Evaluation of a community-based, family-focused healthy weights initiative using the RE-AIM framework

Abstract

Background: Community-based interventions have the potential to reach caregivers and children at risk for overweight and obesity. The overall impact of these programs is rarely assessed. This study evaluated a physical activity and healthy eating family program (Healthy Together; HT) using RE-AIM. Methods: Ten centres implemented the 5-week program. Thirty-nine staff members and 277 program participants (126 caregivers [Mage=35.6] and 151 children/youth [Mage=13]) participated in the evaluation. Each RE-AIM dimension was assessed independently using a mixed-methods approach. Sources of data included archival records, interviews, open-ended surveys and questionnaires. Effectiveness outcome variables were assessed at pre-, post-intervention and 6-month follow-up. Findings: Reach: HT participants were almost entirely recruited from existing programs within community centres. Effectiveness: Caregivers’ nutrition related efficacy beliefs increased following HT (p’s<.03). Participation in HT was not associated with significant changes in physical activity or nutrition behaviour or perceived social support (p’s>.05). Knowledge surrounding healthy diets and physical activity increased in children and caregivers (p’s<.05). Adoption: Thirty-five percent of centres approached to implement HT expressed interest. The 10 centres recruited existing staff members to implement HT. Implementation: Program objectives were met 72.8% of the time and 71 adaptations were made. HT was finance- and time-dependent. Maintenance: Two centres fully implemented HT in the follow-up year and 5 centers incorporated aspects of HT into other programs. Discussion: Working alongside organizations that develop community programs to conduct comprehensive, unbiased evaluations can systematically highlight areas of success and challenges. As a result of this evaluation, modifications are currently being implemented to HT.