Implementation of Matnyttig - a digital dietary resource for the first 1000 days

Development of stakeholder relationships is an important implementation strategy for new interventions. Conducting local consensus discussions through mapping sessions might be a useful strategy.

Background: There is often a failure to implement effective/efficacious public health interventions, known as the ‘research-to-practice gap’. Nutrition Now (NN) is a project designed to address this gap through maximizing the implementation of dietary interventions supported by evidence of effectiveness from randomized controlled trials. The project incorporates these interventions within a digital resource to improve dietary behaviours in both pregnant women, and 0–2-year-olds and their parents. NN is a co-creation project in which stakeholders and researchers collaborate to enhance the chances of effective implementation, including through stakeholder-led development of a conceptual map of the local system influencing dietary behaviours.

Methods: NN is a Hybrid I study, gathering information on implementation strategies used in NN and assessing effectiveness. One of the implementation strategies we used was the development of a conceptual ‘systems’ map, facilitated by a member of the research team. Stakeholders in the municipality were invited to a 2-hour session at the town hall to develop a system map depicting factors affecting childhood nutrition in the municipality, and the relations between these factors. The participants included people working in early childhood education and care (ECEC) and Maternal and Child Health care (MCH), municipality officers, media, NGOs, and local politicians. The stakeholders provided input on both proximal and distal determinants affecting children’s diet.

Results: The mapping session resulted in a conceptual systems map created by the participants. It depicts factors including parental influence, ECEC, and the local food environment. There was a strong consensus that ECEC was a very important setting for improving childhood nutrition.

Conclusions: Development of stakeholder relationships is an important implementation strategy. Genuine dialogue with local stakeholders to identify their views about the complexity of local factors influencing an outcome – in this case early childhood nutrition – through the development of conceptual maps has the potential to strengthen such relationships, and to increase the effectiveness of implementation approaches.