197831 Process evaluation methodology and preliminary results from the HEALTHY Study

Monday, November 9, 2009

Stella Volpe, PhD, RD , Division of Biobehavioral and Health Sciences, University of Pennsylvania, Philadelphia, PA
Arthur Hernandez, PhD , College of Education, Texas A&M University Corpus Christi, Corpus Christi, TX
Katie Hinds, MPH , Medical Center, University of Pittsburgh, Pittsburgh, PA
Trang Pham, MPH , Biostatistics Center, George Washington University, Rockville, MD
Jennifer Rosen, BS , School of Medicine - CORE: Center for Obesity Research and Education, Temple University, Philadelphia, PA
Margaret Schneider, PhD , Department of Planning, Policy and Design, University of California at Irvine, Irvine, CA
Adriana Sleigh, BS , Division of Health Promotion & Sports Medicine, Oregon Health & Science University, Portland, OR
Allan Steckler, DrPH , Department of Health Behavior and Health Education, UNC-Chapel Hill, Chapel Hill, NC
Debbe Thompson, PhD , Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
Abigail D. Zeveloff, MPH , Department of Health Behavior and Health Education, School of Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC
BACKGROUND: The HEALTHY study, a middle-school-based, multi-center, primary prevention trial, is using nutritional, physical education (PE), behavioral and communications strategies to decrease rates of obesity and other risk factors for type 2 diabetes mellitus in middle school youth. PURPOSE: Process evaluation assesses fidelity, reach, and dose of the intervention. SIGNIFICANCE/METHODOLOGY: Though many studies have used process evaluation post-intervention, we used it formatively to modify the intervention delivery throughout the life of the project. RESULTS: For example: (1) In 2007, process evaluation data indicated that the nutrition intervention attained high performance on increasing fruits and vegetables served in the cafeteria, but increasing high fiber foods was a difficult goal to achieve. The nutrition study staff were able to concentrate on continuing to seek high fiber foods and working with vending companies to meet the HEALTHY goals. (2) For PE, the data showed that the strengths of the intervention were the high levels of student and teacher engagement; challenges to PE intervention fidelity included inconsistent implementation of various HEALTHY PE components. As a consequence, PE study staff increased their collaboration with teachers to modify the HEALTHY lessons and develop classroom management strategies to improve PE. (3) Though students were highly engaged in the behavioral intervention (health lessons), student disruptive behavior was often cited as a challenge. This finding resulted in study staff working more closely with teachers to develop better classroom management systems. CONCLUSIONS: In conclusion, process evaluation, used in a formative fashion, helped to further improve components of the HEALTHY study.

Learning Objectives:
After hearing our presentation, the audience will be able to: 1) Define process evaluation methods. 2) Describe ways to use process evaluation in a formative manner.

Keywords: Child Health Promotion, School Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a co-investigator on this study, and I was the main person to put this abstract together. I am also a member of the process evaluation committee of the HEALTHY study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.