Table 2.
Description of the Context for Implementation Guided by Consolidated Framework for Implementation Research (CFIR)
| Contextual Factor | Measure | Results | ||
|---|---|---|---|---|
| Intervention Characteristics – PAT+GWG | Group | n | Mean (SD) | |
| Evidence Strength & Quality | Rodgers 200353a | Total | 13 | 2.77 (0.70) |
| PE | 5 | 2.80 (0.76) | ||
| SL | 8 | 2.75 (0.71) | ||
| Relative Advantage | Rodgers 200353a | Total | 13 | 3.73 (0.63) |
| PE | 5 | 3.90 (0.74) | ||
| SL | 8 | 3.63 (0.58) | ||
| Panzano 201259b | Total | 9 | 6.04 (0.98) | |
| PE | 5 | 5.80 (1.17) | ||
| SL | 4 | 6.33 (0.72) | ||
| Interview | • Current healthy weight info for pregnant women would be enhancement, look for outside resources or refer | |||
| Adaptability | Interview | • Would need training | ||
| • Flexibility to make PAT+GWG relevant | ||||
| • Some educators felt overwhelmed and concerned PAT+GWG might add too much | ||||
| Complexity | Rodgers 200353a | Total | 13 | 2.38 (0.77) |
| PE | 5 | 2.53 (0.80) | ||
| SL | 8 | 2.29 (0.79) | ||
| Pankratz 200258c | Total | 13 | 2.63 (0.86) | |
| PE | 5 | 2.60 (0.98) | ||
| SL | 8 | 2.66 (0.84) | ||
| Panzano 201259b | Total | 6 | 5.28 (1.19) | |
| PE | 3 | 4.70 (1.54) | ||
| SL | 3 | 5.87 (0.40) | ||
| Interview | • Concern about time required for data collection (visit documentation) | |||
| • Two educators mentioned that non-high needs families might not qualify for that many prenatal visits. | ||||
| • Concern if mother has other kids, does not engage in visit, or does not think her weight is an issue | ||||
| Design Quality & Packaging | Interview | • Preferred online, checklist format for documentation | ||
| • Training could be virtual (with video) so travel would not be necessary | ||||
| Outer Setting | ||||
| Participant needs and resources | Interview | • Weight/nutrition issues for some PAT clients; many want this info, but concern some may be uncomfortable. | ||
| • Need low-literacy and Spanish materials | ||||
| External policy and incentives | Interview | • Funders would be supportive | ||
| • Concern funding may not be renewed | ||||
| • One site leader mentioned tension with physicians not wanting educators to discuss health | ||||
| Inner Setting – PAT Site | ||||
| Implementation Climate | Panzano 201259b | Total | 7 | 5.75 (0.87) |
| PE | 3 | 5.30 (1.09) | ||
| SL | 4 | 6.09 (0.61) | ||
| Interview | • One site leader expressed concern about possible changes in funding, might change visit structure, add stress, and make implementation difficult | |||
| Tension for Change | Interview | • Parent educators have limited resources in general, and specifically on healthy weight, for prenatal families | ||
| Compatibility | Pankratz 200258c | Total | 13 | 3.35 (0.49) |
| PE | 5 | 3.13 (0.57) | ||
| SL | 8 | 3.48 (0.41) | ||
| Panzano 201259b | Total | 9 | 6.08 (0.87) | |
| PE | 5 | 6.00 (1.09) | ||
| SL | 4 | 6.19 (0.63) | ||
| Interview | • Appealing that PAT+GWG fits within visit structure and within normal visit (eg, Family Wellbeing), but non-high needs families might be eligible for fewer visits | |||
| Relative Priority | Steckler 199260d | Total | 12 | 1.15 (0.29) |
| PE | 5 | 1.30 (0.41) | ||
| SL | 7 | 1.04 (0.09) | ||
| Interview | • Important issue for families and fits with family wellbeing | |||
| • Two educators concerned healthy weight might not be most important issue | ||||
| Readiness for Implementation | Panzano 201259b | Total | 7 | 5.89 (0.89) |
| PE | 3 | 5.25 (1.00) | ||
| SL | 4 | 6.38 (0.43) | ||
| Leadership Engagement | Interview | • Site leaders and parent educators felt it would be implemented if supervisors decided to do so. | ||
| • Site leaders would remind parent educators to complete paperwork | ||||
| Available Resources | Interview | • Participants requested: training, recruitment materials (eg, flyers and pamphlets), education materials and incentives for families, ways to incorporate dads and other children, and materials in Spanish. | ||
| Access to Knowledge & Information | Steckler 199260d | Total | 13 | 2.54 (0.82) |
| PE | 5 | 2.45 (0.67) | ||
| SL | 8 | 2.59 (0.94) | ||
| Characteristics of Individuals (PAT site leaders and parent educators) | ||||
| Knowledge & Beliefs about PAT+GWG | Aarons 200461e | Total | 12 | 4.02 (0.79) |
| PE | 5 | 3.70 (1.14) | ||
| SL | 7 | 4.25 (0.38) | ||
| Interview | • Participants believe healthy weight gain is important for their clients, but worry some educators and some families may not share belief | |||
| Self-efficacy | Interview | • Confidence in delivering PAT+GWG; many already deliver health information | ||
| Individual Stage of Change | Steckler 199260d | Total | 13 | 3.33 (0.73) |
| PE | 5 | 3.10 (1.08) | ||
| SL | 8 | 3.47 (0.43) | ||
| Individual Identification with Organization | Aarons 200461e | Total | 13 | 4.36 (1.01) |
| PE | 5 | 3.73 (1.42) | ||
| SL | 8 | 4.75 (0.39) | ||
| Interview | • One parent educator described not personally being excited to deliver PAT+GWG, but thought it would benefit the site. | |||
| Personal Attributes of Individuals (Openness) | Aarons 200461e | Total | 12 | 3.92 (0.60) |
| PE | 5 | 3.80 (0.93) | ||
| SL | 7 | 4.00 (0.25) | ||
| Personal Attributes of Individuals (Divergence) | Aarons 200461e | Total | 12 | 1.98 (0.58) |
| PE | 5 | 2.00 (0.66) | ||
| SL | 7 | 1.96 (0.57) | ||
a
Strongly disagree (1) to Strongly agree (5);
b
Strongly disagree (1) to Strongly agree (7);
c
Strongly disagree (1) to Strongly agree (5);
d
Not at all (1) to Very true (4);
e
Not at all (1) to To a very great extent (5)