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A cross-sectional study assessing modifications to the delivery of a multi-component implementation strategy (the Get Outside, Get Active program) to improve child physical activity in early childhood education and care services

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journal contribution
posted on 2025-04-15, 06:18 authored by L Giles, N Pearson, H Lamont, A Grady, Serene YoongSerene Yoong
AbstractIssue AddressedThe Get Outside, Get Active (GOGA) program is a randomised controlled trial which tested the impact of a multi‐component implementation strategy to support early childhood education and care (ECEC) services to replace indoor‐only free play with indoor–outdoor‐free play. This cross‐sectional study aims to describe the extent and nature of modifications made to implementation strategies and Behaviour Change Techniques (BCTs) using the Framework for Reporting Adaptations and Modifications to Evidence‐based Implementation Strategies (FRAME‐IS) and to describe the fidelity of BCT delivery throughout GOGA.MethodsAn audit of records was undertaken throughout the intervention delivery period in the intervention arm. GOGA included 14 standard BCTs within six implementation strategies. Modifications and BCT delivery were recorded by Health Promotion Officers via project records. Modifications were categorised according to the FRAME‐IS. BCT delivery was recorded using a checklist.ResultsForty‐four ECEC services received the GOGA program. Overall, 60 modifications were recorded. According to FRAME‐IS categories, most modifications related to: content; format; pragmatic or practical considerations; tailoring/tweaking/refining in nature; fidelity was inconsistent; the goal was to increase the acceptability, appropriateness, or feasibility of the implementation effort; the rationale was at the practitioner level; and were unplanned/reactive. Overall, 96.4% of standard BCTs were delivered as intended.ConclusionsGOGA was delivered with high fidelity to protocol as indicated by the level of BCT delivery. This article details a thorough approach to documenting modifications and provides guidance for future studies.So What?This article contributes to the emerging evidence regarding documentation of adaptations and modifications to public health implementation interventions.

History

Journal

Health Promotion Journal of Australia

Volume

36

Article number

e920

Pagination

1-9

Location

London, Eng.

Open access

  • Yes

ISSN

1036-1073

eISSN

2201-1617

Language

eng

Publication classification

C1 Refereed article in a scholarly journal

Issue

2

Publisher

Wiley