title: Process evaluation of TXT2BFiT: a multi-component mHealth randomised controlled trial to prevent weight gain in young adults.
abstract: BACKGROUND
  TXT2BFiT was one of the first few innovative mHealth programs designed for young adults (18-35 years) with demonstrated efficacy in weight management. However, research is lacking to understand intervention effectiveness, especially in complex, multi-component mHealth programs. This paper investigates participant perceptions of and engagement with the mHealth program components in the TXT2BFiT to understand program effects.
  
  
  METHODS
  Process evaluation data were collected continuously for the study duration. The TXT2BFiT program was a multi-component lifestyle program delivered intensively for 3-month followed by a 6-month maintenance phase. Program components included personalised coaching calls, text messages, emails, smartphone apps and website access. Process evaluation measures included frequency of use of components and frequency for number of components used (online survey data); dose delivered and engagement with program components (researcher logs and web platform reports); frequency, timing and difficulties experienced with program components (online survey data) and overall perceptions of program components (online survey data and semi-structured telephone interviews). Qualitative data analysis was performed using NVivo10.
  
  
  RESULTS
  Over 80% of participants completed post-intervention (3-months, intervention, n = 110, control n = 104) and follow-up surveys (9-months, intervention, n = 96, control n = 104). Thirty intervention participants completed semi-structured telephone interviews. Participants reported high use of coaching calls, text messages and emails and no issues in content delivery from these components. These components were described as helping them to achieve their goals. Website and app use and engagement was low for the duration of the program. Participants would prefer incorporation of the self-monitoring apps and website resources into one smartphone application that can be individualised by entry of their personal data.
  
  
  CONCLUSIONS
  Our process evaluation has allowed a comprehensive understanding of use and preference for different program components. The high value placed on the coaching calls is consistent with a desire for personalisation of the mHealth program and even further tailoring of text messages and emails. The findings of this study will be used to revise TXT2BFiT for future users.
  
  
  BACKGROUND
  The trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12612000924853 ).
authors.affiliation: School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia. stephanie.partridge@sydney.edu.au.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Partridge
authors.affiliation: School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia. margaret.allman-farinelli@sydney.edu.au.
authors.forename: Margaret
authors.initials: M
authors.lastname: Allman-Farinelli
authors.affiliation: Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia. kevin.mcgeechan@sydney.edu.au.
authors.forename: Kevin
authors.initials: K
authors.lastname: McGeechan
authors.affiliation: School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia. katebal12@yahoo.com.
authors.forename: Kate
authors.initials: K
authors.lastname: Balestracci
authors.affiliation: School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia. annette.wong@sydney.edu.au.
authors.forename: Annette T Y
authors.initials: AT
authors.lastname: Wong
authors.affiliation: School of Life and Environmental Sciences, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia. lana.hebden@sydney.edu.au.
authors.forename: Lana
authors.initials: L
authors.lastname: Hebden
authors.affiliation: Centre for Primary Health Care and Equity, University of New South Wales, Sydney, 2052, Australia. m.f.harris@unsw.edu.au.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Harris
authors.affiliation: Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia. adrian.bauman@sydney.edu.au.
authors.forename: Adrian
authors.initials: A
authors.lastname: Bauman
authors.affiliation: Sydney School of Public Health, Charles Perkins Centre, University of Sydney, Sydney, NSW, 2006, Australia. philayrath.phongsavan@sydney.edu.au.
authors.forename: Philayrath
authors.initials: P
authors.lastname: Phongsavan
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D040421:Cell Phone; D034742:Electronic Mail; D005260:Female; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D063731:Mobile Applications; D009042:Motivation; D009520:New Zealand; D009765:Obesity / Q000517:prevention & control*; D010043:Outcome and Process Assessment, Health Care; D011795:Surveys and Questionnaires; D017216:Telemedicine; D060145:Text Messaging; D015430:Weight Gain; D055815:Young Adult