Designing Behavioral Medicine Programs for Dissemination and Sustainable Practice

Trina Robertson, MS, RDN¹; Jasmine Douglas, PhD²; Aubrey Villalobos, DrPH, Med³; Jessica Gorzelitz, PhD⁴; Reema Persad-Clem PhD, MPH⁵; Population Health Sciences SIG

Value of Designing for Implementation

Designing research for dissemination begins at the conception of research design, which facilitates moving research upstream for broad implementation. This case study shares an exemplary research intervention, Let’s Eat Healthy (formerly Nutrition Pathfinders). The dissemination modalities that transpired since the main outcome publication expands the resource reach and serves as a teaching tool for graduate students to develop their public health competencies related to research. An evaluation¹ of the program using the RE-AIM framework was published in Translational Behavioral Medicine and demonstrated that the fourth grade program has a moderate public health impact on student choices. It serves as an example of how behavioral scientists can broaden intervention reach and promotion through strong evaluation projects to support how to improve health in the communities they serve.

Program Design and Evaluation

Let’s Eat Healthy was developed to address gaps in nutrition education by providing a variety of learning experiences that promote healthy eating habits in 4^th graders. This research intervention was designed for dissemination at the conceptualization stage by taking steps like developing high-quality program materials and doing outreach planning². After the program was found to be effective¹, researchers and program partners extended outreach to increase program adoption and widen impact including adding the program to public databases (e.g., the National Cancer Institute’s Evidence-Based Cancer Control Programs (EBCCP) website) and developing case study stories and applied learning opportunities for graduate students).

Impact of Outreach

Since broadening outreach efforts, designing for dissemination had the following impact:

Broad Dissemination. In 2019, the program was posted on the EBCCP website—a searchable database of cancer control programs across 14 health areas including diet and nutrition. The Let’s Eat Healthy program was featured in the site’s newsletter which has over 12,000 subscribers and has been adapted as video lessons to expand reach.

Program Adoption and Sustainability. The developers’ dissemination success resulted in wide program adoption and it is now an approved classroom resource by the California Department of Public Health and the California Department of Education. In the past five school years, over 11,000 educators have ordered the program requesting over 385,000 student booklets for the continuation of desirable program outcomes.

Student Learning Opportunities

The Let’s Eat Healthy program research methodology is examined in the Evaluation of Research for Implementation teaching case study—a structured learning opportunity for students to develop public health competencies related to research, evaluation, and implementation science. This case study was piloted in a graduate program classroom and the professor shared:

"…the NCI’s case study for teaching was received by our DrPH students as a valuable opportunity to reinforce, clarify, and apply the basic implementation science concepts. This learning case study challenges students to consider critical elements from theory to study design, indicator development, and assessment of evidence, including answering difficult questions like “how much evidence is enough?” I highly recommend using this practical example in the classroom to foster critical thinking and skills development.” - Emily Peca, DrPH, MA, Professorial Lecturer at the George Washington University

Student Reflections

A review of NCI’s case study by SBM’s Student SIG in this issue of the Outlook newsletter highlights the benefits for expanding education to include implementation and dissemination plans at the beginning of a project. This allows for sustainable research, meaningful practice and applied learning opportunities. Collaborating with others and educating students creates a culture of sustainable research that broadens reach.

To learn more or to get involved in designing for dissemination, please consider joining the Population Health Sciences SIG and connecting with community programs that focus on implementation design and would benefit from academic research expertise.

Affiliations

1. Evaluation and Impact Manager, Dairy Council of California
2. Communications Manager, ICF
3. Health Scientist, National Cancer Institute
4. Assistant Professor, Department of Health & Human Physiology, University of Iowa
5. Assistant Professor, Department of Public Health, Arcadia University

References

1. Larsen, A. L., Robertson, T., & Dunton, G. (2015). RE-AIM analysis of a randomized school-based nutrition intervention among fourth-grade classrooms in California. Translational Behavioral Medicine, 5(3), 315-326. https://doi.org/10.1007/s13142-015-0311-6
2. Kwan, B. M., Brownson, R. C., Glasgow, R. E., Morrato, E. H., & Luke, D. A. (2022). Designing for Dissemination and Sustainability to Promote Equitable Impacts on Health. Annual Review of Public Health, 43, 331–353. https://doi.org/10.1146/annurev-publhealth-052220-112457