The development of a multilevel intervention to optimise participant engagement with an obesity prevention programme delivered in children's centres
Background Poor participant engagement threatens the potential impact and cost effectiveness of public health programmes preventing meaningful evaluation and wider application. Although barriers and levers to participant engagement with public health programmes are well documented, there is a lack of proven strategies in the literature addressing these in order to promote recruitment and retention. This paper details the development of a participant engagement intervention aimed at promoting
... med at promoting enrolment and retention to a community based pre-school obesity prevention programme delivered in UK children's centres; HENRY (Health, Exercise, Nutrition for the Really Young). Methods The behaviour change wheel framework was used to guide the development of the participant engagement intervention. The findings of a coinciding focused ethnography study identified barriers and levers to participant engagement with HENRY that informed which behaviours should be targeted within the intervention to promote recruitment and retention. A COM-B behavioural analysis was undertaken to identify whether capability, opportunity or motivation would need to be influenced in order for the target behaviours to occur. APEASE criteria was then used to agree on appropriate intervention function and behaviour change techniques. Results A multi-level participant engagement intervention was developed that aimed to change behaviours across the children's centre context; including local authority commissioners, children's centre managers and staff. The intervention components included improved reporting of HENRY outcomes, centre manager training sessions, additional support provided to staff members involved in recruitment to the programme and refresher training for the facilitators of HENRY. Conclusions This paper describes one of the first attempts to develop a theory based multi-level participant engagement intervention specifically designed to promote recruitment and retention to a community based obesity prevention programme. Given the challenges to implementing public health programmes with sufficient reach, the process used to develop the intervention serves as an example of how programmes that are already widely commissioned could be optimised to enable greater impact.