Project FIT: Rationale, design and baseline characteristics of a school- and community-based intervention to address physical activity and healthy eating among low-income elementary school children

<p>Abstract</p> <p>Background</p> <p>This paper describes Project FIT, a collaboration between the public school system, local health systems, physicians, neighborhood associations, businesses, faith-based leaders, community agencies and university researchers to develop a multi-faceted approach to promote physical activity and healthy eating toward the general goal of preventing and reducing childhood obesity among children in Grand Rapids, MI, USA.</p> <p>Methods/design</p> <p>There are four overall components to Project FIT: school, community, social marketing, and school staff wellness - all that focus on: 1) increasing access to safe and affordable physical activity and nutrition education opportunities in the schools and surrounding neighborhoods; 2) improving the affordability and availability of nutritious food in the neighborhoods surrounding the schools; 3) improving the knowledge, self-efficacy, attitudes and behaviors regarding nutrition and physical activity among school staff, parents and students; 4) impacting the 'culture' of the schools and neighborhoods to incorporate healthful values; and 5) encouraging dialogue among all community partners to leverage existing programs and introduce new ones.</p> <p>Discussion</p> <p>At baseline, there was generally low physical activity (70% do not meet recommendation of 60 minutes per day), excessive screen time (75% do not meet recommendation of < 2 hours per day), and low intake of vegetables and whole grains and high intake of sugar-sweetened beverages, French fries and chips and desserts as well as a high prevalence of overweight and obesity (48.5% including 6% with severe obesity) among low income, primarily Hispanic and African American 3^rd-5^thgrade children (n = 403).</p> <p>Trial registration</p> <p><b>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/NCT01385046">NCT01385046</a></b></p

Collaborative planning approach to inform the implementation of a healthcare manager intervention for hispanics with serious mental illness: a study protocol

Background: This study describes a collaborative planning approach that blends principles of community-based participatory research (CBPR) and intervention mapping to modify a healthcare manager intervention to a new patient population and provider group and to assess the feasibility and acceptability of this modified intervention to improve the physical health of Hispanics with serious mental illness (SMI) and at risk for cardiovascular disease (CVD). Methods: The proposed study uses a multiphase approach that applies CBPR principles and intervention-mapping steps--an intervention-planning approach--to move from intervention planning to pilot testing. In phase I, a community advisory board composed of researchers and stakeholders will be assembled to learn and review the intervention and make initial modifications. Phase II uses a combination of qualitative methods--patient focus groups and stakeholder interviews--to ensure that the modifications are acceptable to all stakeholders. Phase III uses results from phase II to further modify the intervention, develop an implementation plan, and train two care managers on the modified intervention. Phase IV consists of a 12-month open pilot study (N = 30) to assess the feasibility and acceptability of the modified intervention and explore its initial effects. Lastly, phase V consists of analysis of pilot study data and preparation for future funding to develop a more rigorous evaluation of the modified intervention. Discussion: The proposed study is one of the few projects to date to focus on improving the physical health of Hispanics with SMI and at risk for CVD by using a collaborative planning approach to enhance the transportability and use of a promising healthcare manager intervention. This study illustrates how blending health-disparities research and implementation science can help reduce the disproportionate burden of medical illness in a vulnerable population

Transferability of interventions in health education: a review

<p>Abstract</p> <p>Background</p> <p>Health education interventions are generally complex. Their outcomes result from both the intervention itself and the context for which they are developed. Thus, when an intervention carried out in one context is reproduced in another, its transferability can be questionable. We performed a literature review to analyze the concept of transferability in the health education field.</p> <p>Methods</p> <p>Articles included were published between 2000 and 2010 that addressed the notion of transferability of interventions in health education. Articles were analyzed using a standardized grid based on four items: 1) terminology used; 2) factors that influenced transferability; 3) capacity of the research and evaluation designs to assess transferability; and 4) tools and criteria available to assess transferability.</p> <p>Results</p> <p>43 articles met the inclusion criteria. Only 13 of them used the exact term “transferability” and one article gave an explicit definition: the extent to which the measured effectiveness of an applicable intervention could be achieved in another setting. Moreover, this concept was neither clearly used nor distinguished from others, such as applicability. We highlight the levels of influence of transferability and their associated factors, as well as the limitations of research methods in their ability to produce transferable conclusions.</p> <p>Conclusions</p> <p>We have tried to clarify the concept by defining it along three lines that may constitute areas for future research: factors influencing transferability, research methods to produce transferable data, and development of criteria to assess transferability. We conclude this review with three propositions: 1) a conceptual clarification of transferability, especially with reference to other terms used; 2) avenues for developing knowledge on this concept and analyzing the transferability of interventions; and 3) in relation to research, avenues for developing better evaluation methods for assessing the transferability of interventions.</p