Abstract
BackgroundThis article reports on the development of a systematic approach to assess for community readiness prior to implementation of a behavioural intervention for childhood obesity. Using the Consolidated Framework for Implementation Research (CFIR), we developed research tools to evaluate local community centres’ organisational readiness and their capacity to implement the intervention.MethodsFour community Parks and Recreation centres from different states expressed interest in piloting an approach for dissemination and implementation of an evidence-based obesity prevention program for families with young children (Healthier Families). We conducted a mixed methods pre-implementation evaluation using the CFIR to evaluate the alignment of organisational priorities with the Healthier Families programme. Written surveys assessed organisational readiness for change amongst organisational leaders, recreation programmers, and staff (N = 25). Key informant interviews were conducted among staff to assess organisational readiness and with community members to assess community readiness (N = 64). Surveys were analysed with univariate statistics. Interviews were transcribed, coded and analysed using inductive and deductive methods of analysis.ResultsMixed-methods analysis led to the identification of three key domains on which to assess the organisational readiness to adopt a childhood obesity intervention, namely the physical infrastructure, the knowledge infrastructure, and the social infrastructure. The most critical measure of compatibility was the social infrastructure, since obstacles in the knowledge and physical infrastructures could be overcome by the strength of social resources, including the staff’s ingenuity and commitment to a healthier community. This approach guided an assessment of organisational readiness prior to community organisations adopting and preparing to disseminate an obesity prevention community-based program in a wide-range of social and environmental contexts.ConclusionsUsing a comprehensive pre-implementation assessment of the knowledge, physical and social infrastructures in a community is an essential step in effective dissemination for community-based behavioural interventions. Our research found that, when evaluating readiness and alignment, a responsive social infrastructure could provide the capacity to overcome potential barriers to implementation in either the knowledge or physical infrastructures.
Highlights
This article reports on the development of a systematic approach to assess for community readiness prior to implementation of a behavioural intervention for childhood obesity
Implications We provide a systematic process and application using the Consolidated Framework for Implementation Research (CFIR) framework to assess community readiness and alignment for dissemination of an evidence- and communitybased behavioural intervention for childhood obesity
Our data suggest that the leading measure of compatibility was the social infrastructure, whereby obstacles in the knowledge and physical infrastructures could be overcome by the strength of social resources, including the staff’s ingenuity and commitment to a healthier community
Summary
This article reports on the development of a systematic approach to assess for community readiness prior to implementation of a behavioural intervention for childhood obesity. Using the Consolidated Framework for Implementation Research (CFIR), we developed research tools to evaluate local community centres’ organisational readiness and their capacity to implement the intervention. The Consolidated Framework for Implementation Research (CFIR) provides a compelling theoretical basis for assessing organisational readiness and capacity to adopt health-behaviour change interventions, though it has been employed less frequently in community-based dissemination research [2, 3]. The CFIR was validated in 2009 and identifies 39 constructs in five domains to be considered when assessing an intervention in a new context [4]. The study described in this article reports results from a feasibility assessment aimed at determining how the CFIR can be employed to evaluate alignment and organisational readiness for implementation before introducing an intervention in community settings
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