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Evaluation of a large healthy lifestyle program: informing program implementation and scale-up in the prevention of obesity

View Article: PubMed Central - PubMed

ABSTRACT

Background: The Healthy Lifestyle Program for women (HeLP-her) is a low-intensity, self-management program which has demonstrated efficacy in preventing excess weight gain in women. However, little is known about the implementation, reach, and sustainability of low-intensity prevention programs in rural settings, where risk for obesity in women is higher than urban settings. We aimed to evaluate a low-intensity healthy lifestyle program delivered to women in a rural setting to inform development of effective community prevention programs.

Methods: A mixed method hybrid implementation and evaluation study, guided by the RE-AIM framework (addressing the Reach, Effectiveness, Adoption, Implementation, and Maintenance), was undertaken. Data collection tools included anthropometric measures, program checklists, questionnaires, and semi-structured interviews with participants and local stakeholders. The RE-AIM self-audit tool was applied to assess evaluation rigor.

Results: Six hundred and forty-nine women from 41 relatively socio-economic disadvantaged communities in Australia participated: mean age 39.6 years (±SD 6.7) and body mass index of 28.8 kg/m2 (±SD 6.9). A between-group weight difference of −0.92 kg (95% CI −1.67 to −0.16) showed program effectiveness. Reach was broad across 41 towns with 62% of participants reporting influencing some of the health behaviors of their families. Strong implementation fidelity was achieved with good retention rates at 1 year (76%) and high participant satisfaction (82% of participants willing to recommend this program). Over 300 multi-level community partnerships were established supporting high adoption. Stakeholders reported potential capacity to implement and sustain the prevention program in resource poor rural settings, due to the low-intensity design and minimal resources required.

Conclusions: Our comprehensive RE-AIM evaluation demonstrates that an evidence-based obesity prevention program can be successfully implemented in real-world settings. The program achieved broad reach, effectiveness, and satisfaction at the community and stakeholder level, revealing potential for program sustainability. The evaluation addressed implementation knowledge gaps to support future obesity prevention program scale-up.

Trial registration: Australian and New Zealand Clinical Trial Registry ACTRN 12612000115831 [http://www.anzctr.org.au/].

Electronic supplementary material: The online version of this article (doi:10.1186/s13012-016-0521-4) contains supplementary material, which is available to authorized users.

No MeSH data available.


The HeLP-her Rural program community reach. Broad program reach at both the community and organizational levels was achieved by this program. Groups that engaged with the HeLP-her Rural program and their settings included local government agencies, health workers (community health centers, medical clinics, and hospitals), community groups (women’s organizations, neighborhood houses, and sports clubs), education groups (primary schools, kindergartens, and child care centers), and private groups (local businesses and recreational centers)
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Fig2: The HeLP-her Rural program community reach. Broad program reach at both the community and organizational levels was achieved by this program. Groups that engaged with the HeLP-her Rural program and their settings included local government agencies, health workers (community health centers, medical clinics, and hospitals), community groups (women’s organizations, neighborhood houses, and sports clubs), education groups (primary schools, kindergartens, and child care centers), and private groups (local businesses and recreational centers)

Mentions: Meta-evaluation of HeLP-her Rural using criteria developed by RE-AIM


Evaluation of a large healthy lifestyle program: informing program implementation and scale-up in the prevention of obesity
The HeLP-her Rural program community reach. Broad program reach at both the community and organizational levels was achieved by this program. Groups that engaged with the HeLP-her Rural program and their settings included local government agencies, health workers (community health centers, medical clinics, and hospitals), community groups (women’s organizations, neighborhood houses, and sports clubs), education groups (primary schools, kindergartens, and child care centers), and private groups (local businesses and recreational centers)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5121947&req=5

Fig2: The HeLP-her Rural program community reach. Broad program reach at both the community and organizational levels was achieved by this program. Groups that engaged with the HeLP-her Rural program and their settings included local government agencies, health workers (community health centers, medical clinics, and hospitals), community groups (women’s organizations, neighborhood houses, and sports clubs), education groups (primary schools, kindergartens, and child care centers), and private groups (local businesses and recreational centers)
Mentions: Meta-evaluation of HeLP-her Rural using criteria developed by RE-AIM

View Article: PubMed Central - PubMed

ABSTRACT

Background: The Healthy Lifestyle Program for women (HeLP-her) is a low-intensity, self-management program which has demonstrated efficacy in preventing excess weight gain in women. However, little is known about the implementation, reach, and sustainability of low-intensity prevention programs in rural settings, where risk for obesity in women is higher than urban settings. We aimed to evaluate a low-intensity healthy lifestyle program delivered to women in a rural setting to inform development of effective community prevention programs.

Methods: A mixed method hybrid implementation and evaluation study, guided by the RE-AIM framework (addressing the Reach, Effectiveness, Adoption, Implementation, and Maintenance), was undertaken. Data collection tools included anthropometric measures, program checklists, questionnaires, and semi-structured interviews with participants and local stakeholders. The RE-AIM self-audit tool was applied to assess evaluation rigor.

Results: Six hundred and forty-nine women from 41 relatively socio-economic disadvantaged communities in Australia participated: mean age 39.6 years (±SD 6.7) and body mass index of 28.8 kg/m2 (±SD 6.9). A between-group weight difference of −0.92 kg (95% CI −1.67 to −0.16) showed program effectiveness. Reach was broad across 41 towns with 62% of participants reporting influencing some of the health behaviors of their families. Strong implementation fidelity was achieved with good retention rates at 1 year (76%) and high participant satisfaction (82% of participants willing to recommend this program). Over 300 multi-level community partnerships were established supporting high adoption. Stakeholders reported potential capacity to implement and sustain the prevention program in resource poor rural settings, due to the low-intensity design and minimal resources required.

Conclusions: Our comprehensive RE-AIM evaluation demonstrates that an evidence-based obesity prevention program can be successfully implemented in real-world settings. The program achieved broad reach, effectiveness, and satisfaction at the community and stakeholder level, revealing potential for program sustainability. The evaluation addressed implementation knowledge gaps to support future obesity prevention program scale-up.

Trial registration: Australian and New Zealand Clinical Trial Registry ACTRN 12612000115831 [http://www.anzctr.org.au/].

Electronic supplementary material: The online version of this article (doi:10.1186/s13012-016-0521-4) contains supplementary material, which is available to authorized users.

No MeSH data available.