Implementation examined in a health center-delivered, educational intervention that improved infant growth in Trujillo, Peru: successes and challenges.

Publisher: Oxford University Press Country of Publication: England NLM ID: 8608459 Publication Model: Print-Electronic Cited Medium: Print ISSN: 0268-1153 (Print) Linking ISSN: 02681153 NLM ISO Abbreviation: Health Educ Res

Publication: Oxford : Oxford University Press
Original Publication: Oxford ; Washington, D.C. : IRL Press, [c1986-

Outcome and Process Assessment, Health Care*; Caregivers/*education ; Child Development/*physiology ; Child Health Services/*standards ; Health Education/*standards ; Infant Nutrition Disorders/*prevention & control ; Parents/*education ; Urban Health Services/*standards; Child Health Services/organization & administration ; Community Health Centers/standards ; Health Education/methods ; Humans ; Infant ; Infant Care/economics ; Infant Care/methods ; Infant Nutrition Disorders/epidemiology ; Infant Nutritional Physiological Phenomena ; Interviews as Topic ; Peru/epidemiology ; Poverty Areas ; Program Evaluation ; Urban Health Services/organization & administration

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.

Date Created: 20060902 Date Completed: 20070907 Latest Revision: 20191210

20250114

10.1093/her/cyl078

16945983