Organizational contexts, implementation process, and capacity outcomes of multicultural, multilingual Home-Based Programs in public initiatives: A Mixed-Methods study.

Aims: The study aim was to examine the impact of a home-based programme intervention on organizational contexts, implementation processes and organizational capacity outcomes from multicultural, multilingual participants working at community-based organizations.

Design: This was a sequential exploratory, mixed-methods longitudinal study using community-based participatory research principles.

Sample: Twenty participants from nine multicultural, multilingual community-based organizations were in this public health initiative's intervention to develop community-designed, home-based programmes.

Methods: Capacity building providers delivered the intervention selected by the funders. Workshop outcomes were descriptively measured in April/May 2019. In April/May and November 2019, participants completed surveys about organizational contexts, implementation processes and organizational capacity outcomes, which were analysed with t-tests using the organization as the unit of analysis. Qualitative data were analysed using content analysis.

Results: Seven programmes were new and two were modified. As workshop outcomes, 59% of participants reported increased overall implementation knowledge and 74% reported capacity building providers as the most helpful resource. After 6 to 7 months, no statistically significant changes were noted in organizational contexts, implementation processes or organizational capacity outcomes. Participants benefited from capacity building because they had programmes developed, formed partnerships with capacity building providers, gained implementation knowledge, and engaged in networking.

Conclusion: Participants reported excellent individual and organizational strengths. Many Initiative factors contributed to no statistical changes. Namely, there was no opportunity for baseline data; limited community-based organization engagement in the intervention model selection, timeline and processes; the Initiative's timeline did not fit participants' timeline; insufficient time to develop culturally and linguistically appropriate programmes; late literature review abstracts; lack of adequate, planful and paid capacity building time; and a contract requirement to have the programme due when it was not implementable. These Initiative design factors, as reported by participants, limited the Initiative's home-based programme development.

Impact: This study highlights the strengths of participants, community-based organizations and capacity building providers. Model selection, timeline and budget were identified as key factors for equitable implementation in multicultural, multilingual organizations.