A collaborative approach to developing sustainable behaviour change interventions for childhood obesity prevention: Development of the Choosing Healthy Eating for Infant Health (CHErIsH) intervention and implementation strategy

Abstract

Objectives and Design. There is growing recognition of the need for effective behaviour change interventions to prevent chronic diseases that are feasible and sustainable and can be implemented within routine health care systems. Focusing on implementation from the outset of intervention development, and incorporating multiple stakeholder perspectives to achieve this, is therefore essential. This study explores the development of the Choosing Healthy Eating for Infant Health (CHErIsH) childhood obesity prevention intervention and implementation strategy to improve infant feeding behaviours.Methods. Five qualitative and quantitative evidence syntheses, two primary qualitative studies, and formal/informal consultations were conducted with practice, policy, Results. The CHErIsH intervention targets parent-level behaviour change and comprises (1) brief verbal messages and (2) trustworthy resources, to be delivered by health care professionals (HCPs) during routine infant vaccination visits. The implementation strategy targets HCP-level behaviour change and comprises (1) a local opinion leader, (2) incentivized training, (3) HCP resources and educational materials, (4) electronic delivery prompts, (5) awareness-raising across all primary care HCPs, and (6) local technical support.Conclusions. This study provides a rigorous example of the development of an evidence-based intervention aimed at improving parental infant feeding behaviours, alongside an evidence-based behaviour change strategy to facilitate implementation and sustainability in primary care. This approach demonstrates how to systematically incorporate multiple stakeholder perspectives with existing literature and move from multiple evidence sources to clearly specified intervention components for both the intervention and implementation strategy. Statement of ContributionWhat is already known?Incorporating insights from practice, policy, and public/patient stakeholders plays a key role in developing behaviour change interventions that are feasible and sustainable and can be implemented within routine health care systems. However, there are limited examples that provide in-depth guidance of how to do this using a systematic approach.

Exploring healthcare professionals’ views of the acceptability of delivering interventions to promote healthy infant feeding practices within primary care: a qualitative interview study

“…The study also aimed to inform the development of the Choosing Healthy Eating for Infant Health (CHErIsH) intervention and to identify anticipated barriers and enablers to delivering infant feeding interventions during vaccination visits. The CHErIsH multidisciplinary study aims to develop and evaluate a brief intervention to support and promote healthy infant feeding practices delivered during vaccination visits, with an overall goal of preventing childhood obesity (33,34) .…”

Supporting self-management and clinic attendance in young adults with type 1 diabetes: development of the D1 Now intervention

“…the systematic review and qualitative study), which meant that findings were combined iteratively throughout the course of intervention development. The international expert consensus meeting was an important step and allowed the development of the intervention to be informed by international expertise and best practice; such that while developed in Ireland, the intervention has global relevance [ 27 ]. A strength of our work is the interdisciplinary nature of our team with clinicians familiar with young adult diabetes care working alongside experts in behaviour change.…”

“…If found to be efficacious, it will provide important evidence on supporting self-management in young adults living with T1D. The transparency of the processes of intervention development will allow better testing of the logic model and facilitate future replication or refinement of the intervention [ 27 ]. The next stage of the research is to assess the acceptability and feasibility of using the intervention in diabetes clinics as well as the feasibility of running a RCT.…”

Enhancing the Behaviour Change Wheel with synthesis, stakeholder involvement and decision-making: a case example using the ‘Enhancing the Quality of Psychological Interventions Delivered by Telephone’ (EQUITy) research programme

“…One of the weaknesses in the implementation of the Behavioural Change Wheel [1] is the lack of involvement of stakeholders [5], although the situation is changing and authors are increasingly incorporating stakeholder perspectives in their intervention development [36][37][38]. In our worked example, we incorporated stakeholder perspectives and provided solutions to potential issues such as how to include diversity and equity of voice and power across stakeholder groups and how to capture their views in a systematic and auditable way.…”