Implementation of childhood obesity prevention and control policies in the United States and Latin America: Lessons for cross-border research and practice

Progress has been made in the development and widespread implementation of effective interventions to address childhood obesity, yet important challenges remain. To understand how the United States and Latin American countries achieved success in implementing obesity policies and programs (PAPs) and identify improvement opportunities using implementation science principles. We identified three comparative case studies: (1) front-of-food package labeling (Mexico and Chile); (2) Open Streets/play streets (Colombia and the United States); and (3) the Baby-Friendly Hospital Initiative (Brazil and the United States). Information from multiple sources (e.g., scientific and gray literature and key informant interviews) was synthesized to describe barriers, facilitators, and progress of PAPs across RE-AIM framework dimensions. Evidence-based advocacy along with political will and evidence of scalability and impact were key for successful launch and implementation of all PAPs. Diverse adaptations of PAP design and implementation had to be done across contexts. Stronger process and impact monitoring and evaluation systems that track equity indicators are needed to maximize the population benefits of these PAPs. Implementation science offers an important contribution toward addressing knowledge gaps, enhancing obesity policy dialogue, and producing transferable lessons across the Americas and, therefore, should be used for research and evaluation during PAP development and throughout the implementation and maintenance phases

Implementation Science for the Prevention and Treatment of HIV among Adolescents and Young Adults in Sub-Saharan Africa: A Scoping Review.

Despite many evidence-based adolescent and young adult (AYA) HIV interventions, few are implemented at scale in sub-Saharan Africa (SSA). A growing implementation science literature provides important context for scaling up AYA HIV interventions in this high HIV-burden region. This scoping review examined the use of implementation research in AYA HIV studies conducted in SSA. We searched five databases and included articles which focused on AYA (10-24 years old), addressed HIV prevention or treatment, were conducted exclusively in SSA countries, and included an implementation science outcome. We included 44 articles in 13 SSA countries. Most were in East (52.3%) and South Africa (27.3%), and half focused exclusively on HIV prevention components of the care continuum. Acceptability and feasibility were the most cited implementation science outcomes. Only four articles used an established implementation science framework. The findings informed our recommendations to guide the design, implementation, and dissemination of further studies and health policymaking

Discourage Smoking by Minimizing Access to Cigarettes

Produced as a component of the Tobacco Town project, this report demonstrates the role of policy in reducing access to cigarettes, and includes key takeaways for policy makers.https://openscholarship.wustl.edu/cphss/1101/thumbnail.jp

Addressing NCDs through research and capacity building in LMICs: lessons learned from tobacco control

Confronting the global non-communicable diseases (NCDs) crisis requires a critical mass of scientists who are well versed in regional health problems and understand the cultural, social, economic, and political contexts that influence the effectiveness of interventions. Investments in global NCD research must be accompanied by contributions to local research capacity. The National Institutes of Health (NIH) and the Fogarty International Center have a long-standing commitment to supporting research capacity building and addressing the growing burden of NCDs in low- and middle-income countries. One program in particular, the NIH International Tobacco and Health Research and Capacity Building Program (TOBAC program), offers an important model for conducting research and building research capacity simultaneously. This article describes the lessons learned from this unique funding model and demonstrates how a relatively modest investment can make important contributions to scientific evidence and capacity building that could inform ongoing and future efforts to tackle the global burden of NCDs

Implementation determinants and mechanisms for the prevention and treatment of adolescent HIV in sub-Saharan Africa: concept mapping of the NIH Fogarty International Center Adolescent HIV Implementation Science Alliance (AHISA) initiative.

IntroductionAdolescent HIV prevention and treatment is a high priority for youth healthcare in sub-Saharan Africa.MethodsThis study employed concept mapping to identify factors that impact the implementation of HIV prevention and intervention programs for adolescents in sub-Saharan Africa. Key stakeholders including researchers, policymakers, and non-governmental organization (NGO) personnel constituting membership of the NIH-sponsored Adolescent HIV Prevention and Treatment Implementation Science Alliance responded to the question: "In your experience, what factors have facilitated or hindered implementation of evidence-based HIV prevention or treatment for adolescents in sub-Saharan Africa?" Participants generated statements in response to the focus question, sorted them into thematically relevant groups, and rated each statement on its importance and changeability.ResultsThrough data analyses and participant feedback, 15 distinct themes were derived. "Workforce/Workflow" and "HIV Stigma and Adolescent Development" were rated highest for importance, and "Threshold Conditions for Treatment" and "Structure of Implementation Efforts" were rated most changeable.ConclusionsUnderstanding implementation science determinants and mechanisms can facilitate the uptake of successful implementation and sustainment strategies for the prevention and treatment of HIV in a given context. We placed determinants and mechanisms within the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to provide greater contextual integration with broader theories in implementation science. Implementers across multiple disciplines can use these findings to improve the scale-up of evidence-based practices for adolescent HIV prevention and treatment in sub-Saharan Africa. Implementation approaches that consider the determinants and mechanisms identified in this study and integrated in implementation frameworks will likely have utility for other health conditions and contexts

Implementation determinants and mechanisms for the prevention and treatment of adolescent HIV in sub-Saharan Africa: concept mapping of the NIH Fogarty International Center Adolescent HIV Implementation Science Alliance (AHISA) initiative.

IntroductionAdolescent HIV prevention and treatment is a high priority for youth healthcare in sub-Saharan Africa.MethodsThis study employed concept mapping to identify factors that impact the implementation of HIV prevention and intervention programs for adolescents in sub-Saharan Africa. Key stakeholders including researchers, policymakers, and non-governmental organization (NGO) personnel constituting membership of the NIH-sponsored Adolescent HIV Prevention and Treatment Implementation Science Alliance responded to the question: "In your experience, what factors have facilitated or hindered implementation of evidence-based HIV prevention or treatment for adolescents in sub-Saharan Africa?" Participants generated statements in response to the focus question, sorted them into thematically relevant groups, and rated each statement on its importance and changeability.ResultsThrough data analyses and participant feedback, 15 distinct themes were derived. "Workforce/Workflow" and "HIV Stigma and Adolescent Development" were rated highest for importance, and "Threshold Conditions for Treatment" and "Structure of Implementation Efforts" were rated most changeable.ConclusionsUnderstanding implementation science determinants and mechanisms can facilitate the uptake of successful implementation and sustainment strategies for the prevention and treatment of HIV in a given context. We placed determinants and mechanisms within the Exploration, Preparation, Implementation, Sustainment (EPIS) framework to provide greater contextual integration with broader theories in implementation science. Implementers across multiple disciplines can use these findings to improve the scale-up of evidence-based practices for adolescent HIV prevention and treatment in sub-Saharan Africa. Implementation approaches that consider the determinants and mechanisms identified in this study and integrated in implementation frameworks will likely have utility for other health conditions and contexts

Implementación de políticas de prevención y control de la obesidad infantil en Estados Unidos y Latinoamérica: lecciones para la investigación y la práctica transfronterizas

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y (3) la Iniciativa Hospital Amigo de los Niños (IHAN) (Brasil y Estados Unidos). Resumimos la información obte-nida a través de diversas fuentes (publicaciones científicas, bibliografía gris y entre-vistas a informadores clave) para describir las barreras, facilitadores y avances de las PYP en todas las dimensiones del marco RE-AIM. Una campaña de promoción basada en evidencias, junto con la voluntad de los poderes políticos y las evidencias sobre su impacto y sobre la posibilidad de implementarlas a mayor escala, fueron las claves del éxito del lanzamiento y aplicación de las PYP. Su diseño e implementación debían adaptarse a los distintos contextos. Se necesitan herramientas más potentes que per-mitan monitorear y evaluar los procesos y sus resultados, y también hacer un segui-miento de los indicadores de equidad para maximizar los beneficios de las PYP en la población. La ciencia de la implementación ofrece una importante contribución para cubrir lagunas de conocimiento y abrir un diálogo que mejore las políticas contra la obesidad. También ayudará a trasladar las lecciones aprendidas al resto del continente para que puedan utilizarse con fines de investigación y evaluación tanto durante la fase de desarrollo de las PYP como durante su aplicación y mantenimiento

Implementación de políticas de prevención y control de la obesidad infantil en Estados Unidos y Latinoamérica: lecciones para la investigación y la práctica transfronterizas

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y (3) la Iniciativa Hospital Amigo de los Niños (IHAN) (Brasil y Estados Unidos). Resumimos la información obte-nida a través de diversas fuentes (publicaciones científicas, bibliografía gris y entre-vistas a informadores clave) para describir las barreras, facilitadores y avances de las PYP en todas las dimensiones del marco RE-AIM. Una campaña de promoción basada en evidencias, junto con la voluntad de los poderes políticos y las evidencias sobre su impacto y sobre la posibilidad de implementarlas a mayor escala, fueron las claves del éxito del lanzamiento y aplicación de las PYP. Su diseño e implementación debían adaptarse a los distintos contextos. Se necesitan herramientas más potentes que per-mitan monitorear y evaluar los procesos y sus resultados, y también hacer un segui-miento de los indicadores de equidad para maximizar los beneficios de las PYP en la población. La ciencia de la implementación ofrece una importante contribución para cubrir lagunas de conocimiento y abrir un diálogo que mejore las políticas contra la obesidad. También ayudará a trasladar las lecciones aprendidas al resto del continente para que puedan utilizarse con fines de investigación y evaluación tanto durante la fase de desarrollo de las PYP como durante su aplicación y mantenimiento

Measurement challenges for childhood obesity research within and between Latin America and the United States

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/168362/1/obr13242.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/168362/2/obr13242_am.pd