Process Evaluation of an Application-Based Salt Reduction Intervention in School Children and Their Families (AppSalt) in China: A Mixed-Methods Study

被引:5
作者
Sun, Yuewen [1 ]
Li, Yuan [2 ]
He, Feng J. [3 ]
Liu, Hueiming [4 ]
Sun, Jingwen [1 ]
Luo, Rong [1 ]
Guo, Chunlei [1 ]
Zhang, Puhong [1 ,2 ]
机构
[1] Peking Univ Hlth Sci Ctr, George Inst Global Hlth, Nutr & Lifestyle Dept, Beijing, Peoples R China
[2] Univ New South Wales, Fac Med, Sydney, NSW, Australia
[3] Queen Mary Univ London, Inst Prevent Med, Barts & London Sch Med & Dent, London, England
[4] George Inst Global Hlth, Hlth Syst Sci Dept, Sydney, NSW, Australia
关键词
process evaluation; salt reduction; mHealth (mobile Health); primary school; mixed method approach; HEALTH; EHEALTH;
D O I
10.3389/fpubh.2022.744881
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background:& nbsp;Salt reduction is a cost-effective, and rather challenging public health strategy for controlling chronic diseases. The AppSalt program is a school-based multi-component mobile health (mhealth) salt reduction program designed to tackle the high salt intake in China. This mixed-methods process evaluation was conducted to investigate the implementation of this program across sites, identify factors associated with the implementation, and collect evidence to optimize the intervention design for future scale-up.& nbsp;Methods: Mixed methods were used sequentially to collect data regarding five process evaluation dimensions: fidelity, dose delivered, dose received, reach, and context. Quantitative data were collected during the intervention process. Participation rate of intervention activities was calculated and compared across cities. The quantitative data was used for the selection of representative intervention participants for the qualitative interviews. Qualitative data were collected in face-to-face semi-structured interviews with purposively selected students (n = 33), adult family members (n = 33), teachers (n = 9), heads of schools (n = 9), key informants from local health, and education departments (n = 8). Thematic analysis technique was applied to analyze the interview transcripts using NVivo. The qualitative data were triangulated with the quantitative data during the interpretation phase.& nbsp;Results: The total number of families recruited for the intervention was 1,124. The overall retention rate of the AppSalt program was 97%. The intervention was implemented to a high level of fidelity against the protocol. About 80% of intervention participants completed all the app-based salt reduction courses, with a significant difference across the three cities (Shijiazhuang: 95%; Luzhou: 73%; Yueyang: 64%). The smartphone app in this program was perceived as a feasible and engaging health education tool by most intervention participants and key stakeholders. Through the interviews with participants and key stakeholders, we identified some barriers to implementing this program at primary schools, including the left-behind children who usually live with their grandparents and have limited access of smartphones; perceived adverse effects of smartphones on children (e.g., eyesight damage); and overlooked health education curriculum at Chinese primary schools.& nbsp;Conclusion: This process evaluation demonstrated the feasibility and acceptability of using smartphone applications delivered through the education system to engage families in China to reduce excessive salt intake.
引用
收藏
页数:12
相关论文
共 50 条
[41]   Understanding User Reactions and Interactions With an Internet-Based Intervention for Tinnitus Self-Managemen Mixed-Methods Evaluation [J].
Greenwell, Kate ;
Sereda, Magdalena ;
Coulson, Neil S. ;
Hoare, Derek J. .
AMERICAN JOURNAL OF AUDIOLOGY, 2019, 28 (03) :697-713
[42]   Process evaluation of two home-based bimanual training programs in children with unilateral cerebral palsy (the COAD-study): protocol for a mixed methods study [J].
Beckers, Laura ;
van der Burg, Jan ;
Janssen-Potten, Yvonne ;
Rameckers, Eugene ;
Aarts, Pauline ;
Smeets, Rob .
BMC PEDIATRICS, 2018, 18
[43]   Understanding the performance of a pan-African intervention to reduce postoperative mortality: a mixed-methods process evaluation of the ASOS-2 trial [J].
Vickery, Nicola ;
Stephens, Timothy ;
du Toit, Leon ;
van Straaten, Dawid ;
Pearse, Rupert ;
Torborg, Alexandra ;
Rolt, Lucy ;
Puchert, Mariechen ;
Martin, Graham ;
Biccard, Bruce .
BRITISH JOURNAL OF ANAESTHESIA, 2021, 127 (05) :778-788
[44]   Process evaluation of a multicomponent intervention to prevent physical restraints in nursing homes (IMPRINT): A mixed methods study [J].
Abraham, Jens ;
Bake, Mareike ;
Berger-Hoeger, Birte ;
Koepke, Sascha ;
Kupfer, Ramona ;
Meyer, Gabriele ;
Moehler, Ralph .
JOURNAL OF ADVANCED NURSING, 2021, 77 (03) :1465-1477
[45]   Uncovering the wider impact of COVID-19 measures on the lives of children with complex care needs and their families: A mixed-methods study protocol [J].
Curran, Janet A. ;
Lane, Jennifer ;
McCulloch, Holly ;
Keeping-Burke, Lisa ;
Johnson, Catie ;
Wong, Helen ;
Cassidy, Christine ;
Mcisaac, Jessie-Lee ;
Lamptey, De-Lawrence ;
Clegg, Julie ;
Forbes, Neil ;
Breneol, Sydney ;
Sheriko, Jordan ;
Best, Shauna ;
Burgess, Stacy ;
Sinclair, Doug ;
Rose, Annette Elliot ;
Standing, Mary-Ann ;
Somerville, Mari ;
King, Sarah ;
Doucet, Shelley ;
Flieger, Heather ;
Lamb, Margie ;
Leigh, Jeanna Parsons ;
Stewart, Dana .
PLOS ONE, 2024, 19 (07)
[46]   Process evaluation of a cluster-randomised trial testing a pressure ulcer prevention care bundle: a mixed-methods study [J].
Roberts, Shelley ;
McInnes, Elizabeth ;
Bucknall, Tracey ;
Wallis, Marianne ;
Banks, Merrilyn ;
Chaboyer, Wendy .
IMPLEMENTATION SCIENCE, 2017, 12
[47]   Process evaluation of a cluster-randomised trial testing a pressure ulcer prevention care bundle: a mixed-methods study [J].
Shelley Roberts ;
Elizabeth McInnes ;
Tracey Bucknall ;
Marianne Wallis ;
Merrilyn Banks ;
Wendy Chaboyer .
Implementation Science, 12
[48]   Bridging Healing and Therapy A Mixed-Methods Study on Support Group Intervention Based on Watson's Theory of Human Caring [J].
Gonen Senturk, Seher ;
Kucukguclu, Ozlem .
HOLISTIC NURSING PRACTICE, 2021, 35 (02) :81-91
[49]   Process Evaluation of Home-based Bimanual Training in Children with Unilateral Cerebral Palsy (The COAD-study): A Mixed Methods Study [J].
Beckers, L. W. M. E. ;
Smeets, R. J. E. M. ;
de Mooij, M. A. C. ;
Piskur, B. ;
van der Burg, J. J. W. ;
Rameckers, E. A. A. ;
Aarts, P. B. M. ;
Janssen-Potten, Y. J. M. .
DEVELOPMENTAL NEUROREHABILITATION, 2022, 25 (04) :246-262
[50]   Activity in nature mediates a park prescription intervention's effects on physical activity, park use and quality of life: a mixed-methods process evaluation [J].
Petrunoff, Nicholas ;
Yao, Jiali ;
Sia, Angelia ;
Ng, Alwyn ;
Ramiah, Anbumalar ;
Wong, Michael ;
Han, Jane ;
Tai, Bee Choo ;
Uijtdewilligen, Leonie ;
Mueller-Riemenschneider, Falk .
BMC PUBLIC HEALTH, 2021, 21 (01)