Implementation of the OPREVENT2 Multilevel Obesity Program for Native American Adults (P04-175-19)

Abstract

Abstract Objectives Multilevel, multicomponent (MLMC) interventions are a promising strategy to address obesity, yet they are complex to implement with sufficient intensity. We report on the process evaluation of a MLMC to prevent/reduce obesity in Native American (NA) adults. Methods OPREVENT2 is a recently completed MLMC intervention in six NA communities (3 intervention, 3 comparison). OPREVENT2 worked with food stores to increase access to and promote healthy food choices, worksites to provide nutrition education and to improve physical activity (PA) opportunities, schools to educate children (grades 2–6) to act as change agents, media to reinforce key messages, and through a policy-oriented community action committee (CAC). OPREVENT2 was implemented in six phases targeting various foods, PA strategies and related behaviors. Implementation standards were set for each component and assessed reach, dose delivered, and fidelity. Data were collected using a combination of REDCap-programmed tablet computers, paper surveys and attendance sheets at the time of intervention delivery. Implementation was assessed by the degree to which each high standard was met: >100% was considered high, 50–99% moderate, and < 50% low. Results OPREVENT2 was implemented from June 2017 to December 2018, in 3 NA communities located in the Southwestern and Midwestern US. The worksite component was implemented with high reach and dose, but fidelity decreased over time from high to moderate. The food store component was implemented with high reach and dose throughout the intervention, and improved over time. The school component was implemented with low to moderate reach and dose, improving over time. Social media (Facebook, Instagram, Twitter) were implemented with high dose delivered, but implementation declined to the moderate level over time; whereas, reach and fidelity remained at the moderate level or declined to the low level. The CAC was implemented with high reach and dose, with slight declines over time, but remained at moderate to high levels. Conclusions OPREVENT2 implementation varied by intervention component, which will likely impact the overall study outcomes (BMI, diet, physical activity, psychosocial factors). Process evaluation is essential for understanding findings of MLMC interventions. Funding Sources National Heart, Lung, and Blood Institute R01.