Translational Behavioral Medicine最新文献

{"title":"Social determinants of health influence maternal health behaviors and engagement in an obesity prevention intervention.","authors":"Amanda Gilbert, Abygail Martinez, Sarah Farabi, Alejandra Cortez, Ana A Baumann, Debra Haire-Joshu, Ross C Brownson, Alexandra B Morshed, Rachel G Tabak","doi":"10.1093/tbm/ibaf088","DOIUrl":"10.1093/tbm/ibaf088","url":null,"abstract":"<p><strong>Background: </strong>Mothers experience increased risk of obesity due to pregnancy and caregiving demands. Maternal obesity influences women's health, pregnancy outcomes, and children's obesity risk. Effective obesity prevention interventions rely on participant engagement. Research suggests that social determinants of health (SDOH) influence intervention engagement; however, research is limited on how SDOH influence engagement and ways interventions may help mothers navigate SDOH.</p><p><strong>Purpose: </strong>Understand how SDOH influence mothers' obesity risk and participation in the 24-month Healthy Eating and Active Living Taught at Home (HEALTH) intervention delivered by parent educators (PEs) through the Parents as Teachers home visiting organization.</p><p><strong>Methods: </strong>Semistructured interviews were conducted with participants (mothers) from the HEALTH Dissemination and Implementation study. Interviews were recorded, transcribed, and analyzed in NVivo using a priori codes and a dual nonindependent approach.</p><p><strong>Results: </strong>Thirteen mothers (five Spanish-speaking, eight English-speaking) were interviewed. The most common SDOH influencing health behaviors were neighborhood physical activity environment, food environment, and community/social context. Mothers felt that HEALTH was needed, available (PEs flexibility to meet in-person at home/other locations; virtual meetings), fit their needs/strengths (adapted to mothers' health behaviors; motivation for change), and provided actionable steps for navigating SDOH (incorporating short walks or stretching at home to overcome childcare/time demands). Spanish-speaking mothers benefited from shared language and community with PEs.</p><p><strong>Conclusions: </strong>Obesity prevention interventions for mothers may help minimize negative SDOH and leverage positive SDOH for health behaviors. Interventions delivered through community-based home visiting organizations may overcome SDOH barriers to intervention engagement through availability and relational connections with providers.</p><p><strong>Clinical trial information: </strong>The Clinical Trials Registration #NCT03758638.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12951579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145913709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarity and inclusivity as precursors to translating yoga health evidence: a diverse cross-sectional study on barriers, facilitators, and associations of yoga.","authors":"Mary C Frazier, Bradley J Frick, Lauren H Stauffer, Therese M Osborn, Morgan N Gregg, Samantha M Harden","doi":"10.1093/tbm/ibag052","DOIUrl":"https://doi.org/10.1093/tbm/ibag052","url":null,"abstract":"<p><strong>Background: </strong>Translating evidence-based interventions (EBIs) to advance health behaviors and well-being takes 15-17 years. This translational gap is lengthened for specific EBI and populations, such as yoga for people of color, with higher weight, or who live in rural areas. Yoga principles have positively impacted myriad populations and outcomes and align with scientific rigor, but misinformation persists. Applying a translational lens to input from under-represented yoga end-users may speed the gap.</p><p><strong>Purpose: </strong>To examine how underrepresented yoga end-users perceive yoga with consideration to yoga associations, facilitators, and barriers.</p><p><strong>Methods: </strong>We utilized mixed methods in a cross-sectional survey with a large, diverse sample to explore yoga end-user input for communicating yoga-based health information and interventions. We used an inductive approach to qualitatively analyze responses to four prompts on perceptions of yoga.</p><p><strong>Results: </strong>We surveyed 150 end-users (mean age 36 years; 50% female; 54% people of color; 29% with higher body weight) with 28 open-ended questions. Of more than 5000 meaning units, we present a subset of data (31% of total data) that includes associations of yoga (e.g. physical components) as well as present and future yoga facilitators (e.g. benefits) and barriers (e.g. lack of belonging in yoga spaces).</p><p><strong>Conclusions: </strong>Findings from end-users provided insights on how to comprehensively communicate behavioral medicine evidence using clear, inclusive language and representative imagery. Applying precursors of clarity and inclusivity is thus key to translation of yoga-based health information and interventions. Furthermore, these findings can be expanded and applied to bridge translation of other health evidence and interventions.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating an online-delivered resistance exercise intervention for racially diverse breast cancer survivors using the RE-AIM framework.","authors":"Isabel L Wakefield, Océane Streubel, Adana A M Llanos, Shawna V Hudson, Kathryn Schmitz, Siobhan M Phillips, Sharon L Manne, N Lynn Henry, Ken Resnicow, Angela J Fong","doi":"10.1093/tbm/ibag019","DOIUrl":"10.1093/tbm/ibag019","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer survivors (BCS) experience persistent physical and psychological effects after treatment, with racially diverse groups demonstrating lower adherence to cancer-specific resistance exercise guidelines. Online resistance exercise interventions show promise for enhancing accessibility and health outcomes among BCS. However, evidence regarding their feasibility of implementation remains limited. Yet, such information is critical for assessing scalability and implementation in non-laboratory settings.</p><p><strong>Purpose: </strong>Using the RE-AIM (reach, efficacy, adoption, implementation, and maintenance) framework, this study evaluated the reach, efficacy, adoption, and implementation of a 12-week, supervised, online resistance exercise intervention for racially diverse BCS.</p><p><strong>Methods: </strong>A mixed methods approach with a pre-post-study design was used. Quantitative outcomes included sociodemographic representativeness (reach), physical function (efficacy), and session fidelity (implementation). Qualitative interviews examined participant experiences, barriers, and facilitators (adoption).</p><p><strong>Results: </strong>The intervention enrolled a racially diverse BCS sample (N = 47; 57.4% White, 23.4% Black, 14.8% Asian) that was mostly representative of the host institution catchment area, though participants had higher education levels. The intervention group demonstrated statistically significant improvements in upper- (P = .009) and lower-body physical function (P = .003) versus control, only. Adoption facilitators included program convenience, accessibility of online delivery, and trainer support, while barriers were equipment challenges, competing priorities, and cancer-related side effects. Program implementation fidelity was high for core components.</p><p><strong>Conclusions: </strong>Key factors contributed to the feasibility of implementation of the intervention. Future remote exercise interventions should address equipment needs, individualized support, and tailored recruitment to enhance adoption and facilitate scalability in non-laboratory settings.</p><p><strong>Clinical trial information: </strong>The Clinical Trials Registration #NCT04562233.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural adaptation of evidence-based prevention programs for substance use and mental health issues in adolescents: a qualitative secondary analysis of barriers and facilitators.","authors":"Claudia Corpus-Espinosa, Isotta Mac Fadden, Patricia Elizabeth Cossío-Torres, Marta Lima-Serrano","doi":"10.1093/tbm/ibag048","DOIUrl":"10.1093/tbm/ibag048","url":null,"abstract":"<p><strong>Background: </strong>Adolescence is a critical period for the onset of mental health problems and risky behaviors such as substance use. Although culturally adapted evidence-based programs (EBPs) are promising for prevention, the barriers and facilitators shaping adaptation remain underexplored, particularly from a multisectoral perspective.</p><p><strong>Purpose: </strong>This study examines the barriers and facilitators involved in the cultural adaptation of prevention programs targeting adolescent substance use and common mental health problems.</p><p><strong>Methods: </strong>A qualitative secondary analysis was conducted using inductive qualitative content analysis of 22 semi-structured interviews with actors from three quadruple helix sectors: 6 Academia, 6 Nongovernmental organizations, and 10 Public administration, across multiple countries. Participants were recruited through stakeholder mapping, purposive-convenience sampling, and snowball recruitment based on their roles in adapting, implementing, evaluating, or funding prevention programs. Limited recruitment in the business sector led to its exclusion from the analytic sample.</p><p><strong>Results: </strong>Cultural adaptation was hindered by a weak prevention culture, limited and contextually mismatched EBP uptake, conceptual and methodological ambiguity, weak evaluation, limited or unstable resources, political and institutional instability and burden, and difficulties with collaboration, knowledge transfer, and initial engagement with the target population. It was facilitated by recognition of the culture's importance, institutional and policy alignment, evidence-based and collaborative funding criteria, intersectoral synergy and collaboration with target populations, and practical supports for engagement.</p><p><strong>Conclusion: </strong>Cultural adaptation is a systemic and relational process shaped by methodological, organizational, institutional, and intersectoral conditions. Strengthening it requires practical methodological support, institutional and policy commitment, and sustained participatory and cross-sector approaches.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Documenting two decades of longitudinal changes to a community-engaged obesity prevention intervention for Native American families to facilitate scale-up.","authors":"Emily J Tomayko, Paul A Estabrooks, Teresa M Warne, James L Merle, Alexandra K Adams","doi":"10.1093/tbm/ibag056","DOIUrl":"10.1093/tbm/ibag056","url":null,"abstract":"<p><strong>Background: </strong>Community-based participatory research (CBPR) interventions frequently undergo adaptation as they move from efficacy studies to dissemination; yet long-term adaptations are rarely documented in ways that support replication or scale-up.</p><p><strong>Purpose: </strong>To demonstrate a structured approach for retrospectively documenting longitudinal adaptations to Healthy Children, Strong Families (HCSF)-a culturally grounded, evidence-based obesity prevention intervention for Native American families-as it evolved into Turtle Island Tales.</p><p><strong>Methods: </strong>We conducted a retrospective review of permanent records generated between 2006 and 2026 spanning three major program iterations: HCSF1, HCSF2, and Turtle Island Tales. Guided by the Framework for Reporting Adaptations and Modifications to Evidence-based Interventions (FRAME), the implementation-strategy extension FRAME-IS, and the Adaptome, adaptations were categorized as changes to intervention governance, content, structure, or strategy. Data sources included intervention materials, study protocols, quantitative and qualitative trial data, meeting minutes, and emails.</p><p><strong>Results: </strong>Adaptations were layered and interdependent and were documented as preserving core functions while supporting intended implementation outcomes (e.g. acceptability, feasibility, reach, adoption, sustainability). Governance adaptations reflected shifts from more centralized, CBPR-grounded adaptation and implementation processes to greater local decision-making by community implementers. Content adaptations included greater integration of traditional knowledge and new lessons addressing sleep, emotional regulation, and family traditions. Structural adaptations involved delivery changes aligned with community systems and development of culturally resonant branding and characters. Strategy adaptations included opt-out classroom-based recruitment, embedding implementation within existing community roles, and revised training materials.</p><p><strong>Conclusions: </strong>Organizing adaptations into governance, content, structure, and strategy provides a pragmatic approach for documenting flexibility across long-term CBPR partnerships and may offer considerations for documentation of intervention adaptations in similar settings.</p><p><strong>Clinical trial information: </strong>The Clinical Trials Registrations #NCT01776255, NCT06298149.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing community health worker-delivered behavioral health models: A primer for healthcare organizations.","authors":"Erika L Gustafson, Stacy Ignoffo, Kelly McCabe, Gloria Seals, Madeline Woodberry, Anubhav Kidambi, Greg Staszko, Helen Margellos-Anast","doi":"10.1093/tbm/ibag004","DOIUrl":"10.1093/tbm/ibag004","url":null,"abstract":"<p><strong>Background: </strong>Mounting evidence demonstrates the effectiveness of community health worker (CHW) delivered behavioral health (BH) interventions, identifying them as a promising strategy to address the growing unmet BH needs in the United States. However, sustainable CHW BH models require not only a CHW workforce trained in the delivery of BH interventions, but also organizational and systems infrastructure to support ongoing implementation.</p><p><strong>Purpose: </strong>This Commentary describes lessons learned from Sinai Urban Health Institute, a community-engaged research center based in a safety net healthcare system, that since 2000, has developed, implemented, and evaluated CHW models, including CHW BH services.</p><p><strong>Conclusions: </strong>Using an implementation science lens, we apply lessons learned to delineate challenges and recommendations for implementing CHW BH models, focusing on addressing implementation determinants at the organizational and health system levels, as these domains were identified in a systematic review as particularly prevalent and challenging determinants to address. Integrating CHW BH services into health systems will require investments in supervisors for CHW BH models, material resources, team building with partnering clinics, relationship building with community partners, and policy advocacy.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the gap between intervention and implementation science methodologies in physical activity research.","authors":"Jacob Szeszulski, Cassandra M Beattie, Gabrielli T de Mello, Jennie L Hill, M Renée Umstattd Meyer, Rebecca E Lee","doi":"10.1093/tbm/ibag071","DOIUrl":"10.1093/tbm/ibag071","url":null,"abstract":"<p><p>Despite substantial investment in physical activity research and the development of numerous evidence-based interventions, translation into routine practice remains slow and inconsistent. Dissemination and implementation (D&I) science offers methodological tools to address this research-to-practice gap; however, many intervention-trained physical activity researchers report uncertainty about how to design and evaluate implementation strategies and studies. This paper provides practical guidance for integrating D&I science into physical activity research by emphasizing its structural parallels with intervention science. As part of developing a D&I study, we describe how core intervention constructs-interventions, behavioral determinants, and effectiveness outcomes-align with implementation constructs-implementation strategies, determinants of implementation behavior, and implementation outcomes. Drawing on examples from school- and community-based physical activity initiatives, we illustrate how familiar tools such as logic models, behavioral theory, and multilevel design can be applied. Related to D&I study evaluation, we further clarify the strategic use of hybrid effectiveness-implementation approaches (Types I-III) and offer guidance on aligning study design with the maturity of intervention evidence and known implementation barriers. Throughout, we highlight the complementary roles of CEnR and D&I science in co-creating, evaluating, and optimizing sustainable implementation strategies. Finally, we discuss approaches to evaluating implementation outcomes, selecting frameworks such as Reach, Effectiveness, Adoption, Implementation, and Maintenance and Consolidated Framework for Implementation Research, and identifying future methodological needs in community settings. By reframing D&I science as an extension of familiar intervention principles rather than a separate methodological domain, this manuscript aims to equip physical activity researchers with conceptual clarity and practical tools to accelerate population-level impact.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying capacity building priorities for implementation science in suicide prevention: a concept mapping study in Australia.","authors":"Sadhvi Krishnamoorthy, Luke Bayliss, Lennart Reifels, Kairi Kõlves","doi":"10.1093/tbm/ibag076","DOIUrl":"10.1093/tbm/ibag076","url":null,"abstract":"<p><strong>Background: </strong>Capacity building in the science and practice of implementation is critical for driving and evaluating meaningful change. However, capacity needs of stakeholders to effectively apply implementation science in suicide prevention remain unclear.</p><p><strong>Purpose: </strong>To address this gap in Australia, we conducted a concept mapping (CM) study to identify and prioritize stakeholder capacity-building needs in this area.</p><p><strong>Methods: </strong>Diverse stakeholders: practitioners, lived experience advocates, researchers, public servants, and clinicians working within the suicide prevention sector in Australia participated in the study. Using CM, participants individually brainstormed statements representing capacity-building needs for implementation science for suicide prevention. These statements were then organized in clusters and rated on importance and feasibility. Data were collected, analyzed, and visually represented using the groupwisdom™ platform.</p><p><strong>Results: </strong>In total, 52 stakeholders participated in at least one stage of the study (i.e. brainstorming, sorting and/or rating). Brainstorming generated 59 statements, which were synthesized into 53 distinctive statements and supplemented with 13 statements from the literature. A multidimensional scaling and hierarchical cluster analysis generated many cluster solutions, out of which an eight-cluster solution was chosen as the most meaningful. Knowledge dissemination and lived experience integration clusters were rated highest on importance and feasibility.</p><p><strong>Conclusions: </strong>This study provides a snapshot of implementation capacity-building needs and priorities within the suicide prevention sector in Australia. The identified priorities can help inform future sector capacity-building initiatives for implementation.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149228816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: CHARMED Consortium, Applying behavior change theory to intervention design: promoting clinic-level implementation of self-measured blood pressure monitoring in safety net primary care settings.","authors":"","doi":"10.1093/tbm/ibag014","DOIUrl":"10.1093/tbm/ibag014","url":null,"abstract":"","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of implementation fidelity to an adapted community-based model of enhanced group prenatal care.","authors":"Bridgette Blebu, Martha Tesfalul, Guadalupe Ramirez, Kristin Carraway, Erica Martinez, Mary A Garza, Kesia Garibay, Miriam Kuppermann","doi":"10.1093/tbm/ibag001","DOIUrl":"10.1093/tbm/ibag001","url":null,"abstract":"<p><strong>Background: </strong>Group prenatal care (GPC) is a promising intervention for improving maternal health outcomes and reducing disparities. However, implementation can be challenging, and the role of community partnerships in supporting delivery is not well understood.</p><p><strong>Purpose: </strong>This study examined the implementation fidelity of an enhanced GPC (eGPC) program, Glow! GPC and support, delivered collaboratively by prenatal care providers and a community agency, either virtually or in person, within a randomized trial comparing eGPC to enhanced individual prenatal care.</p><p><strong>Methods: </strong>Using a mixed methods convergent design, quantitative surveys completed by co-facilitators assessed adherence to core content and process components, while qualitative data from provider interviews (n = 6) and a facilitator focus group (n = 6) explored implementation experiences. Descriptive statistics and thematic analysis were integrated using a joint display to identify convergence, divergence, and expansion across data sources.</p><p><strong>Results: </strong>Of 59 cohorts initiated, 49% were canceled due to low enrollment. Among 26 completed cohorts (n = 159; mean = 6 participants), mean content fidelity was 68%, higher in virtual (73%) than in-person (61%) cohorts. Process fidelity was high (89%), though virtual sessions had lower adherence to health checks. Qualitative data revealed four themes related to strong facilitator engagement, recruitment challenges, integration with routine care, and virtual delivery. Integration demonstrated convergence between qualitative and quantitative data.</p><p><strong>Conclusions: </strong>Despite moderate-to-high fidelity, eGPC implementation was constrained by recruitment and childcare barriers due to the COVID-19 pandemic. Integrated findings underscore community partnerships as critical to strengthening delivery and sustaining scale-up in resource-limited clinical settings.</p>","PeriodicalId":48679,"journal":{"name":"Translational Behavioral Medicine","volume":"16 1","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}