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Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial

BACKGROUND: Preventing obesity is an international health priority and women living in rural communities are at an increased risk of weight gain. Lifestyle programs are needed as part of a comprehensive approach to prevent obesity. Evaluation provides a unique opportunity to investigate and inform i...

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Autores principales: Kozica, S L, Lombard, C B, Ilic, D, Ng, S, Harrison, C L, Teede, H J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513385/
https://www.ncbi.nlm.nih.gov/pubmed/26205958
http://dx.doi.org/10.1186/s12889-015-1995-8
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author Kozica, S L
Lombard, C B
Ilic, D
Ng, S
Harrison, C L
Teede, H J
author_facet Kozica, S L
Lombard, C B
Ilic, D
Ng, S
Harrison, C L
Teede, H J
author_sort Kozica, S L
collection PubMed
description BACKGROUND: Preventing obesity is an international health priority and women living in rural communities are at an increased risk of weight gain. Lifestyle programs are needed as part of a comprehensive approach to prevent obesity. Evaluation provides a unique opportunity to investigate and inform improvements in lifestyle program implementation strategies. The Healthy Lifestyle Program for rural women (HeLP-her Rural) is a large scale, cluster randomized control trial, targeting the prevention of weight gain. This program utilises multiple delivery modes for simple lifestyle advice (group sessions, phone coaching, text messages, and an interactive program manual). Here, we describe the acceptability of these various delivery modes. METHODS: A mixed-method process evaluation was undertaken measuring program fidelity, recruitment strategies, dose delivered, program acceptability and contextual factors influencing program implementation. Data collection methodologies included qualitative semi-structured interviews for a sub-group of intervention participants [n = 28] via thematic analysis and quantitative methods (program checklists and questionnaires [n = 190]) analysed via chi square and t-tests. RESULTS: We recruited 649 women from 41 rural townships into the HeLP-her Rural program with high levels of program fidelity, dose delivered and acceptability. Participants were from low socioeconomic townships and no differences were detected between socioeconomic characteristics and the number of participants recruited across the towns (p = 0.15). A face-to-face group session was the most commonly reported preferred delivery mode for receiving lifestyle advice, followed by text messages and phone coaching. Multiple sub-themes emerged to support the value of group sessions which included: promoting of a sense of belonging, mutual support and a forum to share ideas. The value of various delivery modes was influenced by participant’s various needs and learning styles. CONCLUSION: This comprehensive evaluation reveals strong implementation fidelity and high levels of dose delivery. We demonstrate reach to women from relatively low income rural townships and highlight the acceptability of low intensity healthy lifestyle programs with mixed face-to-face and remote delivery modes in this population. Group education sessions were the most highly valued component of the intervention, with at least one face-to-face session critical to successful program implementation. However, lifestyle advice via multiple delivery modes is recommended to optimise program acceptability and ultimately effectiveness. TRIAL REGISTRY: Australia & New Zealand Clinical Trial Registry. Trial number ACTRN12612000115831, date of registration24/01/2012. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-1995-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-45133852015-07-25 Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial Kozica, S L Lombard, C B Ilic, D Ng, S Harrison, C L Teede, H J BMC Public Health Research Article BACKGROUND: Preventing obesity is an international health priority and women living in rural communities are at an increased risk of weight gain. Lifestyle programs are needed as part of a comprehensive approach to prevent obesity. Evaluation provides a unique opportunity to investigate and inform improvements in lifestyle program implementation strategies. The Healthy Lifestyle Program for rural women (HeLP-her Rural) is a large scale, cluster randomized control trial, targeting the prevention of weight gain. This program utilises multiple delivery modes for simple lifestyle advice (group sessions, phone coaching, text messages, and an interactive program manual). Here, we describe the acceptability of these various delivery modes. METHODS: A mixed-method process evaluation was undertaken measuring program fidelity, recruitment strategies, dose delivered, program acceptability and contextual factors influencing program implementation. Data collection methodologies included qualitative semi-structured interviews for a sub-group of intervention participants [n = 28] via thematic analysis and quantitative methods (program checklists and questionnaires [n = 190]) analysed via chi square and t-tests. RESULTS: We recruited 649 women from 41 rural townships into the HeLP-her Rural program with high levels of program fidelity, dose delivered and acceptability. Participants were from low socioeconomic townships and no differences were detected between socioeconomic characteristics and the number of participants recruited across the towns (p = 0.15). A face-to-face group session was the most commonly reported preferred delivery mode for receiving lifestyle advice, followed by text messages and phone coaching. Multiple sub-themes emerged to support the value of group sessions which included: promoting of a sense of belonging, mutual support and a forum to share ideas. The value of various delivery modes was influenced by participant’s various needs and learning styles. CONCLUSION: This comprehensive evaluation reveals strong implementation fidelity and high levels of dose delivery. We demonstrate reach to women from relatively low income rural townships and highlight the acceptability of low intensity healthy lifestyle programs with mixed face-to-face and remote delivery modes in this population. Group education sessions were the most highly valued component of the intervention, with at least one face-to-face session critical to successful program implementation. However, lifestyle advice via multiple delivery modes is recommended to optimise program acceptability and ultimately effectiveness. TRIAL REGISTRY: Australia & New Zealand Clinical Trial Registry. Trial number ACTRN12612000115831, date of registration24/01/2012. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12889-015-1995-8) contains supplementary material, which is available to authorized users. BioMed Central 2015-07-24 /pmc/articles/PMC4513385/ /pubmed/26205958 http://dx.doi.org/10.1186/s12889-015-1995-8 Text en © Kozica et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Kozica, S L
Lombard, C B
Ilic, D
Ng, S
Harrison, C L
Teede, H J
Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
title Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
title_full Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
title_fullStr Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
title_full_unstemmed Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
title_short Acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
title_sort acceptability of delivery modes for lifestyle advice in a large scale randomised controlled obesity prevention trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513385/
https://www.ncbi.nlm.nih.gov/pubmed/26205958
http://dx.doi.org/10.1186/s12889-015-1995-8
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