Participant engagement with a UK community-based preschool childhood obesity prevention programme: a focused ethnography study
Participant engagement with a UK community-based preschool childhood obesity prevention programme: a focused ethnography study
复制标题
DOI：
10.1186/s12889-019-7410-0
复制
发表时间：
2019-08-08
影响因子：
4.5
通讯作者：
Bryant, Maria
中科院分区：
文献类型：
--
作者：
Burton, Wendy;Twiddy, Maureen;Bryant, Maria
背景资料：联合王国的儿童中心为公共卫生方案提供了一个环境;为生活在肥胖率最高的最贫困地区的家庭提供支持。健康，运动和营养在真正年轻（亨利）是一个为期八周的肥胖预防计划，目前在英国各地的儿童中心提供。然而，一些地方当局的参与程度低，威胁到其潜在的覆盖面和影响力。本研究旨在探讨参与者参与的影响因素与亨利描述当地的干预可能支持engagementefforts.Method：一个集中的民族志研究进行了5个儿童中心提供亨利在英国各地。在每个中心连续五天进行了190个小时的实地观察，与工作人员（专员、亨利协调员、管理人员和协调员）和六个重点小组（36名家长）进行了22次访谈。实施研究的综合框架（CFIR）被用来指导观察和分析的data.Results：三个首要的主题描述了影响参与者参与亨利的因素：地方当局的决策围绕儿童中心的方案;儿童中心实施亨利;和亨利的参与者的经验。结果表明，影响参与者参与公共卫生方案的因素开始在委托机构一级，影响儿童中心的实施和随后的参与者的经验。地方当局的供资优先事项和制约因素影响到是否有名额以及向谁提供这些名额，而供资往往针对那些被认为最需要的人。这被认为有一个有害的影响参与者的experience of the programme.Conclusion：总之，参与者的参与受到多种因素的影响，工作在不同级别的儿童中心和地方当局的层次结构，其中大部分是在发挥作用，甚至在参与者决定他们是否选择注册和保持出勤。为使方案达到最佳覆盖范围和影响，在解决参与者面临的问题之前，需要先解决委托和地方执行层面的因素。
Background: Children's centres in the UK provide a setting for public health programmes; offering support to families living in the most disadvantaged areas where obesity prevalence is at its highest. Health, Exercise and Nutrition in the Really Young (HENRY) is an eight-week obesity prevention programme currently delivered in children's centres across the UK. However, low participant engagement in some local authorities threatens its potential reach and impact. This study aimed to explore the factors influencing participant engagement with HENRY to describe where local intervention may support engagement efforts.Method: A focused ethnography study was undertaken in five children's centres delivering HENRY across the UK. One hundred and ninety hours of field observations, 22 interviews with staff (commissioners, HENRY co-ordinators, managers and facilitators) and six focus groups (36 parents), took place over five consecutive days in each centre. The Consolidated Framework for Implementation Research (CFIR) was used to guide the observations and analysis of the data.Results: Three overarching themes described the factors influencing participant engagement with HENRY: local authority decision making around children's centre programmes; children's centre implementation of HENRY; and the participant experience of HENRY. The results indicate that factors influencing participant engagement with public health programmes begin at the commissioning body level, influencing children's centre implementation and subsequently the experience of participants. Local authority funding priorities and constraints influence availability of places and who these places are offered to, with funding often targeted towards those deemed most at need. This was perceived to have a detrimental effect on participant experience of the programme.Conclusion: In summary, participant engagement is affected by multiple factors, working at different levels of the children's centre and local authority hierarchy, most of which are at play even before participants decide whether or not they choose to enrol and maintain attendance. For programmes to achieve their optimal reach and impact, factors at the commissioning and local implementation level need to be addressed prior to addressing participant facing issues.