Background
Methods
Development of the framework
Development of the tool
Testing the tool
Intervention Related Group (IRG) identification | 24 high schools * 3 strategies = 72 IRG: 36 IRG-A, 36 IRG-C |
---|---|
Intervention periods identification
| 2 intervention periods = intervention implemented during the grade 10 and 11 school years |
Identification and categorisation of the programme actors
|
Supervisors: PRALIMAP monitors |
Anchor personnel: school professionals (administration staff, teachers, catering professionals, school nurses, …) | |
Targets: high school students | |
Indicator development
|
Non-programme-driven activities indicators:
|
* Developed for the 72 IRG | |
* Concerned respectively the educational nutritional, screening and environmental activities performed independently of the PRALIMAP trial | |
Programme-driven activities indicators:
| |
* Developed for the 36 IRG-A | |
* Concerned the PRALIMAP activities planned by the frame of reference: | |
- 12 IRG-Education: indicators investigated the delivery of lectures and collective works on nutrition and the participation in PRALIMAP meetings | |
-12 IRG-Screening, indicators investigated the delivery of weight and height data and of the proposition to participate to adapted overweight care management and the participation of students in group educational sessions | |
- 12 IRG-Environmental, indicators investigated the delivery of high school environment improvements (adapted food and physical activity availability) and participation in PRALIMAP parties | |
Data collection
|
Data collected before the programme implementation:
|
* High schools nutritional environment (ex: water drinking fountain, proposed physical activities …) : nutritional surveys participated in by school staff | |
* Nutritional behaviours : adolescent self-administered questionnaires and anthropometric measures | |
Data collected during implementation:
| |
* Activities delivery data: activity reports, pupil satisfaction surveys (care management, PRALIMAP meeting…) | |
* Appreciation of PRALIMAP trial : self administered questionnaire | |
* Evolution of the offer of school catering and physical activity free equipment and the nutritional environment close by the high school: nutritional surveys participated in by school staff | |
Data collectedat the end of the programme:
| |
* Activities delivery, school staff and teenagers’ participation and favouring and limiting factors : | |
- focus group of staff responsible for interventional strategies (high school professionals, head teachers) | |
- individual semi-structured interview of the PRALIMAP monitors | |
- focus group of health professionals intervening with overweight and obese adolescents in high school screening | |
- nutritional survey of high school professionals and students | |
Data analysis and evaluation of indicators
|
Indicator report sheets are elaborated for every IRG including:
|
* Quantitative indicators expressed in the form of mean or percentage (eg : pupils' activity participation rate) | |
* Qualitative (literal) indicators (eg : ranges of food proposed in the lunches, delivery or not of activity) | |
The number of indicator report sheets varied from 3 to 6 according to the high school assigned strategies (Table 3) : | |
*IRG–Education : 1 indicator report sheet of non-programme-driven activities + 1 indicator report sheet of programme-driven activities | |
*IRG–Education control : 1 indicator report sheet of non-programme-driven activities | |
*IRG– Screening : 1 indicator report sheet of non-programme-driven activities + 1 indicator report sheet of programme-driven activities | |
*IRG–Screening control : 1 indicator report sheet of non-programme-driven activities | |
*IRG–Environment : 1 indicator report sheet of non-programme-driven activities + 1 indicator report sheet of programme-driven activities | |
*IRG–Environment control : 1 indicator report sheet of non-programme-driven activities | |
Score assignment
|
Number of experts:18 (3 groups of 6) |
Type and specialty of experts: researchers, field professionals or decision-makers, specialists in diet, physical activity and\or evaluation, knowing or not the PRALIMAP trial, practicing or not in Lorraine Region | |
IRG assigned between the experts: the IRG were fairly and anonymously distributed among the experts | |
Individual scoring aid: IT (Excel®) | |
Scoring : ranging from 0 to 20 for every period, domain and characteristic in each IRG
Threshold defined for the standard deviation and/or the range: if a standard deviation was higher than 2.5 or a range higher than 6 was observed, the experts debated and proposed a new notation; discrepant scores were then preserved. | |
Taking into account between-group variability: A fictitious high school was created and scored by the 3 groups | |
Intervention dose calculation
|
Application of intervention dose formula to assigned scores: Dose = DQt x (mean (DQl, PQt, PQl)/20)
|
A group effect has been evidenced thanks to the fictitious high school and required score adjustment varying from 0.8 to 2.8 points. | |
Eventually 216 doses (108 per period) were calculated (Table 3).
|
Results and discussion
Results
Intervention Related Groups (IRG) identification
Setting 1 | Setting 2 | Setting 3 | IRG | |
---|---|---|---|---|
Intervention 1 | Yes | Yes | No |
3 IRG :
|
2 IRG-Active | ||||
1 IRG-Control | ||||
Intervention 2 | No | No | Yes |
3 IRG :
|
1 IRG-Active | ||||
2 IRGs-Control | ||||
IRG
|
2 IRG :
|
2 IRG:
|
2 IRG :
|
6 IRG :
|
1 IRG-Active | 1 IRG-Active | 1 IRG-Active | 3 IRG-Active | |
1 IRG-Control | 1 IRG-Control | 1 IRG-Control | 3 IRG-Control |
PRALIMAP
Intervention periods identification
PRALIMAP
Identification and categorisation of the programme actors
PRALIMAP
Indicators development
PRALIMAP
Data collection
PRALIMAP
Data analysis and valuation indicators
PRALIMAP
N° school | Strategy | Indicator report sheets | ||||
---|---|---|---|---|---|---|
Education | Screening | Environment | Non-programme-driven activities | Programme-driven activities | Score total / school | |
1
| IRG-C | IRG-C | IRG-C | 3 | 0 |
3
|
2
|
IRG-A
|
IRG-A
| IRG-C | 3 | 2 |
5
|
3
|
IRG-A
|
IRG-A
|
IRG-A
| 3 | 3 |
6
|
4
|
IRG-A
| IRG-C |
IRG-A
| 3 | 2 |
5
|
5
|
IRG-A
| IRG-C | IRG-C | 3 | 1 |
4
|
6
|
IRG-A
|
IRG-A
|
IRG-A
| 3 | 3 |
6
|
7
|
IRG-A
|
IRG-A
| IRG-C | 3 | 2 |
5
|
8
| IRG-C |
IRG-A
| IRG-C | 3 | 1 |
4
|
9
|
IRG-A
|
IRG-A
|
IRG-A
| 3 | 3 |
6
|
10
| IRG-C |
IRG-A
|
IRG-A
| 3 | 2 |
5
|
11
|
IRG-A
| IRG-C | IRG-C | 3 | 1 |
4
|
12
| IRG-C |
IRG-A
| IRG-C | 3 | 1 |
4
|
13
| IRG-C | IRG-C | IRG-C | 3 | 0 |
3
|
14
|
IRG-A
| IRG-C |
IRG-A
| 3 | 2 |
5
|
15
| IRG-C |
IRG-A
|
IRG-A
| 3 | 2 |
5
|
16
| IRG-C | IRG-C |
IRG-A
| 3 | 1 |
4
|
17
|
IRG-A
|
IRG-A
| IRG-C | 3 | 2 |
5
|
18
|
IRG-A
| IRG-C |
IRG-A
| 3 | 2 |
5
|
19
| IRG-C | IRG-C |
IRG-A
| 3 | 1 |
4
|
20
| IRG-C | IRG-C | IRG-C | 3 | 0 |
3
|
21
| IRG-C | IRG-C |
IRG-A
| 3 | 1 |
4
|
22
| IRG-C |
IRG-A
|
IRG-A
| 3 | 2 |
5
|
23
|
IRG-A
| IRG-C | IRG-C | 3 | 1 |
4
|
24
| IRG-C |
IRG-A
| IRG-C | 3 | 1 |
4
|
12 IRG Education
|
12 IRG
Screening
|
12 IRG
Environment
|
72
|
36
|
108
| |
12 IRG –Control -Education | 12 IRG –Control-Screening | 12 IRG –Control-Environment |
Assignment of scores
PRALIMAP
Intervention dose calculation
PRALIMAP
Implementation interpretation
PRALIMAP
N | mean | standard deviation | median | Q1 | Q3 | min | max | |||
---|---|---|---|---|---|---|---|---|---|---|
Education | NPDA* | year 1 | 24 | 9.0 | 3.5 | 8.3 | 6.6 | 12.5 | 3.4 | 13.9 |
year 2 | 24 | 7.7 | 2.8 | 7.8 | 5.5 | 10.0 | 2.5 | 13.2 | ||
PDA**
|
year 1
|
12
|
8.2
|
1.9
|
7.8
|
7.3
|
9.3
|
4.7
|
11.8
| |
year 2 | 12 | 6.3 | 3.5 | 7.5 | 2.7 | 8.5 | 0.5 | 10.9 | ||
Screening | NPDA | year 1 | 24 | 5.2 | 3.7 | 5.0 | 2.3 | 8.4 | 0.0 | 11.9 |
year 2 | 24 | 5.0 | 3.4 | 5.4 | 1.8 | 7.9 | 0.0 | 10.1 | ||
PDA | year 1 | 12 | 6.3 | 3.5 | 6.6 | 3.1 | 9.3 | 1.2 | 10.8 | |
year 2 | 12 | 3.6 | 2.7 | 3.0 | 1.9 | 4.8 | 0.5 | 8.8 | ||
Environment | NPDA | year 1 | 24 | 6.4 | 2.3 | 7.0 | 5.8 | 7.8 | 1.8 | 9.4 |
year 2 | 24 | 5.7 | 2.0 | 6.1 | 4.6 | 7.3 | 1.2 | 9.6 | ||
PDA | year 1 | 12 | 7.8 | 1.8 | 7.6 | 6.8 | 8.4 | 5.2 | 12.5 | |
year 2 | 12 | 8.2 | 3.1 | 8.6 | 6.9 | 9.7 | 0.3 | 12.1 |
N | mean | standard deviation | median | Q1 | Q3 | min | max | ||
---|---|---|---|---|---|---|---|---|---|
Delivery | quantity | 12 | 13.6 | 1.5 | 14.2 | 12.4 | 14.8 | 10.5 | 15.7 |
Delivery | quality | 12 | 12.2 | 2.6 | 12.1 | 10.6 | 14.5 | 8.2 | 15.8 |
Participation | quantity | 12 | 12.2 | 2.4 | 12.5 | 11.2 | 13.6 | 6.5 | 15.2 |
Participation | quality | 12 | 11.4 | 2 | 11.2 | 9.8 | 12.8 | 8.7 | 14.5 |
Dose | EDUCATION | SCREENING | ENVIRONNEMENT | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Control | Active | Control | Active | Control | Active | ||||||||
NPDA | PDA | NPDA | PDA | NPDA | PDA | NPDA | PDA | NPDA | PDA | NPDA | PDA | ||
Education | year 1 |
6,3
|
11,7
| 8,2 | 9,2 | 8,8 | 8,9 | 7,6 | 8,2 | 7,7 | 9,9 | 8,7 | |
year 2 |
6,0
|
9,5
| 6,3 | 8,0 | 6,2 | 7,5 | 6,5 |
6,8
| 5,5 |
8,6
| 7,2 | ||
Screening | year 1 | 6,1 | 6,4 | 4,4 | 6,2 |
2,7
|
7,7
| 6,3 | 5,5 | 6,3 | 4,9 | 6,3 | |
year 2 | 5,2 | 3,7 | 4,7 | 3,4 |
2,5
|
7,4
| 3,6 | 5,2 | 3,4 | 4,8 | 3,8 | ||
Environment | year 1 |
5,2
| 8,0 |
7,6
| 7,6 | 6,4 | 8,2 | 6,4 | 7,4 |
5,6
|
7,2
| 7,8 | |
year 2 |
4,9
| 8,9 |
6,6
| 7,5 | 5,7 | 8,3 | 5,7 | 8,0 |
4,9
|
6,6
| 8,2 |
Discussion
Reviews | Dane and Schneider [[2]] | Dusenbury et al. [[1]] | Durlak et al. [[3]] | |
---|---|---|---|---|
Legrand et al. | ||||
Intervention dose
|
Integrity or Fidelity including 5 components : exposure, adherence, quality of delivery, programme differentiation, participant responsiveness |
Fidelity including 5 components: adherence, dose, quality of delivery, programme differentiation, participant responsiveness |
Including 8 coas mponents:Fidelity, Dosage, Quality, Participant responsiveness, Programme differentiation, Contamination, Programme reach, Programme modification | |
Delivery
|
Quantity
| Exposure | Dose | Dosage |
Fidelity (a k a : adherence or compliance or integrity, or faithful replication) | ||||
Adherence | Adherence | |||
Quality
| Quality of delivery, Adherence | Quality of delivery, Adherence | Quality | |
Participation
|
Quantity
| Participant responsiveness | Participant responsiveness | Programme reach |
Quality
| Participant responsiveness | Participant responsiveness | Participant responsiveness | |
Participants/ sources of information
|
Supervisors
| Supervisors, | ||
Developers | ||||
Facilitators | ||||
Anchors personnel (providers / receivers)
| Implementers (receivers) or providers | Providers | Providers | |
Targets
| Participants | |||
IRG
| / | / | / | |
Indicators
|
Non-programme-driven activities
| / | / | / |
Programme-driven activities
| / | / | / |