• Developing Infrastructure to S...

*Result*: Developing Infrastructure to Scale-Up the Med-South Lifestyle Program: A 3-Step Process.

Title:
Developing Infrastructure to Scale-Up the Med-South Lifestyle Program: A 3-Step Process.
Authors:
Leeman J; Author Affiliations: School of Nursing, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina (Dr Leeman); Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina (Ms Draeger); and Gillings School of Global Public Health, Department of Nutrition, Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, North Carolina (Dr Samuel-Hodge)., Draeger LB, Samuel-Hodge CD
Source:
Journal of public health management and practice : JPHMP [J Public Health Manag Pract] 2026 Mar-Apr 01; Vol. 32 (2), pp. E55-E63. Date of Electronic Publication: 2025 Dec 19.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9505213 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1550-5022 (Electronic) Linking ISSN: 10784659 NLM ISO Abbreviation: J Public Health Manag Pract Subsets: MEDLINE
Imprint Name(s):
Publication: 2003- : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Frederick, MD : Aspen Publishers, c1995-
MeSH Terms:
Health Promotion*/methods , Program Development*/methods , Life Style*, Public Health/methods ; Program Evaluation/methods ; Humans
References:
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Samuel-Hodge CD, Gizlice Z, Allgood SD, et al. A hybrid implementation-effectiveness study of a community health worker-delivered intervention to reduce cardiovascular disease risk in a rural, underserved non-Hispanic black population: the CHANGE study. Am J Health Promot. 2022;36(6):948-958. doi:10.1177/08901171221078272. (PMID: 10.1177/08901171221078272)
Samuel-Hodge CD, Pham L, Lyons K, et al. Scaling up the Med-South lifestyle program in public health settings to reduce chronic disease risk: a hybrid implementation-effectiveness study. Front Public Health. 2025;13:1564567. doi:10.3389/fpubh.2025.1564567. (PMID: 10.3389/fpubh.2025.1564567)
Leeman J, Draeger LB, Lyons K, Pham L, Samuel-Hodge C. Tailoring implementation strategies for scale-up: preparing to take the Med-South lifestyle program to scale statewide. Front Health Serv. 2022;2:934479. doi:10.3389/frhs.2022.934479. (PMID: 10.3389/frhs.2022.934479)
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Contributed Indexing:
Keywords: dissemination; implementation infrastructure; implementation strategies; scale-up
Entry Date(s):
Date Created: 20251219 Date Completed: 20260123 Latest Revision: 20260123
Update Code:
20260130
DOI:
10.1097/PHH.0000000000002321
PMID:
41416772
Database:
MEDLINE

*Further Information*

*Context: Widespread implementation (ie, scale-up) of interventions typically involves providing training, technical assistance, and other implementation strategies to the settings intended to deliver the intervention. Researchers rarely plan for how to provide these strategies beyond the period of research funding. Specifically, they do not develop the infrastructure (ie, workforce, resources) required to sustain scale-up. Our research team addressed this gap by developing the infrastructure needed to sustain scale-up of the Med-South Lifestyle Intervention (Med-South) following the end of 10 years of research funding.
Program: Med-South is a research-tested intervention with demonstrated effectiveness at improving participants' dietary and physical activity behaviors. Existing staff in health departments and community clinics deliver Med-South over a series of 4 monthly counseling sessions and 3 booster phone calls. Implementation strategies (eg, training, technical assistance) also have been developed to support Med-South scale-up.
Implementation: We followed a 3-step process to develop infrastructure to support Med-South scale-up. We assessed existing infrastructure (step 1), identified determinants (ie, barriers and facilitators) of adoption (step 2), and then tailored scale-up to fit existing infrastructure and address determinants (step 3). Scale-up infrastructure included: (1) workforce to support implementation, (2) training curriculum, (3) intervention protocols, (4) data monitoring systems, and (5) communication systems.
Evaluation: We engaged 170 public health practitioners in 3 iterative improvement cycles to refine scale-up infrastructure. We evaluated impact on participants' engagement, perceptions of Med-South acceptability, and confidence to deliver and implement Med-South. A total of 88 public health practitioners engaged in all training sessions (51.8%). Practitioners reported high levels of acceptability and confidence in their ability to deliver and implement Med-South.
Discussion: Findings suggest that our 3-step process has potential for use in developing the infrastructure needed to sustain intervention scale-up following the end of research funding.
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