What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants and Recruitment
2.3. Interventions
2.3.1. PA Programme Group
2.3.2. Behaviour Change Support Group
2.3.3. Combined PA Programme and Behaviour Change Support Group
2.3.4. Comparison Group
2.4. Process Evaluation Framework and Data Collection
2.5. Data Sources
2.5.1. Demographic Data
2.5.2. PA Logbooks
2.5.3. Activity Mentor Logbooks
2.5.4. Exit Surveys
2.5.5. Focus Groups and Interviews
2.6. Data Analyses
2.6.1. Analysis of Quantitative Data
2.6.2. Analysis of Qualitative Data
3. Results
3.1. Participant Descriptives
3.2. Reach and Recruitment
3.2.1. PA Programme Group
3.2.2. Behaviour Change Support Group
3.2.3. Combined Group
3.3. Delivery Fidelity
3.3.1. PA Programme Group
3.3.2. Behaviour Change Support Group
‘My main challenge was that some participants missed a number of their scheduled sessions. On my part this meant attempting to reschedule at a mutually convenient time, but sometimes it was hard work to even get a response from the girls!’
3.3.3. Combined PA Programme and Behaviour Change Support Group
‘I work Saturdays so the Saturday morning never worked for me… so I would go back the following day into the (online folder) link and do the workouts then… I liked the flexibility’(Combination group, 16, Ireland)
3.4. Participant Receipt, Engagement, and Enactment
3.4.1. PA Programme Group
‘I tried a few of the videos and I liked some more than others but because you have such a variety it is really good because different people can try lots of different things’(PA programme group, 14, UK)
‘I loved (the text messages) because they reminded me to fill in the logbook. They were also quite motivational to keep going like if you thought “I don’t want to do this exercise today” so that was nice’(PA programme group, 15, Ireland)
‘My outlook on exercise has definitely changed I used to look at exercise as a chore but now it’s something that I wake up and I really want to do so (HERizon) has definitely affected my mindset’(PA programme group, 15, Ireland)
3.4.2. Behaviour Change Support Group
‘I have got more confident now especially in PE in school because I used to not be very confident and really self-conscious but now I am like “oh ye I can do exercise”’(behaviour change group, 14, UK)
3.4.3. Combined PA Programme and Behaviour Change Support Group
‘I thought (the logbook) was really useful, I found motivation from it and support and it helped me plan out the week like I got better at planning my exercise and it was nice to look back at it to see how much exercise you’ve done’(behaviour change support group, 16, Ireland)
‘A lot of the time the group chat was just silent unless (the researcher) sent things in… our group didn’t really talk but I’m not really sure how to fix that’(combined group, 15, Ireland)
‘I have such positivity now around exercise cause I never liked PE cause we do the same thing all the time and I’m not very sporty I have no coordination but last Thursday we were doing laps and before I would have given up but I was thinking “I can do it” I felt determination, motivation, and body positivity as well’(combined group, 16, Ireland)
3.5. Adherence
3.5.1. PA Programme Group
‘I think (three PA sessions) was perfect because it’s not too much especially when you first start (exercising) it can be tough but with 3 it’s easy, it is a small goal, like very achievable’(PA programme group, 14, UK)
3.5.2. Behaviour Change Support Group
‘At the start I really didn’t want to do (PA) at all and I thought about dropping out but then I started actually enjoying it and I found that three times wasn’t enough and wanted to do (PA) four times’(behaviour change support group, 16, UK)
3.5.3. Combined PA Programme and Behaviour Change Support Group
‘On the 1st week I only did 2 (PA sessions) because I think we were all only getting into (the programme) and used to it but then I stuck to 3 sessions a week’(combined group, 15, Ireland)
3.6. Acceptability
3.6.1. PA Programme Group
‘I really liked the live classes like honestly I would pay for it and do them forever I really enjoyed the layout of them and how motivating it was not having to repeat the exercises and I enjoyed that you told us what part of the body you should be working that helped me really focus’(PA programme group, 16, UK)
‘I just felt like I was scared to speak there because no one was speaking… maybe more ice breakers could be a nice thing like questions (posed by the researcher) for next time’(PA programme group,15, Ireland)
3.6.2. Behaviour Change Support Group
‘I thought (the logbook) was really useful, I found motivation from it and support and it helped me plan out the week like I got better at it, it was nice to look back at it to see how much exercise you’ve done’(behaviour change support group, 16, Ireland)
‘You felt like you kind of had to do (PA) because someone else was involved like you had to report back and you didn’t want to be like “no I didn’t do anything”’(behaviour change support group, 16, UK)
‘In the first break a text would have been beneficial but the second break it good to start building your routine because that is when I found my routine really started in the second break’(behaviour change support group, 16, Ireland)
3.6.3. Combined PA Programme and Behaviour Change Support Group
‘I think that the Instagram group was good but it is kind of hard to communicate through it but it was nice just to know that it was there so you could see that there are other people doing the project with you that you’re not alone in it’(combined group, 14, Ireland)
3.7. Mechanisms of Impact
3.7.1. Routine
‘I really liked the schedule of the workouts because even if I am tired I would be like “OK I am just going to do this and then I can be finished” so I wasn’t like dilly daddling, it was at a set time I couldn’t be like “oh I’ll just do it in another hour”’(PA programme group, 15 Ireland)
‘I’m not as afraid of just starting doing physical activity now like it is part of my life but it’s not too big of a part it is just balanced and ye it’s just easy now’(combined group, 15, Ireland)
3.7.2. Sense of Accomplishment
‘It gave me a big sense of accomplishment like looking over it and if I did quite a lot (of PA) that week it was good to be able to see what I had done each day… it gave me kind of motivation’(behaviour change support group, 15, UK)
‘I definitely think I have become physically fitter I am definitely stronger like the first strength workout I did I was so sore I could hardly lift the little tin cans over my head but now it is really cool because now I can feel on my arms there is muscle definition’(combined group, 16, Ireland)
3.7.3. Accountability
‘I feel like since we had the mentor calls and we knew it had to happen every week it kind of motivated me to do more so I could tell her and not just be like “ye I sat down all day”.(combined group, 14, UK)
‘I really liked the bit where you could plan (PA) out, it just makes it a lot easier to plan out what you’re going to do for the week and hold yourself accountable, as well the little bit like the week by week topics I quite enjoyed that it was nice to check up on myself’(PA programme group, 16, UK)
3.7.4. Discovery of Preferred PA
‘I am a lot more physically active now… I used to look at exercise like “Why would someone do that? That looks too hard and too boring”, but now I really enjoy it because of all the options we had at the start and the different (physical activities) you can do’(behaviour change support group, 13, UK)
‘It was more routine than feeling like I had to get up and do the project, it kind of felt like you were just doing your thing like on Monday’s I just knew that I had a workout to do, it was routine, like motivation wasn’t needed as much’(behaviour change support group, 16, Ireland)
3.8. Context
4. Discussion
Strengths and Limitations
5. Conclusions
- Context and its impact should not be undervalued when implementing a PA intervention in a real-world setting. Consideration should be given during intervention development to school terms, examination points, and typical vacation periods.
- Paid advertisements on social media that emphasise the accountability and community aspects of the intervention should be considered when recruiting adolescent girls.
- To foster a sense of community and belonging, providers should facilitate and encourage group discussion, e.g., ice-breaker tasks.
- Encouraging participant autonomy through choice and a flexible treatment design may increase long-term behaviour change and therefore should also be considered.
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
- Janssen, I.; LeBlanc, A.G. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int. J. Behav. Nutr. Phys. Act. 2010, 7, 40. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Eime, R.M.; Young, J.A.; Harvey, J.T.; Charity, M.J.; Payne, W.R. A systematic review of the psychological and social benefits of participation in sport for children and adolescents: Informing development of a conceptual model of health through sport. Int. J. Behav. Nutr. Phys. Act. 2013, 10, 98. [Google Scholar] [CrossRef] [Green Version]
- Bidzan-Bluma, I.; Lipowska, M. Physical Activity and Cognitive Functioning of Children: A Systematic Review. Int. J. Environ. Res. Public Health 2018, 15, 800. [Google Scholar] [CrossRef]
- Pels, F.; Kleinert, J. Loneliness and physical activity: A systematic review. Int. Rev. Sport Exerc. Psychol. 2016, 9, 231–260. [Google Scholar] [CrossRef]
- Guthold, R.; Stevens, G.A.; Riley, L.M.; Bull, F.C. Global trends in insufficient physical activity among adolescents: A pooled analysis of 298 population-based surveys with 1·6 million participants. Lancet Child Adolesc. Health 2020, 4, 23–35. [Google Scholar] [CrossRef]
- Farooq, M.A.; Parkinson, K.N.; Adamson, A.; Pearce, M.; Reilly, J.K.; Hughes, A.R.; Janssen, X.; Basterfield, L.; Reilly, J.J. Timing of the decline in physical activity in childhood and adolescence: Gateshead Millennium Cohort Study. Br. J. Sports Med. 2017, 52, 1002–1006. [Google Scholar] [CrossRef] [Green Version]
- Cowley, E.; Watson, P.; Foweather, L.; Belton, S.; Mansfield, C.; Whitcomb-Khan, G.; Cacciatore, I.; Thompson, A.; Thijssen, D.; Wagenmakers, A. Formative Evaluation of a Home-Based Physical Activity Intervention for Adolescent Girls—The HERizon Project: A Randomised Controlled Trial. Children 2021, 8, 76. [Google Scholar] [CrossRef] [PubMed]
- Yungblut, H.E.; Schinke, R.J.; McGannon, K. Views of Adolescent Female Youth on Physical Activity During Early Adolescence. J. Sports Sci. Med. 2012, 11, 39–50. [Google Scholar] [PubMed]
- Preece, S.; Bullingham, R. Gender stereotypes: The impact upon perceived roles and practice of in-service teachers in physical education. Sport Educ. Soc. 2020, 1, 1–13. [Google Scholar] [CrossRef]
- Cowley, E.S.; Watson, P.M.; Foweather, L.; Belton, S.; Thompson, A.; Thijssen, D.; Wagenmakers, A.J.M. “Girls Aren’t Meant to Exercise”: Perceived Influences on Physical Activity among Adolescent Girls—The HERizon Project. Children 2021, 8, 31. [Google Scholar] [CrossRef] [PubMed]
- Biddle, S.J.; Braithwaite, R.; Pearson, N. The effectiveness of interventions to increase physical activity among young girls: A meta-analysis. Prev. Med. 2014, 62, 119–131. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Camacho-Miñano, M.J.; LaVoi, N.M.; Barr-Anderson, D.J. Interventions to promote physical activity among young and adolescent girls: A systematic review. Health Educ. Res. 2011, 26, 1025–1049. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Owen, M.B.; Curry, W.B.; Kerner, C.; Newson, L.; Fairclough, S.J. The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis. Prev. Med. 2017, 105, 237–249. [Google Scholar] [CrossRef] [PubMed]
- Kelly, M.P.; Barker, M. Why is changing health-related behaviour so difficult? Public Health 2016, 136, 109–116. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Carlin, A.; Murphy, M.H.; Nevill, A.; Gallagher, A.M. Effects of a peer-led Walking In ScHools intervention (the WISH study) on physical activity levels of adolescent girls: A cluster randomised pilot study. Trials 2018, 19, 31. [Google Scholar] [CrossRef] [Green Version]
- Farmer, O.; Cahill, K.; O’Brien, W. Gaelic4Girls—The Effectiveness of a 10-Week Multicomponent Community Sports-Based Physical Activity Intervention for 8 to 12-Year-Old Girls. Int. J. Environ. Res. Public Health 2020, 17, 6928. [Google Scholar] [CrossRef]
- Owen, M.B.; Kerner, C.; Taylor, S.; Noonan, R.J.; Newson, L.; Kosteli, M.-C.; Curry, W.B.; Fairclough, S.J. The Feasibility of a Novel School Peer-Led Mentoring Model to Improve the Physical Activity Levels and Sedentary Time of Adolescent Girls: The Girls Peer Activity (G-PACT) Project. Children 2018, 5, 67. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Sebire, S.J.; Jago, R.; Banfield, K.; Edwards, M.J.; Campbell, R.; Kipping, R.; Blair, P.S.; Kadir, B.; Garfield, K.; Matthews, J.; et al. Results of a feasibility cluster randomised controlled trial of a peer-led school-based intervention to increase the physical activity of adolescent girls (PLAN-A). Int. J. Behav. Nutr. Phys. Act. 2018, 15, 50. [Google Scholar] [CrossRef] [PubMed]
- Geng, E.H.; Peiris, D.; Kruk, M.E. Implementation science: Relevance in the real world without sacrificing rigor. PLOS Med. 2017, 14, e1002288. [Google Scholar] [CrossRef]
- Hagger, M.S.; Weed, M. DEBATE: Do interventions based on behavioral theory work in the real world? Int. J. Behav. Nutr. Phys. Act. 2019, 16, 36. [Google Scholar] [CrossRef] [Green Version]
- Moore, G.F.; Audrey, S.; Barker, M.; Bond, L.; Bonell, C.; Hardeman, W.; Moore, L.; O’Cathain, A.; Tinati, T.; Wight, D.; et al. Process evaluation of complex interventions: Medical Research Council guidance. BMJ 2015, 350, h1258. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Rowbotham, S.; Conte, K.; Hawe, P. Variation in the operationalisation of dose in implementation of health promotion interventions: Insights and recommendations from a scoping review. Implement. Sci. 2019, 14, 56. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Borrelli, B. The assessment, monitoring, and enhancement of treatment fidelity in public health clinical trials. J. Public Health Dent. 2011, 71, S52–S63. [Google Scholar] [CrossRef] [Green Version]
- Glasgow, R.E.; Linnan, L.A. Evaluation of Theory-Based Interventions in Health Behavior and Health Education: Theory, Research, and Practice, 4th ed.; Jossey-Bass: San Francisco, CA, USA, 2008. [Google Scholar]
- Bellg, A.J.; Borrelli, B.; Resnick, B.; Hecht, J.; Minicucci, D.S.; Ory, M.G.; Ogedegbe, G.; Orwig, D.; Ernst, D.; Czajkowski, S. Enhancing Treatment Fidelity in Health Behavior Change Studies: Best Practices and Recommendations From the NIH Behavior Change Consortium. Health Psychol. 2004, 23, 443–451. [Google Scholar] [CrossRef]
- Dusenbury, L.; Brannigan, R.; Falco, M.; Hansen, W.B. A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Educ. Res. 2003, 18, 237–256. [Google Scholar] [CrossRef]
- Glasgow, R.E.; Harden, S.M.; Gaglio, B.; Rabin, B.; Smith, M.L.; Porter, G.C.; Ory, M.G.; Estabrooks, P.A. RE-AIM Planning and Evaluation Framework: Adapting to New Science and Practice With a 20-Year Review. Front. Public Health 2019, 7, 64. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Linnan, L.; Steckler, A. Process Evaluation for Public Health Interventions and Research An Overview; Jossey-Bass: San Francisco, CA, USA, 2002. [Google Scholar]
- Proctor, E.; Silmere, H.; Raghavan, R.; Hovmand, P.; Aarons, G.; Bunger, A.; Griffey, R.; Hensley, M. Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda. Adm. Ment. Health 2010, 38, 65–76. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Oakley, A.; Strange, V.; Bonell, C.; Allen, E.; Stephenson, J. Health services research—Process evaluation in randomised controlled trials of complex interventions. Br. Med. J. 2006, 332, 413–416. [Google Scholar] [CrossRef] [Green Version]
- Billingham, S.A.; Whitehead, A.L.; Julious, S.A. An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC Med. Res. Methodol. 2013, 13, 104. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Ryan, R.M.; Deci, E.L. Self-Determination Theory: Basic Psychological Needs in Motivation, Development, and Wellness; Guilford Press: New York, NY, USA, 2017. [Google Scholar]
- Haase, T.; Pratschke, J. The 2016 Pobal HP Deprivation Index for Small Areas (SA). Available online: http://trutzhaase.eu/wp/wp-content/uploads/The-2016-Pobal-HP-Deprivation-Index-Introduction-07.pdf (accessed on 3 October 2021).
- Ministry of Housing CLG. The English Indices of Deprivation 2019 (IoD2019). Available online: https://www.gov.uk/government/statistics/english-indices-of-deprivation-2019 (accessed on 3 October 2021).
- Braun, V.; Clarke, V. Reflecting on reflexive thematic analysis. Qual. Res. Sport Exerc. Health 2019, 11, 589–597. [Google Scholar] [CrossRef]
- Smith, B.; McGannon, K. Developing rigor in qualitative research: Problems and opportunities within sport and exercise psychology. Int. Rev. Sport Exerc. Psychol. 2016, 11, 101–121. [Google Scholar] [CrossRef]
- Patrick, K.; Calfas, K.J.; Norman, G.J.; Zabinski, M.F.; Sallis, J.F.; Rupp, J.; Covin, J.; Cella, J. Randomized Controlled Trial of a Primary Care and Home-Based Intervention for Physical Activity and Nutrition Behaviors: PACE+ for Adolescents. Arch. Pediatrics Adolesc. Med. 2006, 160, 128–136. [Google Scholar] [CrossRef] [Green Version]
- McDonough, D.J.; Helgeson, M.A.; Liu, W.; Gao, Z. Effects of a remote, YouTube-delivered exercise intervention on young adults’ physical activity, sedentary behavior, and sleep during the COVID-19 pandemic: Randomized controlled trial. J. Sport Health Sci. 2021, 21, 1–12. [Google Scholar] [CrossRef] [PubMed]
- Jenkinson, K.A.; Naughton, G.; Benson, A.C. The GLAMA (Girls! Lead! Achieve! Mentor! Activate!) physical activity and peer leadership intervention pilot project: A process evaluation using the RE-AIM framework. BMC Public Health 2012, 12, 55. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jong, S.T.; Croxson, C.H.D.; Foubister, C.; Brown, H.E.; Guell, C.; Lawlor, E.R.; Wells, E.K.; Wilkinson, P.O.; Wilson, E.C.F.; van Sluijs, E.M.F. Reach, Recruitment, Dose, and Intervention Fidelity of the GoActive School-Based Physical Activity Intervention in the UK: A Mixed-Methods Process Evaluation. Children 2020, 7, 231. [Google Scholar] [CrossRef]
- Åvitsland, A.; Ohna, S.E.; Dyrstad, S.M.; Tjomsland, H.E.; Lerum, Ø.; Leibinger, E. The process evaluation of a school-based physical activity intervention: Influencing factors and potential consequences of implementation. Health Educ. 2020, 120, 121–139. [Google Scholar] [CrossRef]
- Casey, M.M.; Telford, A.; Mooney, A.; Harvey, J.T.; Eime, R.M.; Payne, W.R. Linking secondary school physical education with community sport and recreation for girls: A process evaluation. BMC Public Health 2014, 14, 1039. [Google Scholar] [CrossRef] [Green Version]
- Foster, C.; Richards, J.; Thorogood, M.; Hillsdon, M. Remote and web 2.0 interventions for promoting physical activity. Cochrane Database Syst. Rev. 2013, 9, CD010395. [Google Scholar] [PubMed]
- Fischer, X.; Donath, L.; Zahner, L.; Faude, O.; Gerber, M. Exploring psychosocial mediators of remote physical activity counselling: A secondary analysis of data from a 1-year randomized control trial (Movingcall). J. Behav. Med. 2019, 43, 271–285. [Google Scholar] [CrossRef] [PubMed]
- Cline, A.; Knox, G.; Silva, L.D.M.; Draper, S. A Process Evaluation of A UK Classroom-Based Physical Activity Intervention—‘Busy Brain Breaks’. Children 2021, 8, 63. [Google Scholar] [CrossRef] [PubMed]
- Casey, M.; Eime, R.; Payne, W.; Harvey, J. Using a Socioecological Approach to Examine Participation in Sport and Physical Activity Among Rural Adolescent Girls. Qual. Health Res. 2009, 19, 881–893. [Google Scholar] [CrossRef] [Green Version]
- Eime, R.M.; Harvey, J.T.; Sawyer, N.; Craike, M.; Symons, C.M.; Polman, R.; Payne, W.R. Understanding the Contexts of Adolescent Female Participation in Sport and Physical Activity. Res. Q. Exerc. Sport 2013, 84, 157–166. [Google Scholar] [CrossRef]
- Elder, J.P.; Lytle, L.; Sallis, J.F.; Young, D.R.; Steckler, A.; Simons-Morton, D.; Stone, E.; Jobe, J.B.; Stevens, J.; Lohman, T.; et al. A description of the social-ecological framework used in the trial of activity for adolescent girls (TAAG). Health Educ. Res. 2006, 22, 155–165. [Google Scholar] [CrossRef] [PubMed]
- Holmberg, C.; Larsson, C.; Korp, P.; Lindgren, E.-C.; Jonsson, L.; Fröberg, A.; Chaplin, J.E.; Berg, C. Empowering aspects for healthy food and physical activity habits: Adolescents’ experiences of a school-based intervention in a disadvantaged urban community. Int. J. Qual. Stud. Health Well-Being 2018, 13, 1487759. [Google Scholar] [CrossRef]
- Cox, A.; Duncheon, N.; McDavid, L. Peers and teachers as sources of relatedness perceptions, motivation, and affective responses in physical Education. Res. Q. Exerc. Sport 2009, 80, 765–773. [Google Scholar] [CrossRef] [PubMed]
- Shen, B.; McCaughtry, N.; Martin, J.; Fahlman, M.; Garn, A. Urban High-School Girls’ Sense of Relatedness and Their Engagement in Physical Education. J. Teach. Phys. Educ. 2012, 31, 231–245. [Google Scholar] [CrossRef] [Green Version]
- Ellis, W.E.; Dumas, T.M.; Forbes, L.M. Physically isolated but socially connected: Psychological adjustment and stress among adolescents during the initial COVID-19 crisis. Can. J. Behav. Sci./Rev. Can. des Sci. du Comport. 2020, 52, 177–187. [Google Scholar] [CrossRef]
- Goodyear, V.A.; Wood, G.; Skinner, B.; Thompson, J.L. The effect of social media interventions on physical activity and dietary behaviours in young people and adults: A systematic review. Int. J. Behav. Nutr. Phys. Act. 2021, 18, 72. [Google Scholar] [CrossRef] [PubMed]
- Johns, D.J.; Langley, T.E.; Lewis, S. Use of social media for the delivery of health promotion on smoking, nutrition, and physical activity: A systematic review. Lancet 2017, 390, S49. [Google Scholar] [CrossRef]
- Hutton, C.; Robson, J. Breaking barriers, building community: Improving student engagement with preparation for studying online multidisciplinary science by distance learning—A case study. New Dir. Teach. Phys. Sci. 2019, 14, n1. [Google Scholar] [CrossRef] [Green Version]
- Cuthbertson, W.; Falcone, A. Elevating Engagement and Community in Online Courses. J. Libr. Inf. Serv. Distance Learn. 2014, 8, 216–224. [Google Scholar] [CrossRef]
- Greene, M.; Stewart-Withers, R. ‘Get into Groups’: Exploring how Physical Education (PE) can be a more empowering experience for Pacific Island young women. J. Phys. Educ. N. Z. 2018, 51, 4–10. [Google Scholar]
- Palloff, R.M.; Pratt, K. Building Online Learning Communities: Effective Strategies for the Virtual Classroom, 2nd ed.; John Wiley & Sons: San Francisco, CA, USA, 2007. [Google Scholar]
- Carroll, K. Clinical Treatment Outcome Research: Control and Comparison Groups; Smelser, N.J., Baltes, P.B., Eds.; International Encyclopedia of the Social & Behavioral Sciences: Pergamon, Turkey, 2001; pp. 2043–2048. [Google Scholar]
- Bethlehem, J. Applied Survey Methods: A Statistical Perspective; Wiley: Hoboken, NJ, USA, 2009. [Google Scholar]
Intervention Component | Description | PA 1 Programme Group | Behaviour Change Support Group | Combined Group | Comparison Group |
---|---|---|---|---|---|
PA 1 Logbook | This is a 25-page booklet that contains suggested PA 1 options and weekly optional worksheets to assist participants in setting goals and monitoring their progress. Participants were asked to record their weekly PA 1 in these logbooks. | X | X | X | X |
Behaviour change support calls | Videocalls occurred on weeks 0, 1–6, 9, and 12 from their allocated Activity Mentor. Calls were based on a pre-planned session guide and aimed to support participants in becoming more physically active. | X | X | ||
Live group workouts | These sessions occurred twice per week for the duration of the intervention via an online video-conferencing software. Workouts were approximately 40 min and included a range of cardiovascular and resistance-based exercises. | X | X | ||
Text messaging | Using an online text messaging software, three standardised non-reply text messages were sent per week for the duration of the intervention. Messages provided reminders to live workouts, encouragement, and support. | X | X | ||
Private Instagram group chat | There were two Instagram groups, one for the PA 1 programme group and one for the combined group. The aim was to provide an opportunity for participants to interact with others in their group. The chat was moderated by a researcher and any messages that were sent by the researcher were replicated in both groups. | X | X |
Process Evaluation Component | Definition and Research Question | Data Source |
---|---|---|
Reach and Recruitment | The degree to which the intended audience participates in the intervention, including maintenance of participants involvement in the intervention [28]. The procedures used to approach and attract participants.
| # who expressed interest, # who consented, # who were eligible. Demographic and outcome measures compared to census data. Dropout rates and reasons. Focus groups and interviews. |
Delivery fidelity | The degree to which intervention deliverers implement the intervention as intended by the intervention developers [26].
| Mentor logbook intervention manual live workouts (frequency, content), Instagram group (frequency, content), text messages (total, frequency). Number logbooks sent to participants. |
Participant receipt, engagement, and enactment | The degree to which participants’ understand, and apply the intervention principles [23].
| Focus groups and interviews exit survey. |
Adherence | A participant’s compliance with an intervention’s prescribed treatment [23].
| PA logbook focus groups and interviews, exit survey, mentor logbook. |
Acceptability | The degree to which participants consider the intervention to be appropriate, based on anticipated or experiential cognitive and emotional responses to the intervention [29].
| Focus groups and interviews, exit survey. |
Mechanisms of impact | Participant responses to and interaction with the intervention, mediators and unexpected pathways and consequences [21].
| Focus groups and interviews, exit survey. |
Context | Any aspect of the environment that may influence intervention implementation or study outcomes [21].
| Focus groups and interviews, exit survey. |
Evaluation Method | Process Evaluation Component | Data Collection Time Frame | Number Completed | Response Rate |
---|---|---|---|---|
Exit survey | Fidelity of receipt, enactment fidelity, adherence, acceptability, mechanisms of impact, context | Post intervention | n = 91 | 60.3% of 151 baseline participants |
Focus groups and individual interviews | Recruitment, receipt fidelity, adherence, acceptability, mechanisms of impact, context | Post intervention | n = 34 (11 focus groups & 3 interviews) | 22.5% of 151 baseline participants |
Mentor logbooks | Fidelity of study design, delivery fidelity, receipt fidelity, adherence | From intervention start to end (12 weeks) | n = 12 | 100% |
PA logbook | Receipt of fidelity, enactment of fidelity, adherence | From intervention start to end (12 weeks) | n = 107 | 70.9% of 151 baseline participants |
Characteristics | PA Programme Group (n = 36) | Behaviour Change Support Group (n = 44) | Combined Group (n = 34) | Comparison Group (n = 40) |
---|---|---|---|---|
Age, mean (SD), years | 15.3 (1.0) | 14.6 (1.3) | 14.9 (1.1) | 14.9 (1.2) |
Reside in UK 1, n (%) | 21 (58%) | 20 (46%) | 19 (56%) | 15 (38%) |
Ethnicity, n (%) | ||||
White | 29 (81%) | 34 (77%) | 28 (82%) | 31 (78%) |
Asian or Asian British/Irish | 4 (11%) | 3 (7%) | 3 (9%) | 5 (13%) |
African/Black | 1 (3%) | 3 (7%) | 1 (3%) | 1 (3%) |
Mixed ethnic groups | 2 (5%) | 2 (5%) | 1 (3%) | 1 (3%) |
Caribbean or Black British/Irish | 0 | 1 (3%) | 1 (3%) | 0 |
Socioeconomic status, n (%) a | ||||
Tertile 1 | 10 (28%) | 9 (20%) | 9 (26%) | 18 (45%) |
Tertile 2 | 20 (56%) | 25 (45%) | 23 (68%) | 15 (38%) |
Tertile 3 | 5 14%) | 9 (20%) | 2 (6%) | 4 (10%) |
PA, mean (SD), days | 2.1 (1.5) | 2.3 (1.6) | 2.5 (1.6) | 2.3 (1.9) |
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Cowley, E.S.; Foweather, L.; Watson, P.M.; Belton, S.; Thompson, A.; Thijssen, D.; Wagenmakers, A.J.M. What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls. Int. J. Environ. Res. Public Health 2022, 19, 966. https://doi.org/10.3390/ijerph19020966
Cowley ES, Foweather L, Watson PM, Belton S, Thompson A, Thijssen D, Wagenmakers AJM. What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls. International Journal of Environmental Research and Public Health. 2022; 19(2):966. https://doi.org/10.3390/ijerph19020966
Chicago/Turabian StyleCowley, Emma S., Lawrence Foweather, Paula M. Watson, Sarahjane Belton, Andrew Thompson, Dick Thijssen, and Anton J. M. Wagenmakers. 2022. "What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls" International Journal of Environmental Research and Public Health 19, no. 2: 966. https://doi.org/10.3390/ijerph19020966
APA StyleCowley, E. S., Foweather, L., Watson, P. M., Belton, S., Thompson, A., Thijssen, D., & Wagenmakers, A. J. M. (2022). What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls. International Journal of Environmental Research and Public Health, 19(2), 966. https://doi.org/10.3390/ijerph19020966