Evaluating factors influencing the delivery and outcomes of an incentive-based behaviour change strategy targeting child obesity: protocol for a qualitative process and impact evaluation

Abstract

IntroductionCommunity-based weight management programmes are important in addressing childhood obesity. However, the mechanisms that lead to behaviour change within the programmes are rarely studied within the context of the programmes themselves once they have been implemented. This means that further potential gains in the effectiveness of the programme are often not made and any potential losses of efficacy are often not noticed. Qualitative research alongside randomised controlled trials (RCTs) can tell us the context in which these programmes are implemented and elucidate potential mediators or modifiers of the programmes' effectiveness. The aim of this evaluation is to determine the barriers and enablers to the delivery and impact of an incentive-based behaviour change strategy targeting child obesity to inform future translation.Methods and analysisQualitative analysis, including stakeholder and family interviews, focus groups and a survey, will be used. The research will be conducted in collaboration with policymakers, researchers and community health professionals. Participants will be selected from programme providers, and parents/carers and children participating in an Australian community weight management programme during an RCT examining the effectiveness of incentives for improving behaviour change. A maximum variation sampling method based on participant demographics and group characteristics will be used. Thematic analysis will be carried out inductively based on emergent themes, using NVivo V.9.Ethics and disseminationThis research is approved by the South West Sydney Human Ethics Committee review body (HREC/14/LPOOL/480). The evaluation will provide information about the contextual and influencing factors related to the outcomes of the RCT. The results will assist researchers, community health practitioners and policymakers regarding the development, implementation and translation of behaviour change strategies in community initiatives for obese children. Insights gained may be applicable to a range of chronic conditions where similar preventive intervention approaches are indicated.Trial registration numberACTRN12615000558527, Pre-results.

NAITRE study on the impact of conditional cash transfer on poor pregnancy outcomes in underprivileged women: protocol for a nationwide pragmatic cluster-randomised superiority clinical trial in France

“…Nvivo software, which allows the creation of a code and has been well validated for qualitative analyses, will be used. 30 Qualitative data will be analysed during the data collection. The collection of data will continue until concept saturation is reached.…”

Effectiveness of a Kindergarten-Based Intervention for Preventing Childhood Obesity

“…11 Although there is evidence suggesting that obesity as a chronic condition develops in early childhood years, 12 most childhood obesity intervention studies have been conducted among school-aged children, 13 -15 and few have been targeted at the preschool population, especially in China. 16 -18 Community-based weight management programs, which facilitate weight loss through longterm health-related behavioral changes in nutrition and physical activity, 17,19 may play an important role in the prevention and control of childhood obesity. However, little research into this area has been conducted in China.…”

“…20 Although there is some evidence to suggest such programs require a multidisciplinary approach (including the use of cognitive behavioral strategies and the involvement of multiple stakeholders and sectors 10 ) to achieve and maintain a healthy lifestyle, 21 it is unclear how such intervention strategies can be formulated and implemented in China because of the heterogeneity in policies on health and well-being of preschool-aged children across contemporary urban China. 19,22,23 We conducted a pilot study in Guangzhou, the largest city in southern China, aiming to develop a feasible, multidisciplinary kindergarten-based obesity prevention trial among preschoolaged children and to evaluate the acceptability among stakeholders and the effectiveness of the program. The experience and information obtained in this pilot study would inform the design of a definitive (phase III) cluster randomized controlled trial (RCT).…”