Julie Showich Lundgren

This study explored staff perceptions of the feasibility of the Check-in/Check-Out (CICO) program in Swedish schools. Semi-structured interviews were conducted with 15 school professionals who had at least six months of experience implementing CICO. Data were analyzed using deductive qualitative content analysis grounded in two dimensions of feasibility: practicality and integration. The analysis resulted in five themes under practicality and three themes under integration. Teaming structures for collaboration and foundational competence in positive behavior support emerged as two key findings related to staff perceptions of feasibility. The findings provide insights into the contextual fit of the CICO program in Swedish schools and highlight directions for future research and implementation.

Aim: This study aimed to compare providers' ratings of delivery and fidelity of a post‐natal extended home visiting programme within Child Health Services for visits conducted in families' homes versus the clinic setting. Methods: A retrospective quantitative study based on questionnaires ( n = 3028) from child health services nurses and social workers was conducted using non‐parametric tests to determine if there were any differences in professionals' perceptions of programme delivery and/or quality. Results: The results from this study indicate significant differences in professionals' perceptions of fidelity, confidence in abilities, content coverage, alliance‐building, and emotional climate between home and clinic visits, with higher ratings given in all areas for visits conducted in the home. Conclusion: While clinic visits may offer certain logistical advantages for professionals and primary care clinics, they may not provide the optimal environment for delivering the programme with fidelity, which is necessary for achieving the desired outcomes for child health and family well‐being. The findings need to be taken into consideration when making decisions about resource allocation for early childhood programmes aimed at equitable health for a more sustainable society.

A research‐supported model to support schools' prevention of behavior problems and promotion of a positive school climate is school‐wide positive behavior support (SW‐PBS), in Scandinavia adapted into “positive behavior, interactions and learning environment in school” (PALS). Facilitators and barriers for achieving and sustaining a full implementation of PALS in a Swedish primary school context have not previously been studied. The purpose of this study was to explore school staff and administrators' experiences of implementing PALS in a municipal school district in the western region of Sweden. Using a qualitative focus group design, staff with roles in the implementation and school administrators (N = 22) representing 12 schools were asked about their experiences regarding facilitators and barriers for implementing PALS. Data were analyzed using qualitative content analyses involving a combination of inductive (data‐driven) and deductive (theory‐driven) approaches. In the deductive, final step, the inductively derived categories were associated with the Normalization process theory core constructs coherence, cognitive participation, collective action and reflexive monitoring. The analysis resulted in nine categories in which both facilitators and barriers were identified: alignment with school mission and values; building and strengthening relationships; shared staff engagement; administrators' commitment and leadership; support and resources for adopting PALS; changed experiences of PALS work over time; positive feedback sustains motivation; learning for quality improvement; and staff continuity throughout implementation. Findings indicate that staff and administrators experienced the implementation as predominantly positive, that PALS provides a structure for relationship‐based work, and fits particularly well in primary school contexts. The facilitators and barriers identified provide valuable knowledge that can inform sustainable implementations of PALS in similar contexts.

Background: Although there is growing awareness that early childhood development programs are important for a sustainable society, there is a knowledge gap about how to implement such programs. Successful implementation requires attention to implementation drivers (competency, organization, and leadership) during all phases of the implementation. The purpose of this study was to describe cross-sectoral operational workgroups’ perceptions of facilitators, barriers and solutions related to implementation drivers in the preparationphase of implementing an evidence-based early childhood home visiting program.Methods: Quantitative and qualitative data were collected from twenty-four participants, divided into 5 groups, during implementation planning workshops. The workshops were guided by a structured method informed by the principles of Motivational Interviewing and within a framework of implementation drivers. Groups sorted cards with statements representing implementation drivers according to perceptions of facilitators and barriers, and percentages were calculated for each type of implementation determinant, for each type of driver. The groups discussed their card sorting and wrote action plans to address barriers, yielding documentation that was analyzed using deductive qualitative content analysis.Results: A mixed-methods analysis resulted identification of facilitators, barriers, unknowns and solutions in two to three subcategories under each main category of implementation driver. A competent and confident workforce, and enthusiasm and commitment were key facilitators. Key barriers were unclear roles and responsibilities, and insufficient articulation of local vision and goals. Many factors were described as yet unknown. Specific solutions were generated to support the implementation.Conclusions: Our study furthers the scientific understanding of how to take evidence-based early childhood programs from research to practice within an implementation drivers framework. Facilitators, barriers and solutions in key areas during the preparation phase were identified with the help of a novel tool. The results provide useful knowledge for decision makers and organizations preparing similar initiatives in communities striving to attain sustainable development goals.

Family Check‐up (FCU) was introduced in Sweden more than a decade ago. Little is known about what parents experience as FCU's key mechanisms leading to changes in parenting. The aim of this study was to investigate Swedish parents' satisfaction with FCU, and their experiences of facilitators and barriers for making changes in their parenting. A mixed methods approach was employed using a parent satisfaction questionnaire (n = 77) and focus groups (n = 15). General satisfaction with FCU was adequate, with an average rating of 4 on a five‐point scale (range 3.1–4.6). The analysis of quantitative and qualitative data resulted in eight themes representing facilitators and four themes representing barriers, organized into three categories: (1) access and engagement; (2) therapeutic process; and (3) program components. Ease of access to FCU facilitated initial engagement. Individual tailoring and access to FCU during different phases of change facilitated sustained engagement and change. Therapeutic process facilitators were a meaningful, supportive relationship with the provider, psychological benefits for parents and benefits for the whole family. Program components that facilitated change in parenting were new learning of parenting strategies and use of helpful techniques such as videotaping and home practice. Negative experiences with service systems prior to starting FCU, parent psychological barriers, and parent‐provider mismatch were described as potential barriers. Some parents desired other program formats that were not offered, and some felt that new learning was insufficient to improve child behavior. Understanding the parent perspective can contribute to successful future work with implementing FCU.