Alia Kassandra A, Wilson Dawn K, McDaniel Tyler, St George Sara M, Kitzman-Ulrich Heather, Smith Kelsey, Heatley VaShawn, Wise Courtney
Department of Psychology, University of South Carolina, Columbia, SC, USA.
Department of Psychology, University of South Carolina, Columbia, SC, USA.
Eval Program Plann. 2015 Apr;49:106-16. doi: 10.1016/j.evalprogplan.2014.12.020. Epub 2014 Dec 31.
This study demonstrates how a multi-theoretical, multilevel process evaluation was used to assess implementation of the Families Improving Together (FIT) for weight loss intervention. FIT is a randomized controlled trial evaluating a culturally tailored, motivational plus family-based program on weight loss in African American adolescents and their parents. Social Cognitive, Self Determination, Family Systems theories and cultural tailoring principles guided the conceptualization of essential elements across individual/family, facilitator, and group levels. Data collection included an observational rating tool, attendance records, and a validated psychosocial measure.
Attendance records (0=absent, 1=present, criteria=≥70%) indicated that 71.5% of families attended each session. The survey (1=false, 6=true, criteria=≥4.5) indicated that participants perceived a positive group climate (M=5.16, SD=0.69). A trained evaluator reported that facilitator dose delivered (0=no, 1=yes, criteria=≥75%) was high (99.6%), and fidelity (1=none to 4=all, criteria=≥3) was adequate at facilitator (M=3.63, SD=0.41) and group levels (M=3.35, SD=0.49). Five cultural topics were raised by participants related to eating (n=3) and physical activity (n=2) behaviors and were integrated as part of the final curriculum.
Results identify areas for program improvement related to delivery of multi-theoretical and cultural tailoring elements. Findings may inform future strategies for implementing effective weight loss programs for ethnic minority families.
本研究展示了如何运用多理论、多层次的过程评估来评估“共同改善家庭（FIT）”减肥干预措施的实施情况。FIT是一项随机对照试验，旨在评估一项针对非裔美国青少年及其父母的、经过文化调适的、基于动机加家庭的减肥计划。社会认知理论、自我决定理论、家庭系统理论以及文化调适原则指导了个体/家庭、促进者和群体层面基本要素的概念化。数据收集包括一份观察评分工具、出勤记录以及一项经过验证的心理社会测量指标。
出勤记录（0 = 缺勤，1 = 出勤，标准 = ≥70%）表明71.5%的家庭参加了每一次课程。调查（1 = 否，6 = 是，标准 = ≥4.5）表明参与者感知到了积极的群体氛围（M = 5.16，标准差 = 0.69）。一名经过培训的评估者报告称，促进者的干预实施程度（0 = 否，1 = 是，标准 = ≥75%）很高（99.6%），并且在促进者层面（M = 3.63，标准差 = 0.41）和群体层面（M = 3.35，标准差 = 0.49），干预的保真度（1 = 无至4 = 全部，标准 = ≥3）是足够的。参与者提出了五个与饮食（n = 3）和身体活动（n = 2）行为相关的文化主题，并将其整合到了最终课程中。
结果确定了与多理论和文化调适要素的实施相关的项目改进领域。研究结果可能为未来为少数族裔家庭实施有效减肥计划的策略提供参考。
