WITHDRAWN: “Putting Meat on the Bones”. the Development and Installation of a Wraparound-Inspired Early Parenting Intervention in Community-Based Settings: A Real-World, Theory Based Evaluation.

Background: The lifepath trajectories of at-risk families can be significantly enhanced through early intervention and prevention. However, developing and installing innovations within existing services is a complex undertaking (Powell et al., 2015). Understanding is limited with respect to how to identify, design and implement evidence-informed early intervention programmes within usual care systems and services for young infants and their families (Horwitz et al., 2010). This paper examines the development of a group-based, early parenting intervention, the Parent and Infant (PIN) programme, which aims to promote wraparound-inspired intervention through the multidisciplinary delivery of evidence-informed, group parenting supports on a universal, community-wide basis. The PIN programme combines the Incredible Years Parent and Baby/Toddler programmes with additional developmentally-tailored service provisions (e.g. baby massage, weaning workshops, first aid) and is designed to strengthen parenting competence and promote child health and wellbeing. Methods: Using a multi-method, theory-based framework, we appraised the development and early implementation the PIN programme. Data analysis included the systematic scrutiny of key documents (e.g. programme manuals, meeting minutes), one-to-one interviews (n=15) and six group discussions with programme developers, programme staff and practitioners involved in service delivery (n=29). Results: The triangulated analysis generated 7 key themes: (i) developing an understanding of the local context; (ii) creating a hospitable environment for innovation; (iii) strategic leadership; (iv) diffusing resistance to change; (v) scaffolding change through training, coaching and support; (vi) leveraging capacity; and (vii) strategic organisational and resource development. Conclusion: The findings indicate the importance of generating ‘fit’ between evidence-informed service innovations and the real world setting in which they are implemented. Putting “meat on the bones” of programme implementation requires ongoing relationship building and partnership working in order to engender buy-in and support for innovation amongst key local stakeholders involved at all levels of the implementation process. Likewise, a graduated approach to implementation which provides “on-the-job” coaching and administrative supports for practice change are important in creating an environment conducive to innovation. Overall, these findings provide important lessons for how implementation frameworks can be ‘fleshed out’ and used by service providers/decision makers looking to embed comprehensive, evidence-informed programmes and practices within community-based early child development and family services