Barriers and facilitators to the implementation of a community-based, multidisciplinary, family-focused childhood weight management programme in Ireland: a qualitative study.

Content Provider	Europe PMC
Author	Kelleher, Emily Harrington, Janas M Shiely, Frances Perry, Ivan J McHugh, Sheena M
Copyright Year	2017
Abstract	ObjectiveTo explore the barriers and facilitators experienced by those implementing a government-funded, community-based childhood weight management programme.DesignQualitative using semistructured interviews.SettingTwo geographical regions in the south and west of Ireland.Participants29 national-level and local-level stakeholders responsible for implementing the programme, including professionals from dietetics, psychology, public health nursing, physiotherapy, health promotion and administration.MethodsFramework analysis was used to identify barriers and facilitators, which were mapped onto six levels of factors influencing implementation outlined by Grol and Wensing: the innovation, the individual professional, the patient, the social context, the organisational context and the external environment.ResultsMost barriers occurred at the level of the organisational context. For all stakeholders, barriers arose due to the multidisciplinary nature of the programme, including the lack of role clarity and added complexity of working in different locations. Health professionals’ low-perceived self-efficacy in approaching the subject of weight with parents and parental resistance to hearing about their child’s weight status were barriers to programme implementation at the individual professional and patient levels, respectively. The main facilitators of implementation, occurring at the level of the health professional, included stakeholders’ recognition of the need for a weight management programme and personal interest in the area of childhood obesity. Having a local lead and supportive colleagues were further implementation drivers.ConclusionsThis study highlights the complexities associated with implementing a multidisciplinary childhood weight management programme, particularly translating such a programme to a community setting. Our results suggest the assignment of clear roles and responsibilities, the provision of sufficient practical training and resources, and organisational support play pivotal roles in overcoming barriers to change. This evidence can be used to develop an implementation plan to support the translation of interventions into real-world settings.
Journal	BMJ Open
Volume Number	7
PubMed Central reference number	PMC5623413
Issue Number	8
PubMed reference number	28851786
e-ISSN	20446055
DOI	10.1136/bmjopen-2017-016459
Language	English
Publisher	BMJ Publishing Group
Publisher Date	2017-08-28
Publisher Place	London
Access Restriction	Open
Rights License	This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Subject Keyword	Implementation barriers facilitators childhood obesity community
Content Type	Text
Resource Type	Article
Subject	Medicine