St George Sara M, Wilson Dawn K, McDaniel Tyler, Alia Kassandra A
University of Miami Miller School of Medicine, Miami, FL, USA
University of South Carolina, Columbia, SC, USA.
Health Promot Pract. 2016 Jul;17(4):557-68. doi: 10.1177/1524839916635977. Epub 2016 Apr 15.
This study describes the process evaluation of Project SHINE, a randomized family-based health promotion intervention that integrated parenting and peer monitoring for improving sedentary behavior, physical activity, and diet in African American families. Adolescent-parent dyads (n = 89) were randomized to a 6-week behavioral, positive parenting, and peer monitoring skills intervention or a general health education comparison condition. Process evaluation included observational ratings of fidelity, attendance records, psychosocial measures, and qualitative interviews. Results indicated that the intervention was delivered with high fidelity based on facilitator adherence (>98% of content delivered) and competent use of theoretically based behavior change and positive parenting skills (100% of ratings >3 on a 1-4 scale). Although only 43% of peers attended the "bring a friend" session, overall attendance was high (4.39 ± 1.51 sessions) as was the retention rate (88%). Parents in the intervention condition reported significant improvements in communication related to adolescents' engagement in health behaviors both on their own and with peers. These findings were supported by qualitative themes related to improvements in family communication and connectedness. This study provides an innovative example of how future family-based health promotion trials can expand their process evaluation approaches by assessing theoretically relevant positive parenting variables as part of ongoing monitoring.
本研究描述了“阳光计划”(Project SHINE)的过程评估,这是一项基于家庭的随机健康促进干预项目,该项目整合了育儿和同伴监督,以改善非裔美国家庭的久坐行为、身体活动和饮食。青少年-父母二元组(n = 89)被随机分配到为期6周的行为、积极育儿和同伴监督技能干预组或一般健康教育对照组。过程评估包括对保真度的观察评分、出勤记录、心理社会测量和定性访谈。结果表明,基于促进者的依从性(超过98%的内容得以传授)以及对基于理论的行为改变和积极育儿技能的有效运用(在1-4量表上100%的评分>3),干预得以高度保真地实施。尽管只有43%的同伴参加了“带朋友来”环节,但总体出勤率较高(4.39±1.51次),留存率也较高(88%)。干预组的父母报告称,在与青少年自身及同伴参与健康行为相关的沟通方面有显著改善。与家庭沟通和联系改善相关的定性主题支持了这些发现。本研究提供了一个创新范例,展示了未来基于家庭的健康促进试验如何通过评估理论上相关的积极育儿变量作为持续监测的一部分来扩展其过程评估方法。