The role of communication, building relationships, and adaptability in non-profit organisational capacity for health promotion.

While the non-profit sector has an integral role in health promotion, it is unclear whether these organisations have the capacity for health promotion activities. This study aims to explore and describe capacity changes of a non-profit organisation during a 3-year community-based nutrition intervention. The non-profit organisation, with 3800 members throughout the state of Queensland, Australia, implemented a 3-year food literacy community-based intervention. A team of qualified nutritionists delivered the program in partnership with community-based volunteers. A separate aim of the intervention was to build capacity of the non-profit organisation for health promotion. A qualitative study was undertaken, using a social constructivist approach to explore organisational capacity changes longitudinally. All relevant participants including non-profit executive managers and nutritionists were included in the study (100% response rate). Data collection included semi-structured interviews (n = 17) at multiple intervention time points and document analysis of program newsletters (n = 21). Interview transcripts and documents were analysed separately using thematic and content analysis. Codes and categories between the two data sources were then compared and contrasted to build themes. Organisational capacity was predominantly influenced by four themes; 'communicating', 'changing relationships', 'limited organisational learning' and 'adaptability and resistance to change'. Developing non-profit organisational health promotion capacity appears to require focusing on fostering communication processes and building positive relationships over time. Capacity changes of the non-profit organisation were not linear, fluctuating across various levels over time. Assessing non-profit organisational capacity to implement community interventions by describing adaptive capacity, may help researchers focus on the processes that influence capacity development.

Workplace programmes for supporting breast-feeding: a systematic review and meta-analysis.

OBJECTIVE: To critically review the literature regarding workplace breast-feeding interventions and to assess their impact on breast-feeding indicators. DESIGN: A systematic review and meta-analysis was conducted. Electronic searches for workplace intervention studies to support breast-feeding, without restriction on language or study design, were performed in PubMed, CENTRAL, CINAHL, Embase, Web of Science, Business Source Complete, ProQuest-Sociology and ProQuest-Social Science to 13 April 2020. A meta-analysis of the pooled effect of the programmes on breast-feeding indicators was conducted. RESULTS: The search identified 10 215 articles; fourteen studies across eighteen publications met eligibility criteria. Programmes were delivered in the USA (n 10), Turkey (n 2), Thailand (n 1) or Taiwan (n 1). There were no randomised controlled trials. The pooled OR for exclusive breast-feeding at 3 or 6 months for participants v. non-participants of three non-randomised controlled studies was 3·21 (95 % CI 1·70, 6·06, I2 = 22 %). Despite high heterogeneity, other pooled outcomes were consistently in a positive direction with acceptable CI. Pooled mean duration of breast-feeding for five single-arm studies was 9·16 months (95 % CI 8·25, 10·07). Pooled proportion of breast-feeding at 6 months for six single-arm studies was 0·76 (95 % CI 0·66, 0·84) and breast-feeding at 12 months for three single-arm studies was 0·41 (95 % CI 0·22, 0·62). Most programmes were targeted at mothers; two were targeted at expectant fathers. CONCLUSIONS: Workplace programmes may be effective in promoting breast-feeding among employed mothers and partners of employed fathers. However, no randomised controlled trials were identified, and better-quality research on workplace interventions to improve breast-feeding is needed.

Capacity assessment in public health community interventions: a systematic review.

The importance of building capacity in community interventions is well recognized. There is general agreement about the determinants of capacity and a range of existing capacity frameworks, however there is limited evidence or consistency in practice around assessing capacity in community interventions. The aim of this review was to describe how capacity is assessed in community interventions. A systematic review of the literature across four databases (MEDLINE, CINAHL, PsycINFO and Sociological Abstracts) was performed. Studies in English from 2000 to 2017, that explicitly described how capacity building processes were assessed in community interventions in healthy populations, were included. All types of empirical study designs were eligible. From 2596 records, after exclusion criteria were applied, 19 studies were included describing 12 different capacity assessment frameworks or tools. Seventeen studies assessed capacity processes by measuring individual capacity domains in community interventions. The most common capacity domains used to assess capacity were leadership, resources, partnerships and intelligence. The majority (n = 15) of studies used qualitative or mixed methods designs to measure capacity. Nine studies assessed capacity prospectively over time; three before/after and six multiple times during the intervention. Five studies assessed capacity retrospectively. The findings suggest that capacity assessment may need to remain context specific and flexible in order to capture the ever-changing nature of capacity building over time. Future research should explore the utility of theoretical adaptive capacity assessment guidelines that direct researchers and practitioners when describing capacity assessment in community interventions.