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Table 6 Process evaluation of interventions

From: Process evaluations of early childhood obesity prevention interventions delivered via telephone or text messages: a systematic review

Trial name: First author publication year (year study commenced), Country (Reference #) ‘Process evaluation’ or satisfaction measurement Evaluation components Quantitative evaluation (including during or post-intervention) Qualitative evaluation (including during or post-intervention) Participant perceptions where evaluated
INFANT: Campbell 2008 (2008), Australia [3, 66] Process evaluation through response on a 4-point scale - quantitative At each session, participants were asked to rate usefulness and relevance of the program on a 4-point scale from “not at all useful/relevant” to “very useful/relevant.” (i.e., “How useful was the session overall?” and “How relevant was this session to you and your family?”) Participants were asked to complete forms after each session and indicate usefulness and relevance of the program and components of each of the sessions (during intervention) Qualitative interviews were conducted 3–5 months after the completion of the program (post-intervention) • Preference for combination of delivery modes
• Appealed to first-time mothers
• Participants’ lack of time to participate due to return to work
Carlsen 2013 (2010), Denmark [29] None specified None specified Participants were not asked to rate satisfaction Participants were not interviewed Not evaluated
PRIMROSE: Doring 2014 (2014), Sweden [30] None specified None specified Participants were not asked to rate satisfaction Participants were not interviewed Not evaluated
Franco-Antonio 2018 (2018), Spain [31] None specified None specified None specified None specified Not evaluated
MumBubConnect: Gallegos 2014 (2010), Australia [32] Process evaluation Frequency of text messages sent and responses received; number of telephone calls made by breastfeeding counsellor; Qualitative responses gathered via questionnaire to obtain women’s acceptability of service Frequency of text messages sent and responses received; number of telephone calls made by breastfeeding counsellor (during intervention) Qualitative responses gathered via post-intervention survey questionnaire to obtain women’s acceptability of service (post-intervention) • Considered themselves well supported through participation in program
Gibby 2019 (2019), Hawai’I and Puerto Rico [33] Satisfaction Usefulness of text messages; how participants were influenced to change behaviours; and most and least liked messages; Satisfaction with the text messages delivered. Qualitative interviews at follow-up visits. Most liked and least liked messages were rated by participants At the follow-up visits, participants completed a qualitative interview regarding helpfulness of messages, ways in which receiving the messages influenced or changed feeding practices and overall feedback about receiving the messages. Responses to 6 open-ended questions (post-intervention) • More likely to make changes if the content delivered aligned with their pre-existing beliefs
• Level of engagement with programs fluctuated, based on their needs at a particular point in time and based on their child’s stage of development
Steps to Growing Up Healthy: Gorin 2014 (2014), USA [34] Process evaluation stated in study protocol paper, no evidence of one being conducted At the end of intervention period mothers asked to evaluate the program - helpfulness, components most useful, refer friend to program    Not evaluated
Healthy Habits, Happy Homes: Haines 2013 (2011), USA [35] None specified None specified    Not evaluated
Hannan 2012 (2012), USA [36] None specified None specified    Not evaluated
Harris-Luna 2018 (2018), USA [37] None specified None specified    Not evaluated
M528: Hmone 2017 (2015), Myanmar [38, 65] Process evaluation The process evaluation used both quantitative phone-based surveys and qualitative in-depth interviews. Informal assessment of user experience, acceptability, feedback from participants via text messages (during intervention) In-depth semi-structured interviews with a sub-sample to explore user experience, perception and acceptance (during intervention) •Behaviour modification likely if information is from a credible source such as from health professionals
Healthy Babies: Horodynski 2011 (2011), USA [39] Process evaluation stated in study protocol paper, no evidence of one being conducted Proposal to conduct: Feasibility, fidelity, and educational effectiveness of interventions. Mothers’ satisfaction with the Healthy Babies intervention; Recruitment; retention; Proposal to conduct only - not published Proposal to conduct interviews - not published Not evaluated
Jiang 2014 (2014), China [40, 64] Process evaluation A 3-phase process during planning and development Baseline questionnaire survey to understand potential intervention approaches Qualitative interviews with mothers midterm and at the end of the intervention • Behaviour modification likely if information is from a credible source such as from health professionals
• Delivery of interventions via text messages facilitated sharing of messages with family and friends
• Lack of personalisation of contents in text messages
The Baby Milk Trial: Lakshman 2015 (2011), UK [41, 68] Process evaluation Parents’ satisfaction with different aspects of the intervention will be assessed at 6mo via questionnaire Questionnaire at 6 months to assess parents’ satisfaction with intervention Semi-structured interviews with sub-sample of intervention and control group participants and facilitators to explore barriers and facilitators • All participants reported the trial participation as a positive experience
• They shared various experiences of not getting external help, support, or information about formula-feeding
• Most notably, the most positive outcome of the trial participation for the mothers, probably not captured in the trial’s quantitative outcome measures but a central finding in this qualitative study, was the personal and non-judgmental support they received for formula-feeding
Growing Healthy: Laws 2018 (2015), Australia [42, 67] Process evaluation not specified. Acceptability measured Assessment of App usage and App acceptability Participant views Qualitative follow-up interviews with parents • Behaviour modification likely if information is from a credible source such as from health professionals
• More likely to make changes if the content delivered aligned with their pre-existing beliefs
• Level of engagement with programs fluctuated, based on their needs at a particular point in time and based on their child’s stage of development
• Appealed to first-time mothers
• Preference for a combination of delivery modes (eg., text messages, telephone calls, emails, push notifications, web, group sessions)
Smart Moms: Nezami 2018 (2014), USA [43] None specified None specified    Not evaluated
Patel 2018 (2010), India [44] Process evaluation not specified Process evaluation not specified Not measured None specified Not evaluated
WIC: Pugh 2010 (2003), USA [45] None specified None specified None specified None specified Not evaluated
Tahir 2013 (2010), Malaysia [46] None specified None specified None specified None specified Not evaluated
Baby’s first bites: van der Veek 2019 (2019), Netherlands [47] None specified None specified None specified None specified Not evaluated
Mothers & Others: Wasser 2017 (2013), USA [48] None specified None specified None specified None specified Not evaluated
Healthy Beginnings: Wen 2007 (2007), Australia [2] Process evaluation not specified None specified Questionnaires to participants only to evaluate infant feeding such as duration of breastfeeding, introduction of solids and healthy feeding practice None specified Not evaluated
CHAT: Wen 2017 (2017), Australia [1, 63, 69] Process evaluation in protocol Documentation of contact with families by intervention nurses; recruitment data barriers and enablers; study retention and intervention acceptability; interviews with participants to assess program satisfaction; identify emerging issues Satisfaction questions administered at the 6-month and 12-month surveys Interviews with participants to assess program satisfaction; identify emerging issues (during intervention) • Consented to participate due to convenience of receiving interventions via telephone calls or text messages.
• Behaviour modification likely if information is from a credible source such as from health professionals
• Delivery of interventions via text messages facilitated sharing of messages with family and friends
• Level of engagement with programs fluctuated, based on their needs at a particular point in time and based on their child’s stage of development
• Preference for a combination of delivery modes (eg., text messages, telephone calls, emails, push notifications, web, group sessions)
• Participation via telephone calls and by text messages was convenient
• Appealed to first-time mothers
• Considered themselves well supported through participation in program
• Participants’ lack of time to participate due to return to work
• Lack of personalisation of contents in text messages
• High expectations placed on them as mothers
Linked trial for HB: Wen 2019 (2019), Australia [19] Process evaluation of telephone contact with mothers (stated in study protocol, no evidence since study was ongoing) Thematic analysis of participants’ responses (de-identified) will be evaluated retrospectively Ongoing Ongoing Ongoing