title: Implementing an Injury Prevention Briefing to aid delivery of key fire safety messages in UK children's centres: qualitative study nested within a multi-centre randomised controlled trial.
abstract: BACKGROUND
  To improve the translation of public health evidence into practice, there is a need to increase practitioner involvement in initiative development, to place greater emphasis on contextual knowledge, and to address intervention processes and outcomes. Evidence that demonstrates the need to reduce childhood fire-related injuries is compelling but its translation into practice is inconsistent and limited. With this knowledge the Keeping Children Safe programme developed an "Injury Prevention Briefing (IPB)" using a 7 step process to combine scientific evidence with practitioner contextual knowledge. The IPB was designed specifically for children's centres (CCs) to support delivery of key fire safety messages to parents. This paper reports the findings of a nested qualitative study within a clustered randomised controlled trial of the IPB, in which staff described their experiences of IPB implementation to aid understanding of why or how the intervention worked.
  
  
  METHODS
  Interviews were conducted with key staff at 24 CCs participating in the two intervention arms: 1) IPB supplemented by initial training and regular facilitation; 2) IPB sent by post with no facilitation. Framework Analysis was applied to these interview data to explore intervention adherence including; exposure or dose; quality of delivery; participant responsiveness; programme differentiation; and staff experience of IPB implementation. This included barriers, facilitators and suggested improvements.
  
  
  RESULTS
  83% of CCs regarded the IPB as a simple, accessible tool which raised awareness, and stimulated discussion and behaviour change. 15 CCs suggested minor modifications to format and content. Four levels of implementation were identified according to content, frequency, duration and coverage. Most CCs (75%) achieved 'extended' or 'essential' IPB implementation. Three universal factors affected all CCs: organisational change and resourcing; working with hard to engage groups; additional demands of participating in a research study. Six specific factors were associated with the implementation level achieved: staff engagement and training; staff continuity; adaptability and flexibility; other agency support; conflicting priorities; facilitation. CCs achieving high implementation levels increased from 58% (no facilitation) to 92% with facilitation.
  
  
  CONCLUSIONS
  Incorporating service provider perspectives and scientific evidence into health education initiatives enhances potential for successful implementation, particularly when supplemented by ongoing training and facilitation.
authors.forename: Kate
authors.initials: K
authors.lastname: Beckett
authors.forename: Trudy
authors.initials: T
authors.lastname: Goodenough
authors.forename: Toity
authors.initials: T
authors.lastname: Deave
authors.forename: Sally
authors.initials: S
authors.lastname: Jaeckle
authors.forename: Lisa
authors.initials: L
authors.lastname: McDaid
authors.forename: Penny
authors.initials: P
authors.lastname: Benford
authors.forename: Mike
authors.initials: M
authors.lastname: Hayes
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Towner
authors.affiliation: School of Medicine, Division of Primary Care, University of Nottingham, University Park, Nottingham, UK. Denise.Kendrick@Nottingham.ac.uk.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
mesh_terms: D002648:Child; D005260:Female; D005390:Fires; D006293:Health Promotion; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016730:Program Development / Q000379:methods*; D036301:Qualitative Research; D012449:Safety; D006113:United Kingdom; D014947:Wounds and Injuries / Q000517:prevention & control*