Evaluation of a school-based participatory intervention to improve school environments using the Consolidated Framework for Implementation Research

BMC Public Health

Martha Bigelow¹  Maria Schwedhelm¹  Nicole Bates²  April K. Wilhelm³  Michele L. Allen³  Mikow Hang⁴  Shannon Pergament⁵  Luis Ortega⁵ 

[1] Department of Curriculum and Instruction, College of Education and Human Development, University of Minnesota, Peik Hall, 159 Pillsbury Drive SE, 55455, Minneapolis, MN, USA;ESTEM, Office of Equity, Saint Paul Public Schools, 600 Weir Drive, 55125, Woodbury, MN, USA;Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St. SE, Suite 166, 55414, Minneapolis, MN, USA;Program in Health Disparities Research, Department of Family Medicine and Community Health, University of Minnesota, 717 Delaware St. SE, Suite 166, 55414, Minneapolis, MN, USA;SoLaHmo Partnership for Health and Wellness, Inc, Community University Health Care Center, 2001 Bloomington Avenue, 55404, Minneapolis, MN, USA;SoLaHmo Partnership for Health and Wellness, Inc, Community University Health Care Center, 2001 Bloomington Avenue, 55404, Minneapolis, MN, USA;

关键词: CFIR;    Participatory research;    Implementation;    Qualitative methods;   

DOI  :  10.1186/s12889-021-11644-5

来源: Springer

【 摘 要 】

BackgroundParticipatory research offers a promising approach to addressing health inequities and improving the social determinants of health for diverse populations of adolescents. However, little research has systematically explored factors influencing the implementation of participatory health interventions targeting health disparities.ObjectiveThis study examined the utility of the Consolidated Framework for Implementation Research (CFIR) in identifying and comparing barriers and facilitators influencing implementation of participatory research trials by employing an adaptation of the CFIR to assess the implementation of a multi-component, urban public school-based participatory health intervention.MethodsWe collected qualitative data over a one-year period through weekly team meeting observational field notes and regular semi-structured interviews with five community-based participatory researchers, one school-based partner, and four school principals involved in implementing a participatory intervention in five schools. Adapted CFIR constructs guided our largely deductive approach to thematic data analysis. We ranked each of the three intervention components as high or low implementation to create an overall implementation effectiveness score for all five schools. Cross-case comparison of constructs across high and low implementation schools identified constructs that most strongly influenced implementation.ResultsTen of 30 assessed constructs consistently distinguished between high and low implementation schools in this participatory intervention, with five strongly distinguishing. Three additional constructs played influential, though non-distinguishing, roles within this participatory intervention implementation. Influential constructs spanned all five domains and fit within three broad themes: 1) leadership engagement, 2) alignment between the intervention and institutional goals, priorities, demographics, and existing systems, and 3) tensions between adaptability and complexity within participatory interventions. However, the dynamic and collaborative nature of participatory intervention implementation underscores the artificial distinction between inner and outer settings in participatory research and the individual behavior change focus does not consider how relationships between stakeholders at multiple levels of participatory interventions shape the implementation process.ConclusionsThe CFIR is a useful framework for the assessment of participatory research trial implementation. Our findings underscore how the framework can be readily adapted to further strengthen its fit as a tool to examine project implementation in this context.

【 授权许可】

CC BY