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Process evaluation of a health cente...

Robert, Rebecca C.

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Process evaluation of a health center delivered, nutrition education intervention to improve infant feeding in Trujillo, Peru.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Process evaluation of a health center delivered, nutrition education intervention to improve infant feeding in Trujillo, Peru./
Author:	Robert, Rebecca C.
Description:	368 p.
Notes:	Source: Dissertation Abstracts International, Volume: 65-12, Section: B, page: 6330.
Contained By:	Dissertation Abstracts International65-12B.
Subject:	Health Sciences, Public Health. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3155672
ISBN:	0496164783

Process evaluation of a health center delivered, nutrition education intervention to improve infant feeding in Trujillo, Peru.
Robert, Rebecca C.

Process evaluation of a health center delivered, nutrition education intervention to improve infant feeding in Trujillo, Peru. - 368 p.

Source: Dissertation Abstracts International, Volume: 65-12, Section: B, page: 6330.

Thesis (Ph.D.)--The Johns Hopkins University, 2005.

In Peru and throughout the developing world, childhood malnutrition remains a common public health problem signaling the need to establish effective preventive programs. Process evaluation was undertaken as part of the overall evaluation strategy for a randomized, controlled trial of a health center-delivered, nutrition education intervention to improve the feeding behaviors of caregivers and the nutritional status of children 0--18 months in Trujillo, Peru. Process evaluation examined the implementation, reception and context of the intervention to: (1) thoroughly describe and understand program operations; (2) link together the steps expected to lead to behavior change; (3) explain eventual trial outcomes; and (4) assess the potential sustainability of the intervention. A theory-informed process evaluation was developed. Multiple quantitative and qualitative data collection methods were used to assess the following process indicators: dose delivered; fidelity of implementation; barriers to implementation; caregiver exposure; message recall; proximal outcomes; context; health provider acceptability; and potential intervention sustainability. Results from the intervention group demonstrated variation in intervention delivery: (1) among intervention components; (2) between health services; and (3) among health centers. Barriers to, and facilitators of, implementation were explored with health personnel and helped explain variability. Documented staff turnover was significant and considered a reason for variation. Mid-trial results for caregivers in the intervention communities demonstrated high exposure to at least one intervention component (81%), and recall of at least one key message (70%). Multivariate analysis demonstrated that key message recall was a significant factor in explaining two of three key feeding behaviors. Exposure to the intervention was a significant factor for one behavior. Significantly improved delivery of nutrition education, caregiver exposure to nutrition education, key message recall and efficacy for a key feeding behavior occurred in the intervention centers as compared to control centers. Results also demonstrated how process evaluation could contribute to assessments of intervention sustainability. In summary, although health personnel improved the overall level of nutrition education in the government centers and exposed the majority of caregivers to the intervention, implementation of the nutrition intervention was not optimal. Barriers were identified, which if addressed, would likely lead to improved implementation, caregiver exposure and outcomes.

ISBN: 0496164783Subjects--Topical Terms:

1017659
Health Sciences, Public Health.

Process evaluation of a health center delivered, nutrition education intervention to improve infant feeding in Trujillo, Peru.
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500 $a Adviser: Joel Gittelsohn.
502 $a Thesis (Ph.D.)--The Johns Hopkins University, 2005.
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