Community Stakeholder’s Perceptions of the Core Components of a Pediatric Weight Management Intervention

Abstract Background: Multi-sector stakeholder engagement is essential in understanding what is needed for the implementation, dissemination and sustainability of pediatric weight management interventions (PWMI). Methods: We sought to examine the perspectives of stakeholders during the pre-implementation period of a two-arm, PWMI randomized controlled trial (RCT) in federally qualified health centers and YMCAs. We conducted the interviews prior to the implementation of the RCT and reached thematic saturation. Interviews were transcribed and coded using the Consolidated Framework for Implementation Research (CFIR) approach as the intent of the trial was to observe implementation and efficacy outcomes. Our aims were (1) to understand the core components needed for a successful PWMI and (2) to identify determinants and barriers to implementation and future wide-scale dissemination. We conducted the interviews prior to the implementation of the RCT and reached thematic saturation after interviewing 26 stakeholders representing 13 groups. Interviews were transcribed and coded using the framework analysis approach.Results and discussion: We identified themes that stakeholders perceived as core components of a PWMI: a formal curriculum with illustrative examples for patients (i.e. demonstrating how much sugar is in sugary beverages), a patient and family centered program, group visits, and inclusion of high-quality core personnel such as a community health worker, a physician, a behavior health clinician and a dietitian. Determinants of successful implementation and dissemination included partnerships among community and clinical organizations, sustained funding, supportive policies such as insurance reimbursement for community health workers and dietitians, and identifying and addressing needs of dissemination sites, and identifying and addressing patient barriers. These findings helped to identify the core components required for PWMIs and how best to address key determinants affecting implementation and dissemination. Trial registration: ClinicalTrials.gov: NCT03012126; registration date: 12 December 2016, https://clinicaltrials.gov/ct2/show/NCT03012126