Pillars of the CROWN project represent the initiative’s core activity areas. In setting direction for the work in each of these domains, we apply the principles of human-centered design to guide our thought process about objectives for the Collaborative and optimize how we leverage knowledge from the field generated by each of our partners.
Click on any of the pillar cards below to be directed to more information about our work in the corresponding domain.
Bridging Nutrition Projects
At its core, the CROWN Project functions as the connector between four distinct projects, each of which aims to increase adherence to maternal micronutrient supplements among women of reproductive age. The CROWN Project uses a South-South model of learning by facilitating shared knowledge and growth across projects. Through the CROWN Project, each member project participates in cross-collaboration and knowledge sharing to expand and accelerate what we know about and how we approach adherence to supplementation.
The CROWN Project achieves this in several ways:
Hosting regular web conferences with all member projects to share updates, challenges, and learnings and participate in collaborative problem-solving and planning
Creating (or adapting) a standardized measure for adherence to promote cross-project evaluations
Sharing relevant publications, tools, presentations, trainings, and more in a publicly available online resource repository
Providing private access to an online portal for document sharing across member projects, including but not limited to research protocols, evaluation instruments, project planning materials, and meeting minutes.
As the bridge, the CROWN Project also seeks to make connections beyond its member projects with professionals, researchers, organizations, and other nutrition leaders by identifying potential opportunities for collaboration and facilitating introductions with member projects. To learn more, please contact the CROWN Project .
Implementation Research
The implementation research activities in CROWN are guided by the Practical, Robust Implementation and Sustainability Model (PRISM). PRISM is an implementation framework that builds on the long-standing REAIM framework.1 The REAIM framework focuses on the following outcomes:
| Reach | Effectiveness | Adoption | Implementation | Maintenance |
|---|---|---|---|---|
| The number of individuals who participate or are willing to participate in a program. | The impact of an intervention based on health and client outcomes. | Willingness to try a new program. | Program Implementation and intervention fidelity. | The extent to which a program becomes integrated into their existing programming. |
PRISM expands REAIM by incorporating contextual factors pertaining to the intervention, program and organization recipients, implementation infrastructure and external environment.
In order to be successful, programs need to consider both organization and client perspective of program implementation. The table below list some of the key constructs that should be considered from the intervention and recipients of the intervention at both organization and client perspective.
| Organization and staff | Client | |
|---|---|---|
| Intervention |
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| Recipients |
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As a program is being implemented internal and external factors will determine the success of the program. Influential factors in the External Environment include:
Finally, each organization will reflect on their implementation infrastructure and make any enhancements. Features of a productive implementation infrastructure include:
References
Glasgow, R.E., Vogt, T.M, & Boles, S.M. (1999). Evaluating the public health impact of health promotion interventions: the RE-AIM framework. American Journal of Public Health 89, 1322-1327. https://doi.org/10.2105/AJPH.89.9.1322
Adherence Measurement
Though CROWN projects may study adherence to different forms of nutritional supplementation, such as iron-folic acid (IFA) in Ethiopia and multiple micronutrient supplementation (MMS) in Nigeria, a key objective of CROWN is to create a common definition of adherence to be standardized across CROWN projects to ensure generalizable measurements and results.
While most researchers agree on the conceptual definition of adherence, a widely accepted “gold standard” adherence measure or operational definition does not yet exist. In an extensive literature review conducted by CROWN team in 2023 (publication forthcoming), we found that studies measure adherence using disparate modalities (including self-reports and blood samples), which may lead to different conclusions about adherence patterns in study populations. Many studies have articulated the need for a “gold standard,” but this has remained elusive. Therefore, CROWN aims to shift the focus to triangulating measurements through multiple modalities and methods in order to contribute to a greater understanding of adherence measurement across health areas.
Mentorship
The goal of mentorship under CROWN is to pair nutrition professionals with mentors who can meet their personal goals for professional development, skill building, and promotion of well-being in their lives at work, at home, and beyond. We use a mentee-centered approach that focuses on the individual needs of the mentee.1 In order to measure outcomes of the mentoring relationship, we use an adapted version of the mentoring competencies described by Fleming et al.2, including 1) maintaining effective communication, 2) aligning expectations, 3) providing skills and knowledge for success, 4) addressing diversity, 5) fostering independence, and 6) promoting professional development.
Mentorship is where an individual with more experience (often a peer or someone older) guides a less experienced person on key areas of development or growth. For professional mentorship, this may include guidance on professional development, skill acquisition, navigating interactions in the workplace, and/or balancing work life with personal life. Mentorship is distinct from coaching or sponsorship in that it involves a certain degree of relationship building between the mentor and mentee—the mentor must be someone the mentee can trust, turn to when faced with challenges, and can confide in to promote wellness and personal growth.1 In the most successful mentoring relationships, there is mutual respect, compassion, and empathy, providing a strong foundation for meeting the goals of the mentoring relationship.
Michelle Kaufman, PhD, is a leading expert in e-mentorship, or the use of communications technology with mentoring practices and is leading the mentoring component of the CROWN Project. With funding from the National Institute on Drug Abuse, the Bloomberg American Health Initiative, and the Gates Foundation in collaboration with the National Mentoring Partnership, Dr. Kaufman has been studying how technology and social media can be combined with mentoring to improve health outcomes for vulnerable populations. Much of her work has been focused on adolescent and young adult populations at risk for substance use, mental distress, and/or sexual risk behavior. She also leads a large global project funded by Bloomberg Philanthropies spanning 40+ low- and middle-income countries that includes a focus on mentoring public health professionals working to integrate gender equity in health data collection.