目标:到外面去,GetActive(GOGA)计划是一项随机对照试验,该试验测试了多组件实施策略的影响,以支持早期儿童教育和护理(ECEC)服务,以将仅室内的免费游戏替换为室内-室外免费游戏。这项横断面研究旨在使用报告基于证据的实施策略的适应和修改框架(FRAME-IS)来描述对实施策略和行为改变技术(BCT)进行修改的程度和性质,并描述整个GOGA中BCT交付的保真度。
方法:在干预组的整个干预交付期间对记录进行审核。GOGA在六项实施战略中纳入了14项标准BCT。健康促进官员通过项目记录记录了修改和BCT交付情况。根据FRAME-IS对修改进行分类。使用检查表记录BCT交付。
结果:44个ECEC服务获得了GOGA计划。总的来说,记录了60次修改。根据FRAME-IS类别,大多数修改与:内容;格式;务实或实际考虑;本质上的剪裁/调整/精炼;保真度不一致;目标是增加可接受性,适当性,或实施工作的可行性;理由是在从业者层面;并且是计划外/反应性的。总的来说,96.4%的标准BCT按预期交付。
结论:GOGA以符合方案的高保真度递送,如BCT递送水平所示。本文详细介绍了记录修改的全面方法,并为未来的研究提供了指导。所以呢?:本文为有关公共卫生实施干预措施的适应和修改的记录提供了新的证据。
OBJECTIVE: The Get Outside, Get Active (GOGA) program is a randomised controlled trial which tested the impact of a multi-component implementation strategy to support early childhood education and care (ECEC) services to replace indoor-only free play with indoor-outdoor-free play. This cross-sectional study aims to describe the extent and nature of
modifications made to implementation strategies and Behaviour Change Techniques (BCTs) using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) and to describe the fidelity of BCT delivery throughout GOGA.
METHODS: An audit of records was undertaken throughout the intervention delivery period in the intervention arm. GOGA included 14 standard BCTs within six implementation strategies.
Modifications and BCT delivery were recorded by Health Promotion Officers via project records.
Modifications were categorised according to the FRAME-IS. BCT delivery was recorded using a checklist.
RESULTS: Forty-four ECEC services received the GOGA program. Overall, 60
modifications were recorded. According to FRAME-IS categories, most modifications related to: content; format; pragmatic or practical considerations; tailoring/tweaking/refining in nature; fidelity was inconsistent; the goal was to increase the acceptability, appropriateness, or feasibility of the implementation effort; the rationale was at the practitioner level; and were unplanned/reactive. Overall, 96.4% of standard BCTs were delivered as intended.
CONCLUSIONS: GOGA was delivered with high fidelity to protocol as indicated by the level of BCT delivery. This article details a thorough approach to documenting
modifications and provides guidance for future studies. SO WHAT?: This article contributes to the emerging evidence regarding documentation of adaptations and modifications to public health implementation interventions.