Table 1 Recommended strategies for promoting parent engagement with HENRY
| Â | Who | What | When | Rationale | Informed by | Proposed outcome |
|---|---|---|---|---|---|---|
1. | Local authority commissioner | Support managers to perform target behaviours | Ongoing from the start of the intervention period | Local authority support for HENRY implementation optimisation intervention is likely to influence centre-level practices | Ethnography study findings and the implementation science literature (e.g. [35]) | Manager performs target behaviours influencing enrolment and attendance |
2. | Children’s centre manager | Hold ‘taster’ sessions prior to each HENRY programme where parents can attend an introductory session where the programme and format are explained | Prior to each delivered HENRY programme | Potential participants are more likely to engage if they have a greater understanding of what the programme entails | Experience of HENRY personnel, ethnography study finding (observation) and the literature (e.g. [36]) | Parents have greater understanding of what HENRY is prior to enrolling influencing enrolment attendance |
3. | Children’s centre manager | Increase HENRY training provision for centre staff | From the start of the intervention period | Some children’s centre staff lack knowledge of the HENRY programme and would benefit from training on the HENRY approach | Ethnography study (interviews and observation), experience of team members and the literature (e.g. [37]) | Parents are provided with accurate information on what HENRY entails when approached to attend, influencing enrolment and attendance |
4. | Children’s centre manager | [i] Hold HENRY programmes regularly and [ii] plan HENRY programmes far in advance | Ongoing from the start of the intervention | Some HENRY programmes are planned at short notice which hinders recruitment efforts | Ethnography study (informal conversations) and experience of the intervention development team | HENRY delivery is normalised and has greater visibility in centres influencing enrolment |
5. | Children’s centre manager | Promote HENRY widely in centres using a range of methods | Ongoing from the start of the intervention | There is a general lack of awareness of HENRY among visiting parents | Ethnography study (observations, informal conversations and parent focus groups) | More parents are aware that HENRY programmes are running influencing enrolment |
6. | Children’s centre manager | Allow a mix of referred and self-referred parents to enrol | Ongoing from the start of the intervention | Delivering programmes to a mix of parents (referred and self-referred) reduces barriers associated with stigma and improves group dynamics | Ethnography study (interviews and observations) and the literature (e.g. [38]) | Staff approach more parents to attend and HENRY programmes are de-stigmatised influencing enrolment Group dynamics are improved influencing attendance |
7. | Children’s centre manager and staff | Adopt a whole centre approach to HENRY; whereby [i] HENRY principles are adopted in other programmes and [ii] all staff are involved in the implementation of HENRY | Ongoing from the start of the intervention | Adopting a whole centre approach to HENRY implementation achieves better outcomes for engagement | Ethnography study (observations and informal conversations) and experience of the intervention development team | HENRY becomes more normalised and de-stigmatised in centres influencing enrolment Parents and staff have greater understanding of what programmes entail influencing enrolment and attendance |
8. | Children’s centre staff | Promote HENRY accurately to dispel myths and negative perceptions | Ongoing from the start of the intervention | Misconceptions around what HENRY entails may deter people from engaging | Ethnography study (interviews, observations, focus group and informal interviews) | Parents understand what HENRY programme entails and are not put off by common misconceptions (e.g. that HENRY is a healthy eating programme) influencing enrolment and attendance |
9. | HENRY facilitators | Ensure parents feel comfortable when attending the session by [i] considering characteristics of the parents before they attend and [ii] giving them enough time in sessions for group discussion | During all HENRY programmes | The skills of facilitators are known to influence engagement | Ethnography study (observation, focus groups and interviews) and the literature (e.g. [5, 39]) | Parents feel comfortable attending (i.e. demonstrate confidence to engage) the session and form social bonds with other members of the group influencing attendance |
10. | HENRY facilitators | Follow up on all parents that miss a session to encourage continued attendance | During all HENRY programmes | Participants feel valued if they are followed up after missing a session | Ethnography study (focus groups) and experience of the intervention development team | Parents are motivated to return to programme if a session is missed influencing attendance |
11. | Previous HENRY participants | Encourage friends and family to engage with HENRY | Following HENRY programme attendance | Parents are more likely to attend a programme if they know someone that has attended before | Ethnography study (interviews and focus groups) and the literature (e.g [33, 40]) | More parents are approached to enrol that are not already engaged with the centre and are more likely to sign up as they trust word of mouth recommendation influencing enrolment |