Annals of the New York Academy of Sciences · 2018 · 121 citations · 38 references
Public HealthPediatricsChild DevelopmentEarly InterventionImplementation ScienceFidelity Of ImplementationHybrid Effectiveness-implementation StudiesImplementation Capacity BuildingImplementation OutcomesImplementation StrategiesQuality Improvement In ImplementationFeasibility Studies For IncorporationImplementation Outcomes MeasurementImplementation Processes
Research in early childhood development shows that scaling‑up multisectoral nurturing care interventions can improve socioeconomic outcomes, yet the key elements and processes for implementation and scale‑up remain poorly understood, and effective implementation is essential for positive developmental outcomes. The paper aims to synthesize implementation evidence for nurturing care in early childhood development, identify gaps, and propose strategies for scaling interventions, emphasizing evidence‑based adaptation for high impact, particularly in low‑resource settings. The authors review implementation research for ECD, outlining key dimensions such as context adaptation, standardized reporting, feasibility studies, fidelity, quality improvement, and integration into existing systems, and propose strategies for scaling nurturing care interventions.
Abstract Research in early childhood development (ECD) has established the need for scaling‐up multisectoral interventions for nurturing care to promote ECD, for improved socioeconomic outcomes for sustainable societies. However, key elements and processes for implementation and scale‐up of such interventions are not well understood. This special series on implementation research and practice for ECD brings together evidence to inform effectiveness, quality, and scale in nurturing care programs; identifies knowledge gaps; and proposes further directions for research and practice. This paper frames the dimensions and components fundamental to the understanding of implementation processes for nurturing care interventions, factors for improving implementation of interventions, and strategies to scale by embedding interventions in delivery systems. We discuss emerging issues in implementation research for ECD, including (1) the role of context in adaptation and implementation, (2) standardized reporting of implementation research, (3) the importance of feasibility studies to inform scale‐up and capacity building, (4) fidelity and program quality improvement, and (5) intervention integration into existing systems. Effective implementation of nurturing care interventions is at the heart of achieving positive developmental outcomes for young children. It is pivotal to adapt and implement these interventions based on evidence for high impact, especially in low‐resource settings.
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