Poster Topical Area: Methods and Protocols
Location: Hall D
Poster Board Number: 665
Objective: Process evaluation methods and results are rarely reported in the obesity intervention literature, despite their importance for understanding intervention outcomes. This trend hinders development of novel strategies that can address limitations in traditional process evaluation frameworks. For example, traditional frameworks emphasize adherence to protocols over adaptation, which is neither realistic nor appropriate for community-based interventions. Also, evaluators traditionally withhold process evaluation data from intervention implementers to maximize internal validity, thereby bypassing opportunities to enhance intervention impact. Our objective is to describe the process evaluation approach employed for Communities for Healthy Living (CHL), a preschool obesity prevention intervention. In so doing, we highlight how we have addressed the aforementioned shortcomings of traditional process evaluation frameworks.
Methods: The CHL research team chose a process evaluation framework created for adaptive interventions because it addresses the major challenges of traditional frameworks by emphasizing measurement in three domains: adherence to protocols, adaptation of protocols, and moderators of intervention implementation and effectiveness.
Results: The CHL research team incorporated quality improvement into the intervention to maximize benefit for participants. Data collected for quality improvement will also be used for process evaluation during the trial, reducing the need to withhold data from implementers to protect the trial's internal validity. As process data are collected and used to inform the intervention, adaptions to meet local needs will not be discouraged because adaptation is on par with adherence within the process evaluation framework.
Conclusion: Detailing the CHL process evaluation methods not only addresses the dearth of process evaluation methods and results in the literature, it provides an example of how such methods can be modified to meet unique challenges of community-based interventions. Further development of these methods can deepen the understanding of factors underlying obesity intervention effectiveness and advance development of interventions that can be implemented across diverse settings.
trial reg: NCT03334669
Harvard T.H. Chan School of Public Health