TY - JOUR
T1 - Implementation examined in a health center-delivered, educational intervention that improved infant growth in Trujillo, Peru
T2 - Successes and challenges
AU - Robert, Rebecca C.
AU - Gittelsohn, Joel
AU - Creed-Kanashiro, Hilary M.
AU - Penny, Mary E.
AU - Caulfield, Laura E.
AU - Narro, M. Rocio
AU - Steckler, Allan
AU - Black, Robert E.
N1 - Funding Information:
We acknowledge and gratefully thank our team of data collectors, Rosario Bartolini for conducting interviews and providing insights, Claudia Cuba and Victor Montoya for data management assistance, the health staff and Trujillo MOH commission and the caregivers and infants of Trujillo. This research was funded by the United States Agency for International Development through the Johns Hopkins Family Health and Child Survival Co-operative Agreement and a pre-doctoral research fellowship (National Research Service Award) awarded to the principal author by the National Institute of Nursing Research, National Institutes of Health.
PY - 2007/6
Y1 - 2007/6
N2 - Process evaluation was used to examine the implementation of a randomized, controlled trial of an education intervention that improved infant growth in Trujillo, Peru. Health personnel delivered the multi-component intervention as part of usual care in the government health centers. Quantitative and qualitative methods were used to examine process indicators, which included the extent of delivery (dose), fidelity to intervention protocol, barriers to implementation and context. Results demonstrated that most intervention components were delivered at a level of 50-90% of expectations. Fidelity to intervention protocol, where measured, was lower (28-70% of expectations). However, when compared with existing nutrition education, as represented by the control centers, significant improvements were demonstrated. This included both improved delivery of existing educational activities as well as delivery of new intervention components to strengthen overall nutrition education. Barriers to, and facilitators of, implementation were explored with health personnel and helped to explain results. This study demonstrates the importance of examining actual versus planned implementation in order to improve our understanding of how interventions succeed. The information gained from this study will inform future evaluation designs, and lead to the development and implementation of more effective intervention programs for child health.
AB - Process evaluation was used to examine the implementation of a randomized, controlled trial of an education intervention that improved infant growth in Trujillo, Peru. Health personnel delivered the multi-component intervention as part of usual care in the government health centers. Quantitative and qualitative methods were used to examine process indicators, which included the extent of delivery (dose), fidelity to intervention protocol, barriers to implementation and context. Results demonstrated that most intervention components were delivered at a level of 50-90% of expectations. Fidelity to intervention protocol, where measured, was lower (28-70% of expectations). However, when compared with existing nutrition education, as represented by the control centers, significant improvements were demonstrated. This included both improved delivery of existing educational activities as well as delivery of new intervention components to strengthen overall nutrition education. Barriers to, and facilitators of, implementation were explored with health personnel and helped to explain results. This study demonstrates the importance of examining actual versus planned implementation in order to improve our understanding of how interventions succeed. The information gained from this study will inform future evaluation designs, and lead to the development and implementation of more effective intervention programs for child health.
UR - http://www.scopus.com/inward/record.url?scp=34548454410&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34548454410&partnerID=8YFLogxK
U2 - 10.1093/her/cyl078
DO - 10.1093/her/cyl078
M3 - Article
C2 - 16945983
AN - SCOPUS:34548454410
SN - 0268-1153
VL - 22
SP - 318
EP - 331
JO - Health education research
JF - Health education research
IS - 3
ER -