Session: Abstracts of Distinction: The Family Check-up 4 Health to Reduce Pediatric Obesity: Key Considerations for Sustainable Implementation in Primary Care (Society for Prevention Research 25th Annual Meeting)

The pediatric primary care context is in many ways ideal for the delivery of parenting programs that prevent common problems in childhood (Leslie et al., 2016). Parents routinely interact with their child’s pediatrician and expect to receive advice about parenting. Despite the appropriateness and acceptability of delivering parenting programs in primary care, and the potential to reach a large proportion of the population, sustained implementation is a challenge. In this symposium, the presenters discuss the process and methods being used in a large, CDC-funded trial of the Family Check-Up 4 Health to address three critical challenges: (1) the adaptation of an evidence-based parenting program for the primary care system; (2) establishing partnerships with key stakeholders and community partners; and (3) evaluating the health economics of delivering the program in primary care.

The need to adapt current evidence-based parenting programs is a well-documented barrier given the time demands of primary care and the mismatch with most parenting programs that call for delivering 5-22 sessions (Forgatch & Patterson, 2010). In the first paper, we explain how the Dynamic Adaptation Process (Aarons et al., 2012) was used to adapt the Family Check-Up (FCU) for primary care. This multi-step process included assessment of organizational and client needs and capacity, stakeholder and expert input, family feedback, and pilot testing.

Establishing partnerships and engaging stakeholders in such an effort is emphasized in public health and implementation research. The necessary partnerships for sustainment go beyond the research-community collaboration and extend to other decision makers, such as funders. In the second paper, the Kellam (2012) partnership model is used to describe the process of engaging stakeholders in the effort to sustainably embed the FCU in primary care. Qualitative data will be presented with respect to barriers and solutions identified by the stakeholder board.

Last, the cost associated with implementing a new innovation is one of the primary reasons for failure to sustain delivery and is one of the most convincing pieces of information for decision makers (Glasgow & Emmons, 2007). The third paper describes the aims of a prospective cost analysis and the methodology used to gather relevant data to estimate costs from the perspective of multiple stakeholders in the system: the agency, the family, payors, and public health. Costs are also examined at different stages from initial implementation to ongoing and sustained delivery.

Each of these factors must be addressed for the successful implementation of parenting programs in primary care. The discussant will speak to relevant policy and public health implications.