Background: It is recommended that process evaluations of intervention implementation and fidelity become an integral part of the conduct and evaluation of all health behaviour intervention research. Through the National Institute of Healths (NIH) Behaviour Change Consortium (BCC) framework for tailored health behaviour interventions, the current study aimed to evaluate implementation fidelity of the OneLife Suffolk Integrated Healthy Lifestyle Service (IHLS) with a view of better understanding its long-term sustainability in terms of feasibility and acceptability.
Methods: A convenience sample of 23 individual interviews and 5 focus groups took place. This resulted in a total of 47 (14 male) individuals comprising of key stakeholders (n=18), as well as OneLife Suffolk staff across senior management (n=4), team lead (n=14) and practitioner (n=11) roles. Individual interviews lasted between 21 and 60 minutes, and focus groups lasted between 37 and 50 min.
Results: A mixed degree of implementation fidelity was demonstrated throughout the service. Positive comments around practitioner motivation and rapport were echoed throughout the stakeholders, as well as OneLife Suffolk senior management, management, and team leads. Practitioners were described as fully engaged and motivated to deliver sessions due to their strong beliefs in the potential benefits of the OneLife Suffolk services to clients physical and psychosocial health. Contrastingly, practitioners themselves noted that they received minimal formal operational, data systems, clinical, and curriculum training and that this, along with a lack of personal development opportunities, affected their confidence in delivering sessions and collecting and analysing any data collected. Further negative comments were noted regarding integration between stakeholders and OneLife Suffolk IHLS staff. Specifically, a top-down approach to information dissemination regardless of position. This had a negative effect on OneLife Suffolk IHLS staff motivation and overall team moral.
Conclusions: Although a mixed degree of implementation fidelity was demonstrated, results provide valuable evidence to aid interpretation of overall programme findings and effectiveness and can be used to conceptualise best practices as a process to further strengthen the design, delivery and recruitment strategies of OneLife Suffolk IHLS and future behaviour change interventions.
Keywords: Evaluation, fidelity, intervention
12 Sep 2019 - 13 Sep 2019