Research Article
Predictors of Sustained Implementation of Low-Literacy Health Education Programs
Bergen B Nelson1,2,*, Carol Teutsch3, Paul J Chung1,2,4, and Ariella Herman31Department of Pediatrics, Mattel Children’s Hospital and David Geffen School of Medicine at UCLA, USA
2UCLA Children’s Discovery and Innovation Institute, USA
3Health Care Institute, Anderson School of Management, UCLA, USA
4Department of Health Management and Policy, Fielding School of Public Health, UCLA 5RAND Corporation, Santa Monica, CA, USA
- *Corresponding Author:
- Bergen B Nelson
Division of General Pediatrics
UCLA, 10833 Le Conte Ave
Los Angeles, CA, USA
Tel: (310) 794-8833
Fax: (310) 206-4855
E-mail: bnelson@mednet.ucla.edu
Received date August 12, 2014; Accepted date November 19, 2014; Published date November 21, 2014
Citation: Nelson BB, Teutsch C, Chung PJ, Herman A (2014) Predictors of Sustained Implementation of Low-Literacy Health Education Programs. J Community Med Health Educ 4:314. doi:10.4172/2161-0711.1000314
Copyright: © 2014 Nelson BB, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Sustained implementation of health education interventions is important to optimize the impact of initial investments in program development and training. From 2002-2012, the Health Care Institute (HCI) at UCLA trained 192 Head Start grantees, serving low-income preschool children and families in the U.S., on how to implement lowliteracy health education programs, using a train-the-trainer (TTT) model. The purpose of this study was to investigate what key factors of implementation are associated with sustainability of HCI programs, based on an online survey of Head Start grantees who have participated in the HCI TTT. A 51% response rate was achieved, with 96 surveys returned from the 188 sent to agencies that are still open. Of the grantees responding to the survey, 84% reported that they continue to implement HCI programs and 71% continue to implement them annually. Key predictors of annual implementation included: engagement of stakeholders at all levels; continuing to provide incentives for families; putting HCI into the annual training and technical assistance budget; sending additional staff to the TTT; seeing an improvement in overall program performance; and adapting HCI topics to meet local Head Start grantee needs. Qualitative responses described these same factors in additional detail. These results are consistent with previous research on program sustainability and suggest which elements of implementation may be most important as initial and ongoing investments, if sustainability is a program goal.