Process Evaluation Findings of B'More Healthy Communities for Kids: A Multi‐Level, Multi‐Component Obesity Prevention Program

Abstract

B'More Healthy Communities for Kids (BHCK) is a multi‐level, multi‐component obesity prevention trial directed toward low‐income African American youth in Baltimore. BHCK works with small food stores, recreation centers, carryout restaurants, wholesalers, policymakers and families. Process evaluation is conducted by monitoring 88 implementation standards based on reach, dose delivered and fidelity. Guidelines rank each standard in terms of low, medium or high delivery. Here, we report on findings to date based on two feedback periods. Food store interactive sessions had low reach to the target audience (10‐14 year old youth) with 7.4 + 6.2 interactions/session compared to higher reach for adults (17.1 + 6.6). Dose delivered of food samples (28.5 + 14.4) and giveaways (16.2 + 6.2) distributed was medium to high. Carryout restaurant menu redesign obtained medium to high fidelity with 20% healthy side options and 10% healthy entrée options provided on posted menu boards. Recreation centers achieved high reach with 11.6 + 6.1 youth attending educational sessions. The agent‐based policy model (ABM) had low to medium reach with one local policymaker including the ABM on a formal agenda in the past year. Wholesalers obtained overall high fidelity by stocking food items that met BHCK nutrition guidelines. Social media and text messaging achieved high reach with 70% of BHCK‐enrolled families joining the program. Dose was high with an average of 3.2 text messages sent per week. These findings are used to monitor and modify components during the trial and to assess implementation quality post‐intervention.