Protocol for Healthy Habits Happy Homes (4H) Scotland: feasibility of a participatory approach to adaptation and implementation of a study aimed at early prevention of obesity

Abstract

IntroductionPrevention of childhood obesity is an important public health objective. Promoting healthful energy balance related behaviours (EBRBs) in the early years should be a key focus. In Scotland, one in five children are overweight or obese by age 5 years, with levels highest in deprived areas. This study protocol outlines the stages of a feasibility study to translate the highly promising North American Healthy Habits, Happy Homes (4H) a home based, preschool childhood obesity prevention intervention to Scotland (4H Scotland). First, elements of participatory and co-production approaches utilised to: (a) engage key stakeholders, (b) enable inclusive recruitment of participants and (c) adapt original study materials. Second, 4H Scotland intervention will be tested within a community experiencing health/social inequalities and high levels of deprivation in Dundee, Scotland.Methods and analysis4H Scotland aims to recruit up to 40 families. Anthropometry, objective and subjective measures of EBRBs will be collected at baseline and at 6 months. The intervention consists of monthly visits to family home, using motivational interviewing and SMS to support healthful EBRBs: sleep duration, physical activity (active play), screen time, family meals. The Control Group will receive standard healthy lifestyle information. Fidelity to intervention will be assessed using recordings of intervention visits. Feasibility and acceptability of study design components will be assessed through qualitative interviews and process evaluation of recruitment, retention rates; appropriateness, practicality of obtaining outcome measures; intervention duration, content, mode of delivery and associated costs. Adaptation through participatory and co-production will support development of 4H Scotland. Process evaluation offers two future directions; advancement towards a definitive, larger trial or routine practice.Ethics and disseminationThis study was granted ethical approval by the University of Strathclyde’s School of Psychological Sciences and Health Ethics Committee. Results will be disseminated through lay summaries workshops, peer-reviewed publications and conference presentations.Trial registration numberISRCTN13385965; Pre-results.

Healthy Habits, Happy Homes Scotland (4HS) feasibility study: Translation of a home-based early childhood obesity prevention intervention evaluated using RE-AIM framework

“… Primary outcome measures were acceptability & practicability of 4HS see Gillespie et al. [ 16 ] Secondary outcomes include Quality of life measured using peds QL. (will be addressed in later 4HS outcomes paper) 8 Adoption participation is critical to understand the number and types of organizations, clinics, or agencies that initiate a program or policy.…”

“…In an earlier paper, 4HS theory of change and causal pathway were outlined in a logic model [ 16 ]. This model postulated that time invested in building relationships and involving local people in the research process would lead to suitable ‘buy-in’ and creation of appropriate study materials (related to aim 1 here).…”

“…Fig. 3 , below, summarises the intervention methods, with full details described elsewhere [ 16 ]. RE-AIM dimensions and pragmatic questions [ 18 ] are included in Fig.…”

“…In a previous paper [ 16 ] we described the rationale for translating the highly promising (efficacious and low-cost) 4H to Scotland (4HS), developed a study logic model and theory of change and outlined crucial information about the context in which the feasibility study would take place. Children living in the North East area within the city of Dundee are twice as likely to have obesity by the time they start primary school compared to their peers who grow up across the city in the wealthiest neighbourhoods [ 3 ].…”

Procedures and Challenges of Adapting an Existing Public Health Intervention for Use in Another Setting: The ToyBox-Scotland Preschool Obesity Prevention Program

“…At present, there is no published guidance that details how to achieve this, although guidelines are under development (Evans et al, 2019). (Langford et al, 2019) and the healthy habits, happy homes study (Gillespie et al, 2019); which target obesogenic behaviors and environments at preschools and in children's homes, respectively.…”