Translating a health behavior change intervention for delivery to 2-year college students: the importance of formative research

Abstract

Young adults are at risk for weight gain in the transition to independent adulthood; 2-year college students are at greater risk and understudied relative to 4-year students. This project conducted formative research for a randomized controlled weight gain prevention trial among 2-year college students, to ensure appropriateness of content and delivery of a curriculum originally developed for 4-year college students. Data were collected from community college students, faculty, and staff from October 2009 to August 2011. Work included focus groups and key informant interviews, curriculum pilot testing, and social network and support website beta testing. Based on focus groups and interviews, program content, course delivery modes, and communication channels were adjusted to meet population interests and preferences. The course was delivered successfully in pilot testing, and the website was received well by beta testers. Formative work successfully guided program adaptations to address population needs.

The Transition into Young Adulthood: a Critical Period for Weight Control

“…Recruitment avenues proposed by young and emerging adults include Internet-based outlets such as social media, website ads, and email blasts in addition to more traditional methods such as print flyers and in-person tabling events at colleges and community events [84,90]. The ability to learn more about the study and complete the screening process online rather than via phone or in-person was especially salient in focus groups with emerging adults [33], though this strategy was implemented by a minority of EARLY trials—of note, not only are other screening methods associated with higher staff burden [87], but failure to utilize online recruitment and screening tools might have contributed to lower enrollment of 18–25 year olds in many of these trials.…”

“…Juggling responsibilities between school, work, family, and social life leaves little time for the gym, and makes high-calorie convenience foods more attractive—or conversely, perhaps contributes to skipping meals [33,90]. Stress has also been identified as a significant barrier to maintaining motivation for healthy lifestyle change, sparking an “unraveling” of any progress made [33, p.351].…”

“…Stress has also been identified as a significant barrier to maintaining motivation for healthy lifestyle change, sparking an “unraveling” of any progress made [33, p.351]. Moreover, programs designed for emerging adults must go beyond current standard behavioral weight loss to provide content specifically targeting time and stress management in addition to other key areas identified in formative work such as alcohol use, sugar-sweetened beverage consumption, environmental barriers, and sleep [33,90]. …”

“…Findings of formative work conducted with emerging adults reflect a split preference between a technology delivered program and an in-person program [33], with a suggestion for combined delivery modality [90]. This hybrid approach seems to provide a balance between emerging adults’ preference for a flexible, convenient program and their desire for minimal face-to-face interaction with an interactive or experiential focus [33,90].…”

Understanding and influencing the maintenance of physical activity and dietary behaviour change in breast cancer survivors

“…Formative research to design interventions is critical, particularly when employing novel ways to deliver behaviour change interventions such as mobile technology (Linde et al, 2014;Pfaeffli et al, 2012;Rogers et al, 2010;Waterlander et al, 2014;Whittaker et al, 2012). The iterative process required to conduct formative research is time consuming but, as outlined in mHealth (i.e., text message) intervention development frameworks, reporting development processes can help design tailored and highly acceptable interventions (Waterlander et al, 2014;Whittaker et al, 2012).…”