Table 4 Programme observation and facilitator feedback, resulting programme refinements
Programme session | Issue identified | Changes made/actions taken |
|---|---|---|
Week 2—healthy eating | Visual aids used in the standard programme that had deliberately not been included in the adapted programme were used by facilitators | Researchers rehearsed the week 2 session plan with the facilitators and reminded them not to use the visual aids from the standard programme |
Too much material to deliver within 90 min | The number of activities in the session was reduced to ensure the key nutrition messages were delivered | |
Some of the nutrition messages were not clearly delivered and participants appeared to be confused on occasions | Content was streamlined to ensure more focus on the core nutrition and healthy living messages. Additional notes on key nutritional concepts were included in the facilitator’s manual | |
Week 4—physical activity | Delivery of this session did not require 90 min | Facilitators were encouraged to reiterate nutrition messages in this session |
Week 5—give it a go | Challenging to deliver with only one facilitator, especially with larger group sizes | Extra facilitator provided for this session. A plan for setting up the materials in advance of the session was developed. Participant worksheets were simplified to enable more families to work through them with less facilitator input |
The ‘make a healthy snack’ activity was too messy | The number of healthy snack making options was reduced from four to two, retaining the least messy options | |
The recipe planning activity did not work well | Recipe planning was removed from the session and the group provided with recipes to take home to try | |
Week 6—review and celebrate | Facilitators felt uncomfortable awarding particular participants the ‘star achiever’ certificate | All children received a completion certificate and the ‘star achiever’ certificate was removed |
All sessions | Weekly goal setting and review elements were sometimes missed or rushed and not covered adequately. Participants often arrived late, interrupting the flow of the session | Week 2 was streamlined to allow more time for review and setting of goals. The importance of goal setting and review as a key behaviour change technique was explained to the facilitators and further highlighted in the manual |