title: Development of an innovative process evaluation approach for the Families Improving Together (FIT) for weight loss trial in African American adolescents.
abstract: This study demonstrates how a multi-theoretical, multilevel process evaluation was used to assess implementation of the Families Improving Together (FIT) for weight loss intervention. FIT is a randomized controlled trial evaluating a culturally tailored, motivational plus family-based program on weight loss in African American adolescents and their parents. Social Cognitive, Self Determination, Family Systems theories and cultural tailoring principles guided the conceptualization of essential elements across individual/family, facilitator, and group levels. Data collection included an observational rating tool, attendance records, and a validated psychosocial measure.
  
  
  RESULTS
  Attendance records (0=absent, 1=present, criteria=≥70%) indicated that 71.5% of families attended each session. The survey (1=false, 6=true, criteria=≥4.5) indicated that participants perceived a positive group climate (M=5.16, SD=0.69). A trained evaluator reported that facilitator dose delivered (0=no, 1=yes, criteria=≥75%) was high (99.6%), and fidelity (1=none to 4=all, criteria=≥3) was adequate at facilitator (M=3.63, SD=0.41) and group levels (M=3.35, SD=0.49). Five cultural topics were raised by participants related to eating (n=3) and physical activity (n=2) behaviors and were integrated as part of the final curriculum.
  
  
  CONCLUSIONS
  Results identify areas for program improvement related to delivery of multi-theoretical and cultural tailoring elements. Findings may inform future strategies for implementing effective weight loss programs for ethnic minority families.
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, SC, USA.
authors.forename: Kassandra A
authors.initials: KA
authors.lastname: Alia
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, SC, USA. Electronic address: wilsondk@mailbox.sc.edu.
authors.forename: Dawn K
authors.initials: DK
authors.lastname: Wilson
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, SC, USA.
authors.forename: Tyler
authors.initials: T
authors.lastname: McDaniel
authors.affiliation: Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Sara M
authors.initials: SM
authors.lastname: St George
authors.affiliation: Department of Behavioral and Community Health, University of North Texas, Fort Worth, TX, USA.
authors.forename: Heather
authors.initials: H
authors.lastname: Kitzman-Ulrich
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, SC, USA.
authors.forename: Kelsey
authors.initials: K
authors.lastname: Smith
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, SC, USA.
authors.forename: VaShawn
authors.initials: V
authors.lastname: Heatley
authors.affiliation: Department of Psychology, University of South Carolina, Columbia, SC, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Wise
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data; D002648:Child; D005190:Family / Q000208:ethnology / Q000523:psychology; D005260:Female; D006293:Health Promotion / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D009042:Motivation; D009765:Obesity / Q000208:ethnology / Q000628:therapy; D010290:Parents; D063766:Pediatric Obesity / Q000208:ethnology / Q000628:therapy; D015397:Program Evaluation / Q000379:methods; D061217:Weight Reduction Programs / Q000379:methods* / Q000592:standards
keywords: Adolescents; African American; Process evaluation; Weight loss