Table 3 The RE-AIM framework of implementation evaluation for the FMSPPOC program

Reach

Pilot study

1. The number of target participants who are willing to participate in the pilot study

● 20 obese children from a weight loss center for children and adolescents in Shijiazhuang, China

1. Identify the feasibility of recruiting enough eligible participants

2. Identify the barriers for recruitment and enrolment

3. Identify the facilitators and barriers for obese children

4. Identify the reasons for participants dropout

5. Identify the strategies for improving the adherence

Main study

1. The number of target participants who are willing to participate in the main study

● Expected: 168 obese children from six primary schools of three districts (Yu-Hua, Chang-An and Xin-Hua; two schools per district) in Shijiazhuang, China

Effectiveness

Main study

1. What proportion of participants completes the intervention?

● To ensure more than 85% participants completing the intervention program

1. Explore the experience of participating in the program from participants’ views

2. Identify the conditions and circumstances that influence the intervention effectiveness

3. Identify the reasons that result in the variations/differences in the intervention effects across participants within the program

4. Identify the potential contamination for the intervention effectiveness

5. Count numbers of sports injuries and other unintended consequences during the intervention period, and analyze the reasons

2. How do completers compare to non-completers?

● Dropout analysis will be conducted to identify the baseline difference between completers and dropouts

● Sensitivity test will be conducted to identify the impact of the dropouts on the evaluation of the intervention effects

3. What are the effects of the intervention on participants?

● Significant improvement in primary outcome (FMSs) and other health-related physical and psychological outcomes, e.g., PA, fitness, wellbeing, perceived motor competence and PA enjoyment (detailed outcome measures are shown in Table 4)

● Significant changes in forming a regular PA habit

● Improved awareness and knowledge on the importance of PA habit and healthy lifestyles towards FMSs and obesity prevention

Adoption

Pilot study & Main study

1. The proportion of service providers/collaborators (i.e., Shijiazhuang Education Bureau, Physical Fitness Association, Lab of Measurement and Evaluation in Health Sciences and Sports Nutrition Center, Hebei Normal University, and Department of Physical Education and Research and Department of Health Care in primary schools) involved in the program

● Expected: 4 service providers/collaborators will be involved in the pilot study

● Expected: 5 service providers/collaborators will be involved in the main study

2. How about the efficiency and quality of collaboration?

● Using self-reported scale to assess the satisfaction with efficiency and quality of collaboration among different service providers/collaborators

1. Identify facilitators and barriers that affect service providers/collaborators’ participation

2. Identify the facilitators and barriers that affect the efficiency and quality of collaboration

Implementation

Pilot study & Main study

1. Is the intervention delivered as intended?

● Using a process evaluation framework to assess the fidelity and quality of intervention implementation (e.g., exercise intensity will be monitored during the intervention; a fidelity evaluation scale will be used)

● Trained research staff observe teachers’ implementation of the FMSPPOC program (e.g., percent of lesson content conveyed, whether lessons will be presented in recommended order) and parents’ involvement in the family-based PA assignments

● Using self-reported e-logs to assess the participants’ satisfaction with the intervention implementation

● Using a self-reported scoring sheet to assess the consistency in delivering the intervention and evaluate the consistent commitment of facilitators and collaborators

1. Identify the acceptability, adaptability, and practicality of the intervention

2. Identify any modifications that have been done during the intervention process, and explore the reasons behind them

3. Identify the barriers that influence the fidelity of the intervention

4. Identify the potential facilitators and barriers that influence the intervention implementation and provide strategies to address them in the future

2. Did participants adhere to the intervention program?

● Analyses for the attendance rate of each session and overall completion rate

● Check the completion of the family-based PA assignment by self-reported e-logs

● Self-reported e-logs completed by the intervention facilitators and collaborators

Maintenance

Main study & Follow-up

1. The extent to which the intervention outcomes are sustained

● Data analyses for the sustained intervention effects during 6-month follow-up

1. Identify the components that influence the successful sustainability of the current program

2. Identify the modifications made to sustain the current program

3. Identify the facilitators and barriers of seeking more collaborators in future

4. Identify the facilitators and barriers that maintain the program and promote the program to a wider population in future

2. The number of participants sustained, and the number of new participants enrolled in the program

● Expected: more than 85% of participants sustained and more than 300 new participants from five main districts (60 ~ 80 participants in each district)

3. The number of PE teachers and parents have sustained their implementation of the program or disseminated the program to others

● Expected: more than 70% of PE teachers and parents sustained the implementation of the program or introduce the program to others

3. The degree to which the Shijiazhuang Education Bureau institutionalize the FMSPPOC as an on-going part of their regular activities (i.e., supply their own funding, integrated into programmatic activities, regularly train their staff in implementation, continue to provide data for monitoring and evaluation)

● Expected: more than 70% of service providers/collaborators continue to implement the FMSPPOC program and for at least three years

4. The number of new service providers/collaborators, including but not limited to NGOs, sponsorships, and local government support, join the FMSPPOC

● Expected: more than 15 new collaborators from 5 main districts (3–5 per district)