Abstract
BackgroundDescribing how and why an evidence-based intervention is adapted for a new population and setting using a formal evaluation and an adaptation framework can inform others seeking to modify evidence-based weight management interventions for different populations or settings. The Working for You intervention was adapted, to fit a workplace environment, from Be Fit Be Well, an evidence-based intervention that targets weight-control and hypertension in patients at an outpatient clinic. Workplace-based efforts that promote diet and activity behavior change among low-income employees have potential to address the obesity epidemic. This paper aims to explicitly describe how Be Fit Be Well was adapted for this new setting and population.MethodsTo describe and understand the worksite culture, environment, and policies that support or constrain healthy eating and activity in the target population, we used qualitative and quantitative methods including key informant interviews, focus groups, and a worker survey; these data informed intervention adaptation. We organized the adaptations made to Be Fit Be Well using an adaptation framework from implementation science.ResultsThe adapted intervention, Working for You, maintains the theoretical premise and evidence-base underpinning Be Fit Be Well. However, it was modified in terms of the means of delivery (i.e., rather than using interactive voice response, Working for You employs automated SMS text messaging), defined as a modification to context by the adaptation framework. The adaptation framework also includes modifications to content; in this case the behavioral goals were modified for the target population based on updated science related to weight loss and to target a workplace population (e.g., a goal to avoiding free food at work).ConclusionsIf effective, this scalable and relatively inexpensive intervention can be translated to other work settings to reduce obesity and diabetes risk among low-SES workers, a group with a higher prevalence of these conditions. Using a formal evaluation and framework to guide and organize how and why an evidence-based intervention is adapted for a new population and setting can push the field of intervention research forward.Trial registrationClinicalTrials.gov: NCT02934113; Received: October 12, 2016; Updated: November 7, 2017.
Highlights
Describing how and why an evidence-based intervention is adapted for a new population and setting using a formal evaluation and an adaptation framework can inform others seeking to modify evidence-based weight management interventions for different populations or settings
To put the adaptations made to Be Fit Be Well (BFBW) in context, and inform others seeking to modify evidence-based weight management interventions for new contexts and populations, we used the adaptation framework developed by Stirman et al [55,56,57] This framework was selected as it is recommended by Chambers et al [54] as a method to capture adaptations to a specific evidence-based intervention
The barriers were primarily related to lack of engagement included 1) communication barriers; 2) barriers to healthy eating and program participation; and 3) the opinion of many workers that their work activities provided sufficient exercise, obviating the need for or making them too tired for leisure time physical activity
Summary
Describing how and why an evidence-based intervention is adapted for a new population and setting using a formal evaluation and an adaptation framework can inform others seeking to modify evidence-based weight management interventions for different populations or settings. The Working for You intervention was adapted, to fit a workplace environment, from Be Fit Be Well, an evidence-based intervention that targets weight-control and hypertension in patients at an outpatient clinic. Workplace-based efforts that promote diet and activity behavior change among low-income employees have potential to address the obesity epidemic. National data show that obesity is strongly associated with low socioeconomic status (SES), which includes those in hourly and working-class jobs and employees with low education [9,10,11,12,13,14]. SES factors are related to environmental characteristics and risk behaviors that promote obesity, as well as limited access to weight management resources [15,16,17,18,19]. Adaptation of existing intervention models is needed to improve reach and sustainability while maintaining the effectiveness shown in interventions such as the Diabetes Prevention Program (DPP) [23]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
