What works in practice: user and provider perspectives on the acceptability, affordability, implementation, and impact of a family-based intervention for child overweight and obesity delivered at scale.
What works in practice: user and provider perspectives on the acceptability, affordability, implementation, and impact of a family-based intervention for child overweight and obesity delivered at scale.
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DOI：
10.1186/1471-2458-14-614
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发表时间：
2014-06-17
影响因子：
4.5
通讯作者：
Roberts H
中科院分区：
文献类型：
--
作者：
Lucas PJ;Curtis-Tyler K;Arai L;Stapley S;Fagg J;Roberts H
作为一项研究的一部分，考虑到儿童体重管理计划的影响时，在规模推出的随机对照试验，这项定性研究的重点是可接受性和实施的供应商和家庭参加。参与者是根据提供一系列经验和社会背景的最大变异样本选择的。定性访谈进行了29名专业人士谁委托或交付的程序，和64个人从23个家庭在3个英语地区。专题指南被用作一种工具，而不是一种规则，使参与者能够对他们的经历进行叙述。转录本进行了分析，使用框架分析。诸如交通、工作时间表和家庭时间的竞争性需求等实际问题是参与的常见障碍。交付伙伴往往在招募、留住和激励家庭方面付出相当大的努力，这增加了接受率，但也增加了成本。父母和供应商重视熟练的交付人员。一些提供者作出调整，以满足当地的社会和文化需要。供应商和家长都对长期结果表示担忧，以及这是如何受到致肥胖环境的影响。对供资的关切加上接受和参与方面的障碍可能会转化为委托的障碍。在没有遇到这些障碍的地方，委员们热衷于继续实施该方案。大多数家庭认为他们从该方案中得到了一些东西，但很少有人认为它对他们“起作用”。对家庭的要求，包括时间和情感工作，都是困难的。对于委员们来说，一个具有积极结果的随机对照试验是一个重要的驱动因素，但家庭障碍，以及对招聘和保留的担忧，对合格的积极工作人员的当地适应性的渴望，以及资金变化，阻碍了一些人计划在未来使用干预措施。
As part of a study considering the impact of a child weight management programme when rolled out at scale following an RCT, this qualitative study focused on acceptability and implementation for providers and for families taking part. Participants were selected on the basis of a maximum variation sample providing a range of experiences and social contexts. Qualitative interviews were conducted with 29 professionals who commissioned or delivered the programme, and 64 individuals from 23 families in 3 English regions. Topic guides were used as a tool rather than a rule, enabling participants to construct a narrative about their experiences. Transcripts were analysed using framework analysis. Practical problems such as transport, work schedules and competing demands on family time were common barriers to participation. Delivery partners often put considerable efforts into recruiting, retaining and motivating families, which increased uptake but also increased cost. Parents and providers valued skilled delivery staff. Some providers made adaptations to meet local social and cultural needs. Both providers and parents expressed concerns about long term outcomes, and how this was compromised by an obesogenic environment. Concerns about funding together with barriers to uptake and engagement could translate into barriers to commissioning. Where these barriers were not experienced, commissioners were enthusiastic about continuing the programme. Most families felt that they had gained something from the programme, but few felt that it had ‘worked’ for them. The demands on families including time and emotional work were experienced as difficult. For commissioners, an RCT with positive results was an important driver, but family barriers, alongside concerns about recruitment and retention, a desire for local adaptability with qualified motivated staff, and funding changes discouraged some from planning to use the intervention in future.
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影响因子：
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作者：
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通讯作者：
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作者：
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通讯作者：
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