Barriers and Facilitators in the Strengthening Families Program (SFP 10-14) Implementation Process in Northeast Brazil: A Retrospective Qualitative Study.

Ingrid Gomes Abdala,Larissa De Almeida Nobre-Sandoval,Maria Do Socorro Mendes Gomes,Sheila Giardini Murta,Jordana Calil Lopes De Menezes,Karina Damous Duailibe,Danielle Aranha Farias

doi:10.3390/ijerph17196979

Ingrid Gomes Abdala, Larissa De Almeida Nobre-Sandoval + Show 5 more

Open Access

https://doi.org/10.3390/ijerph17196979

Copy DOI

Abstract

This study analyzed contextual barriers and facilitators in the implementation of Strengthening Families Program (SFP 10–14), Brazilian version, a family-based preventive program focused on the prevention of risk behaviors for adolescent health. SFP 10–14 was implemented between 2016 and 2017 for socioeconomically vulnerable families in four Northeast Brazilian states as a tool of the National Drug Policy. A retrospective qualitative study was carried out in which 26 implementation agents participated. Data from 16 individual interviews and two group interviews were analyzed through content analysis. The most recurrent barriers were the group facilitators’ working conditions, weak municipal administration, precarious infrastructure, inadequate group facilitator training methodologies, low adherence of managers and professionals, and funding scarcity. The conditions highlighted as favorable to the implementation were proper intersectoral coordination, engagement of involved actors, awareness of public agency administrators, municipal management efficacy, and efficient family recruitment strategies. Favorable political contexts, engagement of implementation agents, and intersectoral implementation strategies were identified as central to the success of the implementation of SFP 10–14, especially in the adoption of the intervention, community mobilization, and intervention delivery stages. Further studies should combine contexts, mechanisms, and results for a broad understanding of the effectiveness of this intervention in the public sector.

Highlights

MethodsKnowledge regarding the realities of municipalities and who coordinated intersectoral services and built organizational and community support for the execution of SFP 10–14; (vi) multipliers: in charge of mediating the relationship between the municipality’s local coordinator, federal management (via the federal trainer), and the SFP 10–14 group facilitators and monitoring, supervising, and orienting the local group facilitators and, often in addition to their assigned function, exercising the function of group facilitator; (vii) group facilitators: these workers facilitated the intervention sessions, with at least one group facilitator for the parent groups and two for the adolescent ones; and (viii) childcare providers: workers who cared for and played with children under 10 years of age not attending the intervention
The health of Brazilian adolescents has deteriorated in recent years according to several indicators
Out of the 448 units of analysis identified in the implementation process of SFP 10–14, 234 were barriers (52%) and 214 facilitators (48%)

Summary

Methods

Knowledge regarding the realities of municipalities and who coordinated intersectoral services and built organizational and community support for the execution of SFP 10–14; (vi) multipliers: in charge of mediating the relationship between the municipality’s local coordinator, federal management (via the federal trainer), and the SFP 10–14 group facilitators and monitoring, supervising, and orienting the local group facilitators and, often in addition to their assigned function, exercising the function of group facilitator; (vii) group facilitators: these workers facilitated the intervention sessions, with at least one group facilitator for the parent groups and two for the adolescent ones; and (viii) childcare providers: workers who cared for and played with children under 10 years of age not attending the intervention.

Results

Discussion

Conclusion