMC Public Health

Denise Kendrick¹  Elizabeth Towner⁴  Mike Hayes³  Penny Benford¹  Lisa McDaid⁵  Sally Jaeckle²  Toity Deave⁴  Trudy Goodenough⁴  Kate Beckett⁴ 

[1] School of Medicine, Division of Primary Care, University of Nottingham, University Park, Nottingham, UK;Early Years Learning, Bristol City Council, City Hall, College Green, Bristol, UK;Child Accident Prevention Trust, Canterbury Court, 1-3 Brixton Road, London, UK;Centre for Child & Adolescent Health, Faculty of Health and Life Sciences, University of the West of England, Bristol, UK;NHS Clinical Research and Trials Unit, Norwich Medical School, Norfolk and Norwich University Hospital, University of East Anglia, Norwich, UK

关键词: Facilitation;    Implementation;    Intervention;    Context;    Children’s centre;    Injury prevention;    Fire safety;   

Others  :  1122850
DOI  :  10.1186/1471-2458-14-1256

 received in 2014-07-17, accepted in 2014-11-19,  发布年份 2014

【 摘 要 】

Background

To improve the translation of public health evidence into practice, there is a need to increase practitioner involvement in initiative development, to place greater emphasis on contextual knowledge, and to address intervention processes and outcomes. Evidence that demonstrates the need to reduce childhood fire-related injuries is compelling but its translation into practice is inconsistent and limited. With this knowledge the Keeping Children Safe programme developed an "Injury Prevention Briefing (IPB)" using a 7 step process to combine scientific evidence with practitioner contextual knowledge. The IPB was designed specifically for children’s centres (CCs) to support delivery of key fire safety messages to parents. This paper reports the findings of a nested qualitative study within a clustered randomised controlled trial of the IPB, in which staff described their experiences of IPB implementation to aid understanding of why or how the intervention worked.

Methods

Interviews were conducted with key staff at 24 CCs participating in the two intervention arms: 1) IPB supplemented by initial training and regular facilitation; 2) IPB sent by post with no facilitation. Framework Analysis was applied to these interview data to explore intervention adherence including; exposure or dose; quality of delivery; participant responsiveness; programme differentiation; and staff experience of IPB implementation. This included barriers, facilitators and suggested improvements.

Results

83% of CCs regarded the IPB as a simple, accessible tool which raised awareness, and stimulated discussion and behaviour change. 15 CCs suggested minor modifications to format and content. Four levels of implementation were identified according to content, frequency, duration and coverage. Most CCs (75%) achieved ‘extended’ or ‘essential’ IPB implementation. Three universal factors affected all CCs: organisational change and resourcing; working with hard to engage groups; additional demands of participating in a research study. Six specific factors were associated with the implementation level achieved: staff engagement and training; staff continuity; adaptability and flexibility; other agency support; conflicting priorities; facilitation. CCs achieving high implementation levels increased from 58% (no facilitation) to 92% with facilitation.

Conclusion

Incorporating service provider perspectives and scientific evidence into health education initiatives enhances potential for successful implementation, particularly when supplemented by ongoing training and facilitation.

【 授权许可】

   
2014 Beckett et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Brussoni M, Towner E, Hayes M: Evidence into practice: combining the art and science of injury prevention. Inj Prev 2006, 12(6):373-377.
• [2]Flottorp S, Oxman A, Krause J, Musila N, Wensing M, Godycki-Cwirko M, Baker R, Eccles M: A checklist for identifying determinants of practice: a systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implement Sci 2013, 8:35. BioMed Central Full Text
• [3]Tomm-Bonde L, Schreiber R, Allan D, MacDonald M, Pauly B, Hancock T: Fading vision: knowledge translation in the implementation of a public health policy Intervention on behalf of the RePHS Research Team. Implement Sci 2013, 8:59. BioMed Central Full Text
• [4]May C: Towards a general theory of implementation. Implement Sci 2013, 8:18. BioMed Central Full Text
• [5]Ryecroft-Malone J, Kitson A, Harvey G, McCormack B, Seers K, Titchen A, Estabrooks C: Ingredients for change: revisiting a conceptual framework. Qual Saf Health Care 2002, 11(2):174-180.
• [6]Roberts H, Curtis K, Liabo K, Rowland D, DiGuiseppi C, Roberts I: Putting public health into practice: increasing the prevalence of working smoke alarms in disadvantaged inner city housing. J Epidemiol Community Health 2004, 58(4):280-285.
• [7]Kendrick D, Smith S, Sutton A, Mulvaney M, Coupland C, Mason-Jones A: The effect of education and home safety equipment on childhood thermal injury prevention: meta-analysis and meta-regression. Inj Prev 2009, 15:197-204.
• [8]Ingram J, Deave T, Towner E, Errington G, Kay B, Kendrick D: Identifying facilitators and barriers for home injury prevention interventions for pre-school children: a systematic review of the quantitative literature. Health Educ Res 2011, 27(2):258-268.
• [9]Deave T, Towner E, McColl E, Reading R, Sutton A, Coupland C, Cooper N, Stewart J, Hayes M, Pitchforth E, Watson M, Kendrick D: Multicentre cluster randomised controlled trial evaluating implementation of a fire prevention injury prevention briefing in children’s centres: study protocol. BMC Public Health 2014., 14(69) [ http://www.biomedcentral.com/1471-2458/14/69 webcite]
• [10]Millward L, Morgan A, Kelly M: A Research Development Strategy for Public Health. London: Department of Health; [ http://www.injuryobservatory.net/wp-content/uploads/2012/09/Cross-Research-2003-Prevention-and-Reduction.pdf webcite]
• [11]James-Ellison M, Barnes P, Maddocks A, Wareham K, Drew P, Dickson W, Lyons R, Hutchings H: Social health outcomes following thermal injuries: a retrospective matched cohort study. Arch Dis Child 2009, 94(9):663-667.
• [12]Lawrence J, Mason S, Schomer K, Klein M: Epidemiology and impact of scarring after burn injury: a systematic review of the literature. J Burn Care Res 2012, 33(1):136-146.
• [13]Stubbs T, James L, Daugherty M, Epperson K, Barajaz K, Blakeney P, Meyer W, Palmieri T: Psychosocial impact of childhood face burns: a multicenter, prospective, longitudinal study of 390 children and adolescents. J Burns 2011, 37(3):387-394.
• [14]National Burn care review: Committee Report: Standards and strategy for burn care: a review of burn care in the British isles. 2001. [ http://www.britishburnassociation.org/downloads/NBCR2001.pdf webcite]
• [15]Tinati T, Lawrence W, Ntani G, Black C, Cradock S, Jarman M, Pease A, Begum R, Inskip H, Cooper C, Baird J, Barker M: Implementation of new healthy conversation skills to support lifestyle changes – what helps and what hinders? Experiences of sure start children’s centre staff. Health & Soc Care Community 2012, 20(4):430-437.
• [16]Smithson J, Garside R, Pearson M: Barriers to, and facilitators of, the prevention of unintentional injury in children in the home: a systematic review and synthesis of qualitative research. Inj Prev 2011, 17(2):119-126.
• [17]Kelly M, Chambers J, Huntley J, Milward L: Evidence into Practice: Method 1 for the Production of Effective Action Briefings and Related Materials. London: Health Development Agency; 2004. [ http://www.nice.org.uk/proxy/?sourceUrl=http%3a%2f%2fwww.nice.org.uk%2fniceMedia%2fpdf%2fEIP_Protocol_jan04_V4.pdf webcite]
• [18]Carroll C, Patterson M, Wood S, Booth A, Rick J, Balain S: A conceptual framework for implementation fidelity. Implement Sci 2007, 2:40. BioMed Central Full Text
• [19]Gale N, Heath G, Cameron E, Rashid S, Redwood S: Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol 2013, 13:117. BioMed Central Full Text
• [20]Gibbs L, Waters E, Sherrad J, Ozanne-Smith J, Robinson J, Young S, Hutchinson A: Understanding parental motivators and barriers to uptake of child poison safety strategies: a qualitative study. Inj Prev 2005, 11(6):373-377.
• [21]National Institute for Health and Clinical Excellence guideline PH29: Strategies to prevent unintentional injuries among the under-15s. [ https://www.nice.org.uk/guidance/ph29/resources/guidance-strategies-to-prevent-unintentional-injuries-among-the-under15s-pdf webcite]
• [22]Rycroft-Malone J, Seers K, Crichton N, Chandler J, Hawkers C, Allen C, Bullock I, Strunin L: A pragmatic cluster randomised trial evaluating three implementation interventions. Implement Sci 2012, 7:80. BioMed Central Full Text
• [23]BioMedCentral: Qualitative research review guidelines – RATS. [ http://www.biomedcentral.com/authors/rats webcite]
• [24]Hartung D, Hamer A, Middleton L, Haxby D, Fagnan L: A pilot study evaluating alternative approaches of academic detailing in rural family practice clinics. BMC Fam Pract 2012, 13:129. BioMed Central Full Text