Process evaluation of the Communicating Healthy Beginnings Advice by Telephone trial

Abstract

Prevention of obesity in very early childhood is a public health priority both globally and in Australia. Over the last fifteen years, early childhood obesity prevention trials have demonstrated significant behaviour change outcomes and optimistic age-appropriate child weight outcomes. Increase in use of mobile phones and technology, has created opportunities for interventions to be delivered remotely. The increase in intervention delivery via online modes, telephone or text messages has been promising due to its cost-effectiveness and convenience.

Recently, the Communicating Healthy Beginnings Advice by Telephone (CHAT) trial delivered health promotion messages via telephone calls and text messages to women during late pregnancy and two years post-birth. Healthy Beginnings was a community-based randomised controlled trial of a developmentally staged home visiting intervention to prevent the early onset of overweight and obesity in children. The CHAT trial aimed to achieve age-appropriate weight outcomes in very young children. However, it is important to understand the processes that occurred for the interventions to be scaled up to a larger population.

This thesis presents research evaluating the process of engaging and communicating with pregnant women and mothers of infants about healthy infant feeding and infant growth-related issues via telephone calls or text messages. Specifically, evaluation was conducted during recruitment, intervention implementation and post-implementation phases of the CHAT trial. Pregnant women’s interest in receiving information via telephone calls or text messages was an indication that women valued the trial. Participants’ responses indicated a clear need for stage-based information provision with preference of choice and flexibility in mode of intervention delivery due to their changing needs. Participants’ engagement with the program interventions was high. Engagement with the telephone support program was significantly associated with certain socio-demographic characteristics. Stakeholders highlighted the importance of good communication, effective partnerships and leadership to implement a successful trial. This process evaluation of the CHAT trial indicates high likelihood of engagement and participation if the CHAT trial was scaled up.