Factors contributing to the sustained implementation of an early childhood obesity prevention intervention: The INFANT Program

Reaching Priority Populations When Scaling Up: A Qualitative Study of Practitioners' Experiences of Implementing Early Childhood Health Interventions in Victoria, Australia

Implementing evidence-based health promotion programmes at scale is important for achieving population-level health outcomes. However, achieving equitable reach can be challenging. An evidence-based early-life nutrition and movement intervention (INFANT) is currently being implemented at scale in Australia. This study explored practitioners' perceptions about reaching priority population groups through INFANT or similar universal preventive health programmes and services implemented at scale. Fifteen semi-structured online interviews were conducted with purposively selected experienced practitioners. Interviews were transcribed and analysed using reflexive thematic analysis. Two main themes were developed, representing the complexities of reaching priority population groups through universal health programmes and services in early childhood. Theme 1: "We're not hitting the mark"-Underlying issues influence universal healthcare access, highlighted (a) the perception that parents felt out of place through a sense of not belonging or being unfamiliar with universal services and (b) that practical constraints and pressing priorities impacted access. Theme 2: "There are no easy answers"-Varied approaches can enhance engagement, but the path is not straightforward, encompassed (a) the importance of trust and familiarity with providers, (b) the suitability of programmes and services for target communities, and (c) factors such as practitioner uncertainty regarding approaches that could address the needs of families from priority populations and resourcing that can limit targeted efforts. Our findings highlight the complexities of achieving equitable reach during scale-up and the varied decision-making and resourcing for addressing inequity in a local context. While our findings identify local-level strategies to address equitable reach during scale-up, we emphasise that striving to achieve health equity should be embedded and prioritised in scale-up efforts.

Exploring parental and professional perceptions of weight management services among under-fives in England: A qualitative study

Background

Childhood obesity is a significant public health challenge, particularly among children under five. In England, weight management programs aim to address this issue; however, engagement and uptake of these services remain low. Understanding the perceptions of parents and professionals involved in these programs is crucial to enhancing participation and improving health outcomes. This study explores these perceptions to identify barriers and facilitators to effective engagement with weight management services.

Method

This qualitative study used purposive sampling to recruit parents and professionals involved in weight management programs across England. Semi-structured interviews were conducted with 15 participants (8 parents and 7 professionals). Data were transcribed, coded, and thematically analyzed using Braun and Clarke's six-phase framework to identify key themes related to engagement, cultural influences, and program effectiveness.

Results

The study identified several key themes: parental engagement, the impact of virtual versus face-to-face sessions, motivations for participation, barriers to involvement, and the role of cultural beliefs. Parental involvement was critical for the success of weight management programs, but barriers such as time constraints, cultural beliefs, and socioeconomic factors hindered participation. Professionals highlighted the need for more training and resources to effectively address these challenges. Cultural sensitivities and systemic support were found to be crucial for improving engagement and outcomes.

Conclusions

The findings emphasize the need for culturally tailored, accessible, and sustainable weight management interventions. Enhanced professional training, increased community outreach, and policy-level support are essential to improve engagement and ensure long-term success in addressing childhood obesity.

Implementing an early-life nutrition intervention through primary healthcare: staff perspectives

BACKGROUND

Nutrition interventions targeting early childhood can be cost-effective and may provide lifelong, intergenerational benefits. From October 2022 to April 2023 the Nutrition Now (NN) e-learning resource was implemented within Early Childhood Education and Care centres and the Maternal and Child Healthcare Centre (MCHC) in a southern Norwegian municipality. As part of the NN project, the present study aims to explore the MCHC staff's experiences with implementing the NN resource, to gain insights into measures important to scale up digital early-life nutrition interventions.

METHODS

Three group interviews were conducted among public health nurses and midwives alongside one individual interview with the department leader of a MCHC in May 2023. An inductive thematic analysis, as described by Braun and Clarke, was conducted to generate the key themes and subthemes regarding the implementation process of NN within the MCHC.

RESULTS

Three main themes were generated: [1] Important resource but not always utilized; [2] Parents are interested but had issues with access; and [3] Staff and stakeholder buy-in and commitment needed from the start. Overall, the staff viewed the NN resource as a potential tool for promoting diet-related topics and believed it could support the guidance they were already providing parents. However, few staff members fully familiarized themselves with the resource. While staff perceived parents as positive when informed about NN, they believed issues such as access challenges, competing platforms, and time constraints reduced parental engagement. Lastly, staff suggested improvements for NN's implementation, including enhanced training, better planning, assigning champions, and lowering the threshold for access.

CONCLUSION

The findings of this study suggest that the real-world implementation of digital evidence-based health behaviour interventions is feasible but would be enhanced by employing strategies focusing on engagement and utilization.

TRIAL REGISTRATION

The main study is registered in the ISRCTN registry with ID ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967 . (Registration date: 19-06-2022).

Movement behaviour education for parents in prenatal, postnatal, and pediatric care in Canada: A needs assessment

BACKGROUND

Parents/guardians can greatly influence their child's movement behaviours (i.e., physical activity, sedentary behaviour, and sleep). Yet, they have reported to lack sufficient background knowledge to foster healthy movement habits, and little is known about specific educational gaps. The aim of this study was to explore the educational background and needs regarding promoting healthy movement behaviours in early childhood among parents/guardians living in Canada.

METHODS

A cross-sectional study was conducted with parents/guardians living in Canada who had at least one child under the age of 5 years. Participants completed an online survey capturing their demographics, information they received about movement behaviours in early childhood during their prenatal/postnatal care or child's pediatrician appointments, where they sourced information about these topics, content areas they would like more information on, and preferred format for delivery. Descriptive statistics and frequencies were calculated for all outcome variables and logistic regression was used to explore if sociodemographic variables were associated with receiving movement behaviour-related education across care types.

RESULTS

Among the 576 parents/guardians who completed the survey, many reported no mention of any movement behaviour in their prenatal (49.4%), postnatal (29.6%), and pediatric care (37.2%). Physical activity was the most cited movement behaviour across care types, with 42.4%, 57.9%, and 54.8% of participants indicating this was discussed in their prenatal, postnatal, and pediatric care, respectively. Only 41.7% of parents/guardians reported asking their child's pediatrician about movement behaviours, while most relied on social media (70.9%), internet websites/news articles (68.7%), and family/friends (67.6%). The most sought-after movement behaviour topics included incorporating movement into traditionally sedentary activities (68.8%) and activity ideas to break up sitting time (65.0%), and participants expressed preference to receive more information via social media (63.2%), an online resource package (47.8%), or email (46.6%).

CONCLUSIONS

Given the noted inconsistencies in education relating to movement behaviours in maternal and pediatric care, this study highlights the opportunity for greater integration of this type of education across care types. Ensuring all parents/guardians receive evidence-based and consistent guidance on their child's movement behaviours will help ensure young children receive the best start to a healthy active life.

A translational model for early childhood intervention: developing, implementing, and scaling-up effective practices

Early intervention (EI) researchers (i.e., those focused on children birth to age 3 and their families who experience early vulnerabilities) often engage in translational research and implementation science at the intersection of public health, pediatrics, and EI. There is currently a significant research-to-practice gap in EI despite ongoing efforts to close it. Translational research and implementation science are promising approaches to promote transdisciplinary collaborations among researchers and to move EI research into practice, thus supporting positive outcomes for young children and families. This commentary proposes a contemporary alignment of translational research phases for EI. Two literature reviews served to inform development of this alignment: (1) a narrative literature review identified existing applications of translational phases to EI; and (2) a rapid review identified examples of existing behavior-focused translational models across disciplines. Several case examples of current translational research being conducted in EI are discussed and classified according to their respective translational phase. The proposed alignment and case examples provide a basis for transdisciplinary conversations among those working across the various fields and disciplines relevant to EI research. A shift in EI research to reflect a translational and implementation focus will help bridge the research-to-practice gap and, most importantly, speed the movement of scientific evidence into real-world contexts to positively impact young children and families.