Reach of “VAMOS” program in basic healthcare - organizational barriers and facilitators

Borges, Rossana Arruda; Tomicki, Camila; Almeida, Fabio A.; Schwingel, Andiara; Chodzko-Zajko, Wojtek; Benedetti, Tânia Rosane Bertoldo

doi:10.1590/1981-22562019022.180225

Cited by 3 publications

(3 citation statements)

References 20 publications

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“…25,26 A health intervention for Brazilian elderly reported a reach of 17.2%. 27 Another study reported that low attendance of clients at nutrition-education and PA sessions was largely due to inadequate attention of trainers or coaches paid to activities of participants. 28 In the current study, some clients stated that the prescribed physical activities were not suitable for their health conditions and they sometimes experienced difficulties in carrying them out.…”

Section: Discussionmentioning

confidence: 99%

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

Foroumandi¹,

Alizadeh²,

Khodayari‐Zarnaq³

et al. 2020

RMHP

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Objective: As aging populations increase, many countries have begun implementation of policies to improve elder health and nutrition. This study evaluated key process components of nutrition sections of a national elderly integrated-care program in health-care centers in Iran. Methods: With stratified three-stage random cluster sampling, a total of 256 elderly subjects (clients) and 76 staff members of health-care centers (providers) participated in the study. Quantitative and qualitative data were collected using two self-administrated questionnaires to evaluate various components of process evaluation for clients and providers. Program reach was measured by the ratio of the number in the target group who underwent the program to the number of eligible individuals. Exposure rate was measured as clients' awareness of program services. Delivery and fidelity were assessed from providers' reports for each service. Satisfaction rates were assessed for the whole program and for each service of the program. All reasons behind strengths and weaknesses in each of the processevaluation components were examined and are reported in detail. Results: The clients reported low-reach (20.0%) and moderate-exposure rates of 77.5%, with a program target of 90%. Primary training sessions were delivered to the providers as intended (100%), but most planned services for clients, especially vitamin and mineral supplementation, follow-up, and physical activity sessions, were poorly implemented, as they were delivered correctly to 24.7% (n=63, vitamin and mineral supplementation), 24% (n=62, follow-up), and 40.3% (n=103, physical activity sessions) of the clients, with a set program goal of 60%. An overall low level of implementation fidelity was observed, and 39.3% (n=30) of the providers believed that most clients did not benefit from the nutritional services. Overall, less than half (42.8%, n=101) the clients were highly satisfied with the program. Conclusion: The process evaluation showed insufficient reach, exposure, and fidelity of the program, as well as imprecise delivery of some services, which resulted in low levels of client satisfaction. The findings may have implications for further reinforcement of the program, and indicate the importance of continuous monitoring and evaluation of such programs.

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Section: Discussionmentioning

confidence: 99%

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

Foroumandi¹,

Alizadeh²,

Khodayari‐Zarnaq³

et al. 2020

RMHP

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“…The reported reach rate of the evaluated program (20.0%) was considered as a low level reach rate. In another study, the reach rate of a health program on Brazilian elderly was reported 17.2% (35). The low reach of existing programs has made the policy makers worried.…”

Section: Overall Contextual Aspects Affecting the Programmentioning

confidence: 99%

Process evaluation of a national elderly nutrition care program in Iran: Perspectives of clients and providers

Kheirouri

Alizadeh

Foroumandi

et al. 2020

Preprint

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Background The rapid growth of Iran elderly population highlights the importance of more attention to nutritional needs of this age group. Process evaluation study on the nutritional part of the national Elderly-Integrated Care Program was conducted to examine degree of exposure and satisfaction of the targets with the program components, and assess the reach, delivery, fidelity, and external contexts of the program.Methods To evaluate perspectives of clients on elderly integrated nutrition care program (EINCP) implementation process, a self-administrated questionnaire was constructed, validated, and applied to 256 individuals with the age of above 60 years attending the program at 57 health care centers of Tabriz metropolitan area of East Azerbaijan province in Iran using convenience sampling method. Another valid questionnaire was also applied to investigate viewpoint of the perceptions of 76 staffs of these health care centers as the program providers around the EINCP.Results The reach rate of the clients was reported 20.0%. Delivery of the educational components to entire program providers was accomplished (100.0%); however, the delivery of some parts of the program to the clients had some main weaknesses. The fidelity of the program tools was considered inadequate from perspectives of both clients and providers. 77.5% of the clients had exposure to the program. Clients’ satisfaction rate was varied from 4.2 to 34.7% with various available services, but 42.8% of the clients had high satisfaction with overall parts of the EINCP. The program also suffered from some external contexts such as the lack of financial support of program providers.Conclusion The format of the EINCP and strategies related to recruitment of the clients should be improved in order to minimize the barriers highlighted in this study. The providers should focus on raising the compliance of clients to receive a higher reach rate. It is suggested that program planners add periodic monitoring and evaluation of the program.

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“…The "Vida Ativa Melhorando a Saúde -VAMOS" (Active Life Improving Health) is a behavior change program that aims to motivate people to adopt an active and healthy lifestyle regarding physical activity and eating 3,4 . The VAMOS is a pioneer in Brazilian public health, and it has shown improvements in the level of physical activity 5,6 , the increase in healthy food consumption 6,7 , and bodyweight reduction 6 .…”

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confidence: 99%

Food consumption scale validation in VAMOS Program: a proposal to assess eating behavior changes in Brazil

Benedetti

Christofoletti

Quinaud

et al. 2023

Ciênc. saúde coletiva

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This study aimed to validate the frequency consumption scale (FCS) and establish cut-off points to assess changes in the eating behavior of participants in the VAMOS Program. The study was based on a community intervention conducted in 2019 in 70 Brazilian cities, with 458 adults from Primary Care. The questionnaire consisted of 12 questions about food frequency consumption. The questions were inserted into the analytical workflow, divided into the descriptive analysis, exploratory and confirmatory factor analysis (EFA), item response theory (IRT) modeling, and construction and validity of an applied questionnaire score. EFA indicated a two-factor structure, with three “healthy” (raw vegetables, fruits, and cooked vegetables) and three “unhealthy” (sugary drinks, sweets, and the replacement of meals with snacks) eating items. Items responses’ probabilities indicate a daily consumption of two healthy and once or nonweekly consumption of unhealthy items. Finally, the four categories proposed for FCS can respond over time. Therefore, the FCS proposal can be used effectively for program nutrition evaluation. Furthermore, it is possible to attribute behavior change in Brazilian primary care users with six items.

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Reach of “VAMOS” program in basic healthcare - organizational barriers and facilitators

Cited by 3 publications

References 20 publications

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

Process evaluation of a national elderly nutrition care program in Iran: Perspectives of clients and providers

Food consumption scale validation in VAMOS Program: a proposal to assess eating behavior changes in Brazil

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