Application of the consolidated framework for implementation research
| Construct | Application to intervention |
|---|---|
| Intervention characteristics: characteristics of the healthy eating and physical activity policies and practices | |
| Intervention source: Was the intervention developed internally by childcare services or by external agencies? | The intervention was designed externally by an expert advisory group of health promotion practitioners, psychologists, dietitians, behavioural scientists and physical activity experts, in consultation with nominated supervisors from local childcare services. Components of the intervention (including staff training workshops and the tools and resources) will be pilot tested with childcare services prior to implementation |
| Evidence strength and quality: What are the nominated supervisor's and childcare service staff's perceptions of the strength and quality of evidence that the intervention will have the intended outcomes? | There is strong evidence to support childcare services as a setting to create environments more supportive of child healthy eating and physical activity. The strength of evidence will be communicated to childcare service staff during telephone contact, face-to-face meetings, training workshops, service visits and newsletters. Policies and practices are consistent with licensing and accreditation requirements and evidence-based best practice guidelines for the childcare setting |
| Adaptability: Is the intervention able to be adapted or tailored to meet the needs of the childcare service? | Staff training workshops will be tailored to meet service needs based on the policies and practices not being implemented at baseline. Implementation support staff will employ consensus processes regarding how to implement policies and practices that best suit the service needs. Advice on the use of tools and resources will be tailored based on identified barriers to changing healthy eating and physical activity policy and practice |
| Complexity: What are the nominated supervisor's and childcare service staff's perceptions of implementation difficulty? | Healthy eating and physical activity policies and practices endorsed by the intervention are consistent with existing licensing and accreditation requirements for the setting. Support will focus on integrating policies and practices into existing service routines to reduce the burden on childcare service staff. This will be communicated to childcare service staff during telephone contact, face-to-face meetings, training workshops, service visits and newsletters |
| Design quality and packaging: What are the nominated supervisor's and childcare service staff's perceptions of how the intervention is presented? | Tools and resources will be reviewed by nominated supervisors and childcare service staff to ensure that they are professionally presented, attractive and user friendly. Newsletters will be bright and visually appealing |
| Cost: What are the costs of the intervention and associated implementation? | The intervention will be provided to childcare services at no cost. This will be communicated to childcare service staff during telephone contact, face-to-face meetings, training workshops, service visits and newsletters |
| Outer setting: the economic, political and social context within which the childcare service operates | |
| Peer pressure: Is there competitive pressure to implement the intervention? | Successful implementation of all policies and practices by childcare services will be communicated to other intervention services using a communications strategy. Individual service performance will be compared against the performance of all services receiving the intervention to permit peer comparison |
| External policy and incentives: What are the external strategies to spread the intervention (including policy and regulations, external mandates, recommendations and guidelines)? | Policies and practices are consistent with licensing and accreditation requirements and evidence-based best practice guidelines for the childcare setting. The use of continuous quality improvement principles during support contacts aligns with external policy and accreditation requirements for the childcare setting |
| Inner setting: the childcare service structural, political and cultural contexts through which the implementation process will proceed | |
| Tension for change: Do the nominated supervisor and childcare service staff perceive the current situation as needing to change? | The need for change will be explored during consensus processes, communicated to childcare service staff through newsletters via presentation of data and advocated by implementation support staff at training workshops and other service contacts |
| Relative priority: Do childcare service staff have a shared perception of the importance of implementation within the childcare service? | Nominated supervisors will communicate to childcare service staff that implementation of the targeted policies and practices represent an organisational priority during training workshops and staff meetings and via the development and endorsement of supportive policy |
| Organisational incentives and rewards: Does the intervention include incentives such as goal-sharing awards, performance reviews, increased stature? | Services that demonstrate achievement of all policies and practices will receive a certificate of recognition and will be promoted to other intervention services in newsletters and through training workshops |
| Goals and feedback: Are goals clearly communicated, acted on and fed back to nominated supervisor and childcare service staff? | Implementation support staff contacts with childcare service staff will draw on continuous quality improvement principles to review progress, provide positive reinforcement, discuss deficits identified from self-monitoring and facilitate reflection, problem solving, goal setting and action. Furthermore, performance feedback will be provided to services regarding achievement of key implementation goals |
| Leadership engagement: Are nominated supervisors committed, involved and accountable for the implementation? | Nominated supervisors and management committees will be engaged and encouraged to communicate their endorsement of practice changes to childcare service staff during staff meetings, training workshops and via the consensus processes. Performance feedback reports will be circulated to management committees and childcare service staff |
| Access to information and knowledge: How easy is it for childcare service staff to access information and knowledge about the intervention and how to incorporate it into work tasks? | Nominated supervisors and childcare service staff will receive resources and ongoing support from implementation support staff via face-to-face meetings, telephone and email. Services will also be able to contact implementation support staff at any time for advice or assistance |
| Characteristics of individuals: characteristics of childcare service staff | |
| Knowledge and beliefs about the intervention: What are the nominated supervisor and childcare service staff attitudes towards the intervention? | Beliefs of nominated supervisors and childcare service staff will be explored during initial service contacts. Beliefs which are incongruent with policy or practice implementation will be targeted during future intervention contacts. A focus of training workshops will be to provide knowledge for childcare service staff to motivate and equip staff with knowledge to facilitate implementation |
| Process: the active change process aimed to achieve individual staff and childcare service use of the intervention | |
| Engaging: Are appropriate individuals involved in the implementation through education, role modelling, training? | Service management committees, nominated supervisors and childcare service staff will be engaged in implementation through involvement in discussions regarding service priorities, service goals and strategies to meet goals and overcome barriers. Services will be encouraged to explain and communicate any changes to service operation to families |