P98 Refining a Maternal Self-Care Intervention to Promote Family Health Using the Plan, Do, Study, Act (PDSA) Model

Abstract

<h3>Background</h3> Maternal self-care, behaviors facilitating healthy eating, physical activity (PA), and stress management, are targets for child obesity prevention efforts and there is a need for optimized interventions to enhance these efforts. Plan, Do, Study, Act (PDSA) Cycling, a quality improvement process using rapid cycle testing to develop and refine interventions within healthcare settings, is less often used in maternal health and nutrition studies. <h3>Objective</h3> PDSA Cycles were applied during the development of the Healthy EnviROnments (HEROs) Self-care intervention to refine and verify intervention components including content, delivery methods, and digital strategies. <h3>Study Design, Setting, Participants</h3> HEROs Self-care was designed for low-income mothers of preschoolers in rural Colorado to improve healthy eating, PA, and stress management. Three sequential PDSA cycles were conducted via group or individual interviews with: 1) an expert panel (n = 8), 2) a convenience sample (n = 5), and 3) target audience (n = 6). <h3>Outcomes, Measures and Analysis</h3> Three cycles of group and/or individual interviews provided insights into intervention components: Cycle 1 provided input on program content: flow, activities, and materials; Cycle 2 provided feedback on delivery methods: in-person and videoconferencing meeting strategies, duration, and use of electronic binders; and Cycle 3 gathered information about the feasibility of digital strategies: website, iPad, and an activity tracker. Interviews were transcribed, data were compiled from group discussion notes, and data from each cycle was analyzed for emergent themes around intervention components. <h3>Results</h3> In Cycle 1, areas for refinement included the addition of mindfulness activities, revision of handouts for literacy level, and additional time for group discussion. Cycle 2 verified that content was acceptable to the target audience and delivery methods functioned in rural areas. Cycle 3 verified that digital strategies were feasible. <h3>Conclusion</h3> PDSA cycles allow for the optimization of intervention components prior to full-scale implementation, potentially saving resources and resulting in more efficacious interventions.