Adaptations to interventions for specific settings or communities are critical for facilitating successful implementation. The Dynamic Adaptation Process model was applied to systematically assess the adaptation process made to an in-person parenting intervention (FPNG+) prior to its implementation online. This qualitative case study design included meeting notes and interviews completed with project team members. Meeting notes were analyzed using content analysis. Semi-structured interviews regarding project team members’ roles on FPNG+ and processes and activities they identified as critical for the adaptation of FPNG+ to an online intervention were analyzed using a deductive-inductive approach. In the formative phase, three primary processes were identified: information gathering to determine if the environment existed for the implementation of an online program; considerations to support the facilitation process of FPNG+ to an online environment, and decision-making to support modifications to FPNG+. The pre-implementation phase consisted of three processes: information shared by the instructional designer to facilitate the delivery of the FPNG+ content online; modifications made to the format of the intervention to meet the cultural needs of Hispanic families and address contextual issues; and iterative efforts to tailor the intervention by the project team. This study used implementation science to distinguish the dynamic processes that occurred across different systems and multiple levels in the project team’s effort to modify FPNG+ to an online intervention. The contribution of this study underscores the importance of identifying the processes that facilitate the modifications made to an intervention and the capacity to implement the modified intervention with Hispanic families.
El día 29 de Julio del 2006 se publicó, en el Diario Oficial El Peruano, el Reglamento de Ensayos Clínicos del Perú con Decreto Supremo no. 017-2006SA. A raíz de este hecho el Perú fue albo de comentarios favorables, ya que el mencionado reglamento ha llegado a ser considerado innovador por parte de la comunidad científica nacional e internacional. Sin embargo, el 16 de Enero del 2007, se publicó en la página web del Ministerio de Salud una propuesta modificatoria al Reglamento, sosteniendo que los grandes avances de la ciencia médica producidos en los últimos 6 meses (tiempo de vigencia del Decreto Supremo no. 017-2006SA) han provocado que éste sea obsoleto. Nosotros hacemos una argumentación de la necesidad de regulación sobre ensayos clínicos en el Perú y el proceso de más 2 años que tuvo para su publicación. Asimismo, analizamos las modificaciones propuestas y su correlación con el avance de la ciencia y la tecnología médica, no encontrando una fundamentación racional para esta modificatoria y más bien abría una brecha que vulneraba la protección de los derechos de los participantes en la investigación.
Objectives To determine how health-related conversations between parents and their adolescent children is associated with mealtime media device use by adolescents. Methods A sample of primarily Hispanic parents (n = 347; 43 ± 6.5 years; 89.3% female) of 6th, 7th or 8th grade adolescents enrolled in a parenting intervention focusing on the promotion of healthy nutrition and substance use prevention. Parents completed baseline surveys to self-report the frequency with which they had health-related conversations with their adolescent child (healthy eating, being physically active, adolescent's weight, adolescent weighing too much, eating differently to lose weight, exercising to lose weight), and the frequency with which the adolescent used media devices during mealtimes (television and movie watching, cellphone use or texting, handheld gaming devices, listening to music with headphones). Spearman's rank correlations were used to assess the associations between health-related communication and mealtime media device use. Results Reported conversations about healthy eating, being physically active, and general weight of the adolescent were not associated with reported use of media devices by adolescents during mealtimes. Having conversations related to the adolescent weighing too much was positively and significantly correlated with television/movie watching (r = 0.219; P < 0.0001), talking on a cellphone (r = 0.130; P < 0.05), using gaming devices (r = 0.140; P < 0.05), and listening to music with headphones (r = 0.136; P < 0.05). Having conversations about exercising to lose weight was also significantly correlated with television/movie watching during mealtimes (r = 0.137; P < 0.05). Conclusions Findings suggest that higher frequency of weight-related conversation is associated with higher usage of media devices during mealtimes. Whether parenting practices, parental concerns about their children's weight, and the home mealtime environment play a role on adolescent weight status in Hispanic households warrants further investigation. Funding Sources National Institute on Minority Health and Health Disparities and Health Resources and Services Administration of the U.S. Department of Health and Human Services as part of a Maternal Child Health Bureau Nutrition Training Grant.
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