Adapting Parents as Teachers and Healthy Eating Active Living Taught at Home (PAT + HEALTH) for pregnant mothers in Nigeria using the FRAME implementation science framework
Year: 2026
Type: article
Abstract: Background Pregnancy and the postpartum periods are key life-stages to support cardiovascular health. Healthy Eating Active Living Taught at Home (HEALTH) promotes healthy gestational weight gain and postpartum weight loss. HEALTH is embedded within Parents as Teachers (PAT), which is an evidence-based home visiting model. Interventions such as PAT + HEALTH need to be adapted to be culturally appropriate and to be adapted to support implementation in the local delivery context in Abuja, Nigeria. Purpose This study describes the process of adapting PAT + HEALTH to the Nigerian context, documented according to the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME). Methods PAT is delivered through affiliates worldwide, and the evidence-based model includes several steps to initiating a new PAT affiliate, which were followed in the Federal Capital Territory of Nigeria. These steps included tailoring and adaptation of the PAT + HEALTH intervention components to fit the local context. The iterative adaptation process involved ongoing engagement with key partners in the Federal Capital Territory, resulting in a rich understanding of the implementation context. Results Adaptations were proactive and reactive and conducted prior to implementation. The adapted intervention, PAT + HEALTH, maintains the evidence-base underpinning the original intervention. However, content, context, training and evaluation, and implementation and scale-up activities were modified, as defined by FRAME. Modifications were made across levels of the intervention (e.g. training for trainers, support for implementers, and modifications to curricular content and modality of delivery). Conclusions If effective, this intervention is designed to be scalable in Nigeria to promote cardiovascular health in mothers and their babies.
DOI: 10.1093/tbm/ibag037
Authors: Rachel G Tabak, Allison Kemner, Emmanuel Okpetu, Kathryn J Lindley, Julia D López, Tiedra Marshall, Ucheoma C Nwaozuru, Olubunmi I Ojji, Ekundayo Ocholi, Anthony Ik Orji, Steve Kumode, Ajibola Adesope, Bosede E Adebayo, Gina Oladokun, Cecilia Naa Ometse Nartey, Nanna R Ripiye, Gabriel L Shedul, Victor Davila-Roman, Godwin Akaba, Mark D Huffman, Dike Ojji, ENHANCE CVH Investigators, Dike Ojji, Godwin Akaba, Ekundayo Ocholi, Olubunmi I Ojji, Nanna R Ripiye, Anthony Orji, Clementina Okoro, Gabriel Lamkur Shedul, Awayimbo Ruth Jaggu, Ajibola Adesope, Chikodi Stella, Steve Kumode, Emmanuel Okpetu, Omotayo Owoade, Chinyere Ekwueme, Evelyn Apeh Benododo, Vincent Ezema, Chinwe Chidebe, Paul Fiase, Lydia Yakubu, Joshua Chijioke, Temilade Deborah Adeyanju, Fatima Rachael Okolo, Blessing Egbeyemi, Danlami Afiniki Gata, Aishatu Babankudi, Florence James Awodo, Ibrahim Mercy, Stephen Magode, Uthman Hannatu, Adama Musa Shekwolo, Comfort Nuhu, Ibrahim Abubakar, Emmanuel Zagni, Godiya P Kaham, Baba Ibrahim Dikko, Umar Bako, Yusuf Samo, Essien Akon, Aishatu Shuaibu, Musa Ishaku Sakanko, Shuaibu Amina Onoze, Binta Mohammed Ahmed, Victoria M Frederick, Martha Z Dikko, Egwe Yunana, Kanang Ibrahim Mauisky, Yohanna Kosau, Adala Talatu, Adegbe Sally Enebi, Hadiza Isah Abdullahi, Grace Clement, Malam Udoji Akila, Christiana Ubur, Udoakpan Immaculata Paul, Chukwuja Rejoice C, Vivian Uzoigwe, Peter-Chiemeke Josephine Okwuoma, Shedrach Amos Danaan, Fatima Salihu, Aisha Suleiman, Gloria Nkemdilim Eze, Ogah Mercy, Blessing Peter, Jaamila Bello, Joy Augustine, Hannah John, Oluwagbemiro Deborah Ebunoluwa, Maimuna Idris, Reuben Tanko, Aguma J Sardauna, Felicia Kibanba, Abdulhakim Abdulkarim, Martha Marcus, Hafsat Mohammed, Faith Martins Gbokosai, Miajinya Koyah, Danlami Afiniki Gata, Blessing Ayenana, Theresa Eze, Muhammad Rumaisa’u Sani, Rabiu Abdullahi, Mary Umaru, Biyaya Philip, Maltina Emmanuel Budai, Grace Chukwudi, Dogara Zack Adams, Imani Mami, Rose Gideon, Theresa Dike, Ahmed Jamila, Rhoda Michael, Fatimatu Yunusa Ewan, Jummai Terwese, Fatima Mohammed, Ugwu Angela Uche, Idike Francisca Amoge, Sarah Mailafia, Isiaka Ohunene Rafat, Blessing Nwachukwu, Mercy Ajogwu, Okwuma Camila, Rose Omale, Okpala Peace Chinenye, Adeleke Florence, Bitrus Godiya Yakubu, Agness Ayuba, Ugwu Salome Ifeoma, James Elizabeth, Ikewusi Chinemerem Precious Justina Malum, Yusuf Habib Shugaba, Phoebe Caleb Gotan, Patience Samuel, Emmanuel Zimane Yusuf, Hauwa Isah, Mohammed A Yahaya, Lucy Yunana, Egu Ifeoma Philomena, Wesley Victoria Kusuma, Clara Omeje, Onwuka Eunice Chinenye, Yakubu Madina, Linda Ohiri, Rukaiya M Chapa, Christiana Apeh, Abdullahi Isah, Blessing S Pada, Keziah P Samaila, Hassana Isah, Felicia Ngozi Okoro, Florence Onojo, Agnes Ajuma Odeh, Alice Magaji, Oladipo Emmanuel, Comfort ALi, Okolo Fatima, Silas Haruna Anthony, Saraphina Gideon, Victor Amos, Mary Magdalene Oreiji Chidinma Gloria, Akinsua Taiwo Oluwole, Juliet Omeje, Ibrahim Victory, Waiye Eunice Olubunmi, Ameh Celestine Gabriel Abalaka, Daniel Danjuma, Daniel Mercy Ozohu, Grace Onah, Nwokoye Peculiar, Leads Chinedu Deborah Adeyanju, Kayode Olugbenga, Audu Emmanuel James, Akokote Victor, Miri David Samuel, Nkwoma Jane Ogonnaya, Ahmed Aishat, Egbunu Otini Halima, Olowoyeye Temitope Andrew, Osuagwu Chioma Deborah, Abdul Happiness Ojoma, Igwe Ifeoma Glory, Nao’mi Ogwu, Michael Deborah, Jonathan Dung Asheazi, Ali Salome Onechojo, Adepoju Blessing Oluwakemi, Samuel Oluwakemisola Rachael, Ezeokafor Ekene Samuel, Anande Kundayol, Labija Keren Ojonugwa, Zhili Barnabas Precious, Omatule Okas Moses, Olojo Deborah Aderele, Musa Bah Samirah, Ajogi Onuh Linus, Shikel Juliana Julimwa, Bosede Omueti, Gina Oladokun, Mark Huffman, Victor Dávila-Román, Debra Haire-Joshu, Julia López, Rachel Tabak, Lisa de las Fuentes, Ken Schechtman, Zainab Mahmoud, Cindy Schwarz, Mansi Agarwal, Anju Ogyu, Cecilia Naa Ometse Nartey, Valerie Graham, Ucheoma C Nwaozuru, Kathryn Lindley, David Dowdy, Olugbenga Ogedegbe, Angela Aifah, Allison Kemner, Tiedra Marshall, Patty Velasquez, Roschel Servantes, Lindsey Shah
Institutions: Washington University in St. Louis, Northwestern University, University of Abuja Teaching Hospital, University of Abuja, Vanderbilt University Medical Center, Wake Forest University Health Sciences, Wake Forest University, University of Nigeria, University of Ibadan, University College Hospital, Ibadan, UNSW Sydney, The George Institute for Global Health
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,253
OpenAlex ID: W7204934293