Process evaluation of the ‘Singapore Physical Activity and Nutrition Study’

Wong, Elaine Yee-Sing; Lee, Andy H.; James, Anthony P.; Jancey, Jonine

doi:10.1016/j.evalprogplan.2020.101847

Cited by 4 publications

(3 citation statements)

References 41 publications

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“…The SPANS intervention had a low attrition rate (15%), which may have been due to its acceptability and accessibility for the Singaporean women aged 50 years and older. 24 This compared favorably with similar PA and nutrition RCTs for older adults (19% to 22%). [3][4][5][6] The GEE analyses confirmed significant improvements in behavioral and health outcomes between the intervention and control groups.…”

Section: Discussionmentioning

confidence: 69%

Effectiveness of a Singaporean Community-Based Physical Activity and Nutrition Intervention: A Cluster Randomized Controlled Trial

Wong

James

Lee

et al. 2020

Asia Pac J Public Health

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This study examined the effectiveness of a 6-month intervention to improve the health behaviors and outcomes among women aged 50 years and older. A sample of 580 (intervention n = 295; control n = 285) women was recruited from 26 recreational centers. Only the intervention group participated in the Singapore Physical Activity (PA) and Nutrition Study (SPANS), received health resources (calendar, recipe, and booklets) and motivational support from program ambassadors. The intervention group showed significant improvements in moderate-intensity PA, vigorous-intensity PA, and total PA ( P < .001), increased intake frequency of fruit and vegetables ( P = .049), a reduction in salt and sugary beverage intake ( P ≤ .042), and reductions in systolic blood pressure (BP; −3.68 mm Hg), diastolic BP (−3.54 mm Hg), and percentage body fat (−2.13%; P ≤ .020) when compared with the control group. The SPANS appeared to be efficacious in improving PA and dietary behaviors, reducing BP and percentage body fat among Singaporean women.

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Section: Discussionmentioning

confidence: 69%

Effectiveness of a Singaporean Community-Based Physical Activity and Nutrition Intervention: A Cluster Randomized Controlled Trial

Wong

James

Lee

et al. 2020

Asia Pac J Public Health

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“…Similarly, a recent health behaviour change programme used ambassadors to drive physical activity and dietary habits to achieve desired behaviour change. 47 This was possible because the ambassadors had more communication time with the participants in our study. A society rich in communication technology usage such as social media access with mobile communication devices could strengthen health message communication.…”

Section: Lessons and Limitationsmentioning

confidence: 99%

Improving centre-based group exercise participation of older adults using the behaviour change wheel

2021

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An emphasis on active ageing could help to delay the onset of frailty. In Singapore, Senior Activity Centres provide free and guided group exercise sessions for older adults. However, one such centre had very low participation rates among community-dwelling older adults despite running standardised programmes. Based on a needs analysis from a prior project, this paper reports on strategies implemented to improve the daily centre-based group exercise participation rate among community-dwelling older adults. Using the behaviour change wheel model, participant motivation domains were identified as primary gaps, while the psychological capability and physical opportunity were categorised as secondary gaps. A logic model was used to design a project to respond to these identified gaps and guide the evaluation approach. Three strategies were implemented over a 4-week period and reviewed at 6 months: (1) promotion of the exercise classes, (2) delayed rewards for participation and (3) health ambassadors. Evaluation findings highlighted that more resources were needed for the training of community-dwelling older adult healthcare ambassadors in the use of motivational interviewing. The interventions were found to be efficacious in increasing daily group exercise participation rate at the centre, from an average of three to nine participants per day over the 4 weeks. Furthermore, more than 60% of these participants achieved the WHO’s weekly minimum exercise recommendation for older adults (150 min moderate-intensity physical activity). To increase the engagement of older adults in physical activity or exercise participation, we recommend the use of behaviour change wheel model and the use of community-based health ambassadors. In conclusion, the project found improved daily centre-based group physical exercise participation rates when all the domains in the behaviour change wheel model were addressed.

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“…Elements of process evaluation were translated into structured questions to develop these study questionnaires. 20,22 For the next stage, a panel of experts specializing in the fields of gerontology (n=2), nutrition (n=3), and health policy (n=5) validated the instruments. Content-validity index and content-validity ratio values of both questionnaires were calculated and found acceptable: 0.93 and 0.89 for the clients' questionnaire and 0.79 and 0.88 for the providers' questionnaire, respectively.…”

Section: Design and Process-evaluation Componentsmentioning

confidence: 99%

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

Foroumandi¹,

Alizadeh²,

Khodayari‐Zarnaq³

et al. 2020

RMHP

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Objective: As aging populations increase, many countries have begun implementation of policies to improve elder health and nutrition. This study evaluated key process components of nutrition sections of a national elderly integrated-care program in health-care centers in Iran. Methods: With stratified three-stage random cluster sampling, a total of 256 elderly subjects (clients) and 76 staff members of health-care centers (providers) participated in the study. Quantitative and qualitative data were collected using two self-administrated questionnaires to evaluate various components of process evaluation for clients and providers. Program reach was measured by the ratio of the number in the target group who underwent the program to the number of eligible individuals. Exposure rate was measured as clients' awareness of program services. Delivery and fidelity were assessed from providers' reports for each service. Satisfaction rates were assessed for the whole program and for each service of the program. All reasons behind strengths and weaknesses in each of the processevaluation components were examined and are reported in detail. Results: The clients reported low-reach (20.0%) and moderate-exposure rates of 77.5%, with a program target of 90%. Primary training sessions were delivered to the providers as intended (100%), but most planned services for clients, especially vitamin and mineral supplementation, follow-up, and physical activity sessions, were poorly implemented, as they were delivered correctly to 24.7% (n=63, vitamin and mineral supplementation), 24% (n=62, follow-up), and 40.3% (n=103, physical activity sessions) of the clients, with a set program goal of 60%. An overall low level of implementation fidelity was observed, and 39.3% (n=30) of the providers believed that most clients did not benefit from the nutritional services. Overall, less than half (42.8%, n=101) the clients were highly satisfied with the program. Conclusion: The process evaluation showed insufficient reach, exposure, and fidelity of the program, as well as imprecise delivery of some services, which resulted in low levels of client satisfaction. The findings may have implications for further reinforcement of the program, and indicate the importance of continuous monitoring and evaluation of such programs.

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Process evaluation of the ‘Singapore Physical Activity and Nutrition Study’

Cited by 4 publications

References 41 publications

Effectiveness of a Singaporean Community-Based Physical Activity and Nutrition Intervention: A Cluster Randomized Controlled Trial

Effectiveness of a Singaporean Community-Based Physical Activity and Nutrition Intervention: A Cluster Randomized Controlled Trial

Improving centre-based group exercise participation of older adults using the behaviour change wheel

<p>Process Evaluation of a National Elderly Nutrition–Care Program in Iran: Perspectives of Clients and Providers</p>

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