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Theory-Guided Process Evaluation of a Multicomponent, Technology-Based 'SMART Eating' Trial among Indian Adults: An Embedded Mixed-Methods Study

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Title: Theory-Guided Process Evaluation of a Multicomponent, Technology-Based 'SMART Eating' Trial among Indian Adults: An Embedded Mixed-Methods Study
Language: English
Authors: Kaur, Jasvir (ORCID 0000-0002-2351-2856), Kaur, Manmeet (ORCID 0000-0003-2450-3115), Chakrapani, Venkatesan (ORCID 0000-0001-9998-9135), Kumar, Rajesh (ORCID 0000-0001-9750-3437)
Source: Health Education Research. Oct 2023 38(5):469-489.
Availability: Oxford University Press. Great Clarendon Street, Oxford OX2 6DP, UK. Tel: +44-1865-353907; Fax: +44-1865-353485; e-mail: jnls.cust.serv@oxfordjournals.org; Web site: http://her.oxfordjournals.org/
Peer Reviewed: Y
Page Count: 21
Publication Date: 2023
Document Type: Journal Articles
Reports - Research
Descriptors: Adults, Eating Habits, Nutrition, Health Behavior, Intervention, Computer Mediated Communication, Internet, Indians
DOI: 10.1093/her/cyad020
ISSN: 0268-1153
1465-3648
Abstract: We report process evaluation findings from the 'SMART Eating' intervention trial, which significantly improved fat, sugar and salt (FSS), and fruits and vegetables (FVs) intake among adults. Intervention used information technology [short message service (SMS), WhatsApp and website] and interpersonal communication (distribution of SMART Eating kit) and pamphlet for comparison group. Guided by UK Medical Research Council's framework, using embedded mixed-methods design, continuous process evaluation documented fidelity, dose, reach, acceptability and mechanisms. Intervention was implemented as intended, with high reach (91%) in both groups: 'comparison group' (n = 366): inadequate use of pamphlets (46%); 'intervention group' (n = 366): with timely remedial measures to remove implementation/usage barriers, dose of SMS (93%), WhatsApp (89%) and 'SMART Eating' kit (100%) was adequate, but website usage was low (50%); compliance was evident from participants' interactions with the implementor and observations on kit usage. All these might have improved attitude, social influence, self-efficacy and household behaviours, which, in turn, mediated intervention's effect on improving FSS and FV intake. Among poor performers, lack of effect on FV intake was perceived to be related to high cost/pesticides use and FSS intake was related to lack of family support. Low website usage, challenges with WhatsApp messaging and contextual factors (cost, pesticides abuse and family support) need to be considered while designing similar future interventions.
Abstractor: As Provided
Entry Date: 2023
Accession Number: EJ1394757
Database: ERIC
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  Data: Theory-Guided Process Evaluation of a Multicomponent, Technology-Based 'SMART Eating' Trial among Indian Adults: An Embedded Mixed-Methods Study
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  Data: <searchLink fieldCode="AR" term="%22Kaur%2C+Jasvir%22">Kaur, Jasvir</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-2351-2856">0000-0002-2351-2856</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kaur%2C+Manmeet%22">Kaur, Manmeet</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-2450-3115">0000-0003-2450-3115</externalLink>)<br /><searchLink fieldCode="AR" term="%22Chakrapani%2C+Venkatesan%22">Chakrapani, Venkatesan</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9998-9135">0000-0001-9998-9135</externalLink>)<br /><searchLink fieldCode="AR" term="%22Kumar%2C+Rajesh%22">Kumar, Rajesh</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9750-3437">0000-0001-9750-3437</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Health+Education+Research%22"><i>Health Education Research</i></searchLink>. Oct 2023 38(5):469-489.
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  Data: Oxford University Press. Great Clarendon Street, Oxford OX2 6DP, UK. Tel: +44-1865-353907; Fax: +44-1865-353485; e-mail: jnls.cust.serv@oxfordjournals.org; Web site: http://her.oxfordjournals.org/
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  Data: <searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Eating+Habits%22">Eating Habits</searchLink><br /><searchLink fieldCode="DE" term="%22Nutrition%22">Nutrition</searchLink><br /><searchLink fieldCode="DE" term="%22Health+Behavior%22">Health Behavior</searchLink><br /><searchLink fieldCode="DE" term="%22Intervention%22">Intervention</searchLink><br /><searchLink fieldCode="DE" term="%22Computer+Mediated+Communication%22">Computer Mediated Communication</searchLink><br /><searchLink fieldCode="DE" term="%22Internet%22">Internet</searchLink><br /><searchLink fieldCode="DE" term="%22Indians%22">Indians</searchLink>
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  Data: 10.1093/her/cyad020
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  Data: We report process evaluation findings from the 'SMART Eating' intervention trial, which significantly improved fat, sugar and salt (FSS), and fruits and vegetables (FVs) intake among adults. Intervention used information technology [short message service (SMS), WhatsApp and website] and interpersonal communication (distribution of SMART Eating kit) and pamphlet for comparison group. Guided by UK Medical Research Council's framework, using embedded mixed-methods design, continuous process evaluation documented fidelity, dose, reach, acceptability and mechanisms. Intervention was implemented as intended, with high reach (91%) in both groups: 'comparison group' (n = 366): inadequate use of pamphlets (46%); 'intervention group' (n = 366): with timely remedial measures to remove implementation/usage barriers, dose of SMS (93%), WhatsApp (89%) and 'SMART Eating' kit (100%) was adequate, but website usage was low (50%); compliance was evident from participants' interactions with the implementor and observations on kit usage. All these might have improved attitude, social influence, self-efficacy and household behaviours, which, in turn, mediated intervention's effect on improving FSS and FV intake. Among poor performers, lack of effect on FV intake was perceived to be related to high cost/pesticides use and FSS intake was related to lack of family support. Low website usage, challenges with WhatsApp messaging and contextual factors (cost, pesticides abuse and family support) need to be considered while designing similar future interventions.
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        Value: 10.1093/her/cyad020
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        StartPage: 469
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        Type: general
      – SubjectFull: Eating Habits
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      – SubjectFull: Nutrition
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      – SubjectFull: Health Behavior
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      – SubjectFull: Intervention
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      – SubjectFull: Computer Mediated Communication
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      – SubjectFull: Internet
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      – SubjectFull: Indians
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