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Table 3 Process evaluation indicators and their definition stratified for the three dissemination phases

From: Exploring facilitating factors and barriers to the nationwide dissemination of a Dutch school-based obesity prevention program “DOiT”: a study protocol

Process indicator Definition
Context Factors of the physical, social, and political environment that either directly or indirectly affect the introduction of DOiT:
a. Support within the schools (director and colleagues)
b. School size; available budget; available hours for implementation of DOiT
c. School environment (school canteen and sport facilities)
d. Contamination with other programs aiming at a healthy lifestyle at school
e. Teacher characteristics (e.g. knowledge, attitude, perception, willingness, self-efficacy, expectancy)
f. Decision making process in the school
g. Compatibility of the DOiT program with the regular curriculum
Recruitment Exposure to sources and procedures applied for the recruitment of schools and teachers:
a. Ways of approaching schools by the DOiT support office (used materials, message sent out)
b. Ways of approaching schools by stakeholders (used materials, message sent out)
c. Response of schools (reasons for agreement with participation, subgroups of recruited individuals or organisations, biases in response)
d. Use of adoption materials
e. Possible reasons for refusal or participation
Reach (1) The extent to which the target population is reached by the recruitment strategy:
a. Number of reached schools
b. Number of reached stakeholders
Reach (2) The extent to which the target population is reached by the implementation of DOiT:
a. Number of teachers using DOiT
b. Number of students using DOiT
c. Number of parents reached by DOiT
Dosage The proportion of DOiT lessons that were actually delivered or performed by the teachers and received by students:
a. Implementation strategy activities that are accomplished
b. Amount of DOiT lessons that are delivered or taught by teachers
c. Completeness/delivery of implementation by the teachers (frequency, duration, mode of delivery, timing)
d. Reasons for not delivering/implementing DOiT (facilitators/barriers for implementation)
Fidelity The quality of the implementation of DOiT; the extent to which the teachers have implemented DOiT as intended by the developers:
a. Compliance to the implementation strategy of DOiT (core elements)
b. Compliance to the teacher manual of DOiT (core elements, standardisation)
Satisfaction Subjective evaluation of DOiT and materials:
a. General opinion about DOiT (by teachers, students and parents)
b. Satisfaction with the DOiT program, materials, time spent and amount of lessons
c. Satisfaction with implementation strategy, materials and support by DOiT support office
Effectiveness The extent to which the DOiT program is effective:
a. Behavioural and anthropometric change (students)
b. Availability and accessibility of healthy products and activities in the home environment (parents)
c. Availability and accessibility of foods and physical activity facilities in and around the school
Maintenance The extent to which DOiT becomes routine and part of the curriculum and school policy:
a. Embedding of DOiT in school health policy
b. Embedding of DOiT in the curriculum of the school
c. Future activities and intention to use DOiT
d. Facilitators and barriers for future implementation