Process evaluation of an integrated community-based intervention for promoting health equity in children in a new residential development area

Stephan Voss; Julia Bauer; Caroline Jung-Sievers; Graham Moore; Eva Rehfuess; Valerie Zu Rhein; Michaela Coenen

doi:10.1186/s13690-024-01246-z

Process evaluation of an integrated community-based intervention for promoting health equity in children in a new residential development area

Arch Public Health. 2024 Feb 6;82(1):19. doi: 10.1186/s13690-024-01246-z.

Authors

Stephan Voss^{1

2}, Julia Bauer^{3

4}, Caroline Jung-Sievers^{3

4}, Graham Moore^{5

6}, Eva Rehfuess^{3

4}, Valerie Zu Rhein^{3

4}, Michaela Coenen^{3

4}

Affiliations

¹ Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Elisabeth-Winterhalter-Weg 6, Munich, 81377, Germany. svoss@ibe.med.uni-muenchen.de.
² Pettenkofer School of Public Health, Munich, Germany. svoss@ibe.med.uni-muenchen.de.
³ Chair of Public Health and Health Services Research, Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Elisabeth-Winterhalter-Weg 6, Munich, 81377, Germany.
⁴ Pettenkofer School of Public Health, Munich, Germany.
⁵ Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, UK.
⁶ Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.

Abstract

Background: Reducing health inequities for children from a disadvantaged background is an important task in public health. While intersectoral partnerships are a promising way to achieve this, few studies have examined the factors influencing the success of these interventions. In this study, we conducted a process evaluation of the integrated community-based intervention Präventionskette Freiham that the city of Munich, Germany, has implemented in a new residential development area. The aim was to investigate the implementation process as well as barriers and facilitators.

Methods: Following a mixed methods approach, we collected data from different core groups making up Präventionskette Freiham from April 2020 to August 2022, exploring their perspective on the implementation process. We conducted repeated qualitative interviews with the network coordinators and eleven local professionals from institutions engaged with or relevant for the intervention. We also undertook a focus group with four members of the advisory group representing the three municipal departments guiding the intervention. Ego-centered network maps were drawn by the network coordinators to chart the development of the network. Subsequently, we also conducted an online survey with local network members.

Results: At the early stage of the implementation process, the intervention was able to integrate actors from different sectors, serving as a platform for mutual exchange. However, the network produced limited output. According to the interviews, this may be mainly attributable to the early development status of the area. We identified seven topics that may act as facilitators or barriers to implementation of Präventionskette Freiham: (1) availability of resources, (2) political and administrative support, (3) the network coordinators, (4) network-internal processes, (5) trans-institutional cooperation, (6) perceived benefits of engagement, and (7) the output of the network.

Conclusions: The early development status of the area was a challenge for the intervention. This emphasizes the need to carefully consider context when planning and implementing integrated community-based public health interventions in new residential development areas.

Keywords: Child and adolescent health; Health equity; Health promotion; Integrated community-based intervention; Mixed methods; Process evaluation; Public health service.