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Abstract
Objectives:This paper presents the process evaluation of a community-based randomized psycho-social trial aimed to enhance reproductive and mental health outcomes of disadvantaged women living in the southern suburb of Beirut-Lebanon. Process evaluation of public health interventions involves the monitoring and documentation of interventions’ implementation to allow for better understanding of planned outcomes and of intervention effectiveness.Methods:A community-based randomized trial was conducted. The intervention consisted of 12 sessions (of combined 30 minutes of relaxation exercises and 75 minutes of structured support groups) delivered twice per week over a period of six-weeks. A process evaluation was conducted during the implementation of the intervention. This process evaluation aimed to ensure that the intervention was delivered and implemented as planned, as well as to monitor women’s satisfaction and attendance. The main components of the process evaluation included: dose delivered, dose received, and reach. Closed ended questionnaires were administered before/after/during each intervention session. Data was entered and analyzed using SPSS. Analysis revolved around simple frequency distribution for categorical variables and means (SD) for continuous variables. Limited bivariate analysis (using CHI Square and Anova) was done.Results:Results indicated that the delivery, implementation, and reach of the intervention were favorable. Participation was acceptable and satisfaction rates were very high.Conclusion:These favorable findings pertaining to intervention satisfaction, reach and participation highlight a number of lessons for future intervention studies in the context of disadvantaged settings. They also support the importance of involving the local community members in intervention planning, implementation and evaluation early on. We believe that the community involvement in this trial directly and significantly contributed to the results of this process evaluation.
Highlights
Process evaluation of public health interventions involves the monitoring and documentation of interventions’ implementation to allow for better understanding of planned outcomes and intervention effectiveness
In the relaxation exercise (RE) component 32.2% of women attended 90% of the sessions, 20.9% of the women attended 70-90% of the sessions, 11.3% attended 50-69%, 20.9 % attended less than 50%, and 14.8% none of the sessions (Figure 2)
The objective of this process evaluation was to ensure that the intervention was delivered and implemented as planned as well as to monitor women’s satisfaction and attendance
Summary
Process evaluation of public health interventions involves the monitoring and documentation of interventions’ implementation to allow for better understanding of planned outcomes and intervention effectiveness. Possible challenges to intervention implementation could include low participation and attendance, as well as discrepancy in delivery of what was planned as an intervention (dose intended), and what was delivered or received by participants (actual dose received) (Johnson et al, 2009). The literature provides numerous frameworks for process evaluation, one of which: is Linnan and Steckler’s, 2002. This framework outlines the basic elements of a comprehensive process evaluation plan, which include: a measure of fidelity, dose delivered, dose received, reach, recruitment, and context. Context includes characteristics of the environment that may affect implementation development including the physical, social, and political environment (Linnan & Steckler, 2002 p. 12)
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