Table 3 Process evaluation and monitoring plan

Reach

Screening form

• Inquiries

• Non-eligible

• Recruitment/referral source

Screening

Baseline questionnaire

• Participant demographics

• New or past YMCA members

• Motivation to join

• Willingness to participate (distance to travel)

• Competing programs

Enrollment

Efficacy

Lifestyle coach training survey & focus group

• Prior experience as a Lifestyle/DPP^a Coach

• Comprehension of material

• Knowledge and skills acquired

• Self-efficacy/preparedness

• Perceived barriers/ potential solutions

• Motivation to lead

• Acceptability (likes/ dislikes)

Pre-study training (1 time)

Telephone debriefing with lifestyle coaches

• Ease of implementation

• Barriers/potential solutions

• Perceived participation

• Time management

After first lesson (1 time)

Lifestyle coach weekly survey

• Curriculum comprehension

• Ease of implementation

• Fidelity of lesson (delivered as written & on time)

• Perceived self-efficacy

• Motivation to lead again

• Perceived participant participation

• Perceived barriers/solutions

• Acceptability (likes/dislikes)

Weekly after each lesson (11 times)

Attendance record

• Adherence (in-person)

• Mobile data analytics (adherence for mobile-device delivered group)

Weekly (12 times)

Participant weekly questionnaire (Child, parent)

• Comprehension

• New knowledge

• Usefulness

• Motivation

• Likelihood to adopt (short & long-term)

• Enjoyment

• Acceptability (likes/dislikes)

• Suggestions for improvement

Weekly after each lesson (11 times)

UA staff observation rubric

• Study fidelity (delivered as written and on time)

• Participant engagement (quantity & quality)

• Instructor communication/organization

• Instructor classroom management

• Instructor support of student needs

4x each study site

Lifestyle coaches final survey

• Perceived efficacy of intervention

• Desire to continue program

• Average preparation time

• Time substitution (substituted activity if not involved in the intervention delivery)

• Enjoyment & acceptability (likes/dislikes)

End of program (1 time)

Participant final survey (Child and parent)

• Perceived effectiveness of instructor

• Adoption of lifestyle changes due to program

• Perceived long-term maintenance of changes

• Likelihood to recommend program & perceived effectiveness of intervention for others

• Use of YMCA for other purposes

• Likelihood of future YMCA use

• Cost of physical activity or food items due to intervention^b

• Time substitution (activity substituted if they were not in the intervention)^b

End of program (1 time)

Study outcomes

• Anthropometric (BMI-percentile, waist circumference)

• Behavioral (24-hr dietary recalls, accelerometry, psychosocial (e.g., self-efficacy)

• Physiological (fasting insulin & glucose, blood lipids & pressure)

Pre-post study and follow-up 12 weeks later (3 times)

N/A – program data

• Cost

• Lifestyle Coach and Research Staff Training requirements (time, effort, effectiveness)

• Recruitment source success rate

• Quality assurance/control

Throughout intervention

Potential adoption, maintenance and implementation by YMCA^c

YMCA administrator interview

• Likelihood of adoption

• Perceived needs to implement and maintain

• Suggestions for improvement

Perceived efficacy of intervention