Formative Process Evaluation of the “Connect” Physical Activity Feasibility Trial for Adolescents

Abstract

Most interventions do not reach full implementation in real-world settings. Due to this issue, formative process evaluation during pilot programs can be especially useful to understand implementation strengths and areas for improvement so that full implementation can be reached in future iterations. This study demonstrated how a formative process evaluation of the Connect through Positive Leisure Activities for Youth (Connect) pilot informed course corrections for year 2 implementation. Connect is an intervention to promote a positive social motivational climate for physical activity (PA) in pre-existing after school programs. Connect ran 3 days a week for 8 weeks and had 2 components: a 30-minute “Get-to-Know-You” (GTKY) session and a 60-minute PA session. Formative evaluation was assessed using an observational tool and staff surveys. Changes in youth PA during program hours was assessed as a process outcome using the System for Observing Children’s Activity and Relationships during Play (SOCARP). All Connect essential elements were assessed with the observational tool including (a) social goal-oriented support; (b) collaborative, cooperative play; (c) equal treatment/access; and (d) an inclusive and engaging climate. Adequate dose was achieved on all items in all sessions. Although GTKY and PA sessions both reached high fidelity in promoting equal treatment and access, success in reaching fidelity varied for the 3 remaining essential elements. Post-intervention staff surveys indicated acceptability/adoptability of the Connect program and SOCARP observations indicated significant increases in PA from baseline to post-intervention. Changes for year 2 implementation based on the findings are discussed.

The Feasibility and Acceptability of the Developing Real Incentives and Volition for Exercise (DRIVE) Program: A Pilot Study for Promoting Physical Activity in African American Women

“…Past studies have highlighted the importance of a supportive social climate within group-based interventions, emphasizing autonomy, nurturance, and behavioral skill development (Law et al, 2019; Zarrett et al, 2020). Whereas these previous climate-based programs have focused on enhancing autonomous motivation, this pilot study provides support for the feasibility of using a climate-based approach to appeal to those with low autonomous motivation (Teixeira et al, 2012).…”

“…The PA session included a warm-up (stretching and easy walking). Participants completed team-based PA games, including tag and relay-based activities, which were designed to be collaborative (Zarrett et al, 2020).…”

“…One approach to enhancing the impact of community-based interventions is to use process evaluation to ensure that an intervention is implemented as planned with adequate levels of fidelity, dose, and reach (Durlak & DuPre, 2008). Although process evaluation is often used to evaluate effectiveness, it also serves an important formative role in understanding feasibility during intervention development (Moore et al, 2015; Zarrett et al, 2020). Given the complexity of community-based interventions, which often integrate multiple theories and need to be adapted to varying contexts, formative process evaluation is critical for ultimately optimizing full implementation.…”

Process evaluation of a programme to empower community nurse leadership

“…A formative evaluation was conducted to anticipate implementation difficulties during subsequent rounds, and possibly adjust the NitL programme. Formative evaluations are often designed using mixed methods, to be able to gain a deeper understanding of how a programme is implemented [ 21 – 23 ]. By combining qualitative and quantitative methods, we were able to provide broader insights on the implementation of NitL.…”

Youth Participatory Action Research for Health Equity: Increasing Youth Empowerment and Decreasing Physical Activity Access Inequities in Under‐resourced Programs and Schools

“…Essential elements were (a) moral, emotional, and social goal‐oriented support; (b) collaborative, cooperative play centered on friendship and informal‐fun; (c) equal treatment/access; and (d) an inclusive and engaging climate for youth and staff. Processes and outcomes of Connect through PLAY are discussed elsewhere (Zarrett, Abraczinskas, Cook, Wilson, & Roberts, 2020; Zarrett et al, 2018).…”