Implementation Constructs Associated with Parent Engagement for the Brighter Bites Program
Researchers and public health practitioners continue to identify problems with program effectiveness and scaling in a real-world setting. Implementation research aims to expand the use of theoretical approaches and to better understand implementation successes and failures of health promotion programs. The purpose of this study was to identify key factors that affect program implementation for Brighter Bites. Brighter Bites utilizes a school-based food co-op model to provide access to fresh fruits and vegetables, a fun food experience through recipe samples, and nutrition education for families in low income schools via CATCH. Parents are the primary change maker for their children, which is why parent engagement is an important metric for program success. It was hypothesized that parent engagement outcomes are associated with the fidelity of program implementation. A questionnaire was developed based on constructs found in the Consolidated Framework for Implementation Research (CFIR) and administered to personnel in schools where Brighter Bites is implemented. Data was collected from 436 participants from 49 schools in Houston, Austin, and Dallas, Texas. Tests of reliability and validity of the questionnaire and of the CFIR implementation constructs were conducted including factor analysis, interrater reliability, and interrater agreement. Correlations were run and linear regression models were constructed between parent engagement outcomes measures for parent volunteering and program participation, and CFIR implementation constructs: available resources, engaging champions, and implementation climate. Various statistical analyses were conducted to evaluate the validity of the questionnaire and the CFIR implementation constructs, including mean, standard deviation, range, Cronbach’s alpha, and CFA. These analyses supported the aggregation of individual questionnaire items into CFIR implementation construct scales. Tests for interrater agreement and reliability were conducted also. These analyses were used to determine whether individual-level respondent data should be aggregated to represent school-level data. The statistics did not overwhelmingly support data aggregation, but a case could be made. Thus, individual respondent data was aggregated to the school-level. This school-level data was used in further analyses to determine the existence of associations between implementation constructs and the parent engagement process outcomes. Only two correlations were found to have significant p values, and regression models were unable to account for a notable portion of parent process outcome variance. There were limitations that likely affected the results of this study including an information bias of the population sampled, questionnaire scope and sensitivity, and a small sample size. This study provides value to the fields of implementation research and health promotion research in that it presents a framework and recommendations for addressing limitations and challenges to comprehensive implementation evaluation of school-based health promotion programs.
Nutrition|Public health|Behavioral Sciences|Individual & family studies
McMath, Colton, "Implementation Constructs Associated with Parent Engagement for the Brighter Bites Program" (2017). Texas Medical Center Dissertations (via ProQuest). AAI10278136.