Structuring Process Evaluation to Forecast Use and Sustainability of an Intervention: Theory and Data From the Efficacy Trial for <i>Lunch Is in the Bag</i>

Roberts-Gray, Cynthia; Sweitzer, S.J.; Ranjit, Nalini; Potratz, Christa; Rood, Magdalena; Romo-Palafox, Maria Jose; Byrd-Williams, Courtney E.; Briley, Margaret E.; Hoelscher, Deanna M.

doi:10.1177/1090198116676470

Cited by 11 publications

(13 citation statements)

References 20 publications

(28 reference statements)

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“…Data from the Lunch is in the Bag (LIITB) trial, collected in Texas between 2011 and 2013 were used. 24–26 LIITB was a multi-level behaviorally-based intervention intended for implementation at Early Care and Education (ECE) centers where parents sent lunches from home. The aim of the intervention was to increase the servings of fruits, vegetables and whole grains that parents packed in their preschoolers’ lunch.…”

Section: Methodsmentioning

confidence: 99%

Contribution of Beverage Selection to the Dietary Quality of the Packed Lunches Eaten by Preschool-Aged Children

Romo-Palafox¹,

Ranjit²,

Sweitzer³

et al. 2018

Journal of the Academy of Nutrition and Dietetics

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Section: Methodsmentioning

confidence: 99%

Contribution of Beverage Selection to the Dietary Quality of the Packed Lunches Eaten by Preschool-Aged Children

Romo-Palafox¹,

Ranjit²,

Sweitzer³

et al. 2018

Journal of the Academy of Nutrition and Dietetics

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“…Measuring intervention sustainability also informs modification efforts by identifying which intervention components promote or hinder integration into organizational practice [ 8 ]. In order to ensure long-term beneficial outcomes of a complex intervention, it is necessary to critically assess intervention sustainability and, if needed, modify the intervention to promote sustainability [ 14 ]. The reach of an intervention is defined as the proportion of the intended target audience that receives each component of an intervention [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation

et al. 2018

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BackgroundThe Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities.MethodsTo assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January–December 2014). We administered a 20-item survey to the staff involved with transplant education in 67 dialysis facilities randomized to participate in intervention activities. Survey items assessed facility participation in the intervention (fidelity and reach), helpfulness and willingness to continue intervention activities (sustainability), suggestions for improving intervention components (sustainability), and factors that may have influenced participation and study outcomes (context). We defined high fidelity to the intervention as completing 11 or more activities, and high participation in an activity as having at least 75% participation across intervention facilities.ResultsStaff from 65 of the 67 dialysis facilities completed the questionnaire, and more than half (50.8%) reported high adherence (fidelity) to RaDIANT intervention requirements. Nearly two-thirds (63.1%) of facilities reported that RaDIANT intervention activities were helpful or very helpful, with 90.8% of facilities willing to continue at least one intervention component beyond the study period. Intervention components with high participation emphasized staff and patient-level education, including in-service staff orientations, patient and family education programs, and patient educational materials. Suggested improvements for intervention activities emphasized addressing financial barriers to transplantation, with financial education materials perceived as most helpful among RaDIANT educational materials. Variation in facility-level fidelity of the RADIANT intervention did not significantly influence the mean difference in proportion of patients referred pre- (2013) and post-intervention (2014).ConclusionsWe found high fidelity to the RaDIANT multicomponent intervention at the majority of intervention facilities, with sustainability of select intervention components at intervention facilities and feasibility for dissemination across ESRD Networks. Future modification of the intervention should emphasize financial education regarding kidney transplantation and amend intervention components that facilities perceive as time-intensive or non-sustainable.Trial registrationClinicaltrials.gov number NCT02092727. Registered 13 Mar 2014 (retrospectively registered).Electronic supplementary materialThe online version of this article (10.1186/s12882-017-0807-z) contains supplementary material, which is available to authorized users.

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“…Prevalence of specific implementing actions was consistent with the research team’s pre-trial forecasts except that more parents than expected read the newsletters (83% vs 50%) and fewer reported hearing their children talk about the classroom activities (4% vs 50%). More detail about implementation is presented elsewhere (Roberts-Gray et al, 2016b).…”

Section: Resultsmentioning

confidence: 99%

“…Debriefing interviews were conducted with parents, teachers, and ECE directors to evaluate qualities of use, usefulness, and usability of the intervention. More detail about the structure and content of each of these tools and procedures is reported elsewhere (Roberts-Gray et al, 2016b).…”

Section: Methodsmentioning

confidence: 99%

Parent packs, child eats: Surprising results of Lunch is in the Bag‘s efficacy trial

Roberts-Gray¹,

Ranjit²,

Sweitzer

et al. 2018

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Early care and education (ECE) centers that require lunch brought from home provide an uncluttered view of parent-child dietary interactions in early childhood. Children's eating from parent-provided bag lunches was observed at 30 ECE centers in Texas, with 15 randomly assigned to the Lunch is in the Bag intervention to improve the lunch meal and 15 to a wait-list control condition. Study participants were parent and child aged 3-5 years (N = 633 dyads). Data were collected at baseline (pre-intervention) and follow-ups at weeks 6 (post-intervention), 22 (pre-booster), and 28 (post-booster). Changes effected in the children's lunch eating-e.g., increase of 14 percent in prevalence of children eating vegetables (SE = 5, P = 0.0063)-reciprocated changes in parent lunch-packing. Irrespective of intervention, however, the children consumed one-half to two-thirds of the amounts of whatever foods the parents packed, and the eat-to-pack ratio did not change across time. Thus, children's lunch eating at the ECE centers appeared to be regulated by perceptual cues of food availability rather than food preferences or internal cues of hunger and satiety.

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Structuring Process Evaluation to Forecast Use and Sustainability of an Intervention: Theory and Data From the Efficacy Trial for Lunch Is in the Bag

Abstract: This approach can assist interpretation of trial outcomes, aid decisions about dissemination of the intervention, and contribute to translational science for improving health.

Cited by 11 publications

References 20 publications

Contribution of Beverage Selection to the Dietary Quality of the Packed Lunches Eaten by Preschool-Aged Children

Contribution of Beverage Selection to the Dietary Quality of the Packed Lunches Eaten by Preschool-Aged Children

Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation

Parent packs, child eats: Surprising results of Lunch is in the Bag‘s efficacy trial

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