ABSTRACT
Background: Childhood obesity is highly prevalent in the US and disproportionately impacts minorities;these disparities have worsened during the COVID-19 pandemic. Adoption of effective pediatric weight management interventions (PWMI) that have been evaluated among low-income minority populations is needed. Connect for Healthy Weight, a package co-developed by the AAP and MGH, helps federally qualified health centers (FQHC) establish multidisciplinary healthy weight clinics based on previous effective RCTs. We sought to identify the determinants to successful adoption of Connect for Healthy Weight in pre-and post-implementation sites. Methods: We interviewed 19 stakeholders, 10 from two FQHCs in MS where Connect for Healthy Weight will be piloted and 9 from health centers that have previously implemented it. Separate interview guides informed by the Consolidated Framework for Implementation Research were developed. Qualitative data analysis was conducted using the immersion-crystallization method. Results: In pre-implementation sites, an inner setting facilitator mentioned was a positive learning climate. Characteristics of individuals that can facilitate adoption include staff willingness to learn, valuing evidence-based care for childhood obesity, and culturally and weight-sensitive staff. In terms of patient needs and resources (outer setting), social determinants of health are barriers to adoption, but creative solutions were suggested to mitigate these. Other facilitators related to the intervention included its multidisciplinary model and adaptability. Similar themes were elicited from post-implementation sites;adaptations brought on by the pandemic, such as telehealth visits and content modification to align with distancing guidelines and the effects of social isolation were also described. Conclusions: Understanding the determinants to adoption of an evidence-based PWMI allows for necessary adaptations to be made to facilitate adoption and nationwide dissemination.