During interventions, researchers may have to account for secular trends such as long-term environmental events that impact intervention delivery. The Nutritious Eating with Soul (NEW Soul) study, designed for in person delivery, shifted to online delivery due to the social distancing restrictions caused by the secular trend of the COVID-19 pandemic.
“The NEW Soul Study: Implementation and Evaluation Impact From the Secular Trend of the COVID-19 Pandemic” summarizes changes in intervention delivery due to the COVID-19 pandemic and examines differences in process evaluation measures between in person and online delivery.
Read the Article in JPHMP
In the two-year Nutritious Eating with Soul (NEW Soul) study, African Americans were randomized to follow a low-fat omnivorous (omni) or vegan diet, both focused on soul food dishes and rooted in the Oldways African Heritage diet. Participants were recruited in two cohorts, separated by one year. Class sessions contained 1) nutrition content taught by a nutrition interventionist, 2) facilitated discussion regarding the successes and challenges of adhering to the assigned diet, and 3) cooking demonstrations and taste testing using a recipe catered towards the vegan or omni group. In addition, participants received podcasts, newsletters, and a private Facebook group to support adherence and engagement during the intervention year.
The onset of the secular trend of the COVID-19 pandemic resulted in a shift from in person to online meetings in March 2020. To ensure the intervention continued, the research team shifted intervention delivery to online in several steps:
- Identify an online meeting platform (Zoom)
- Develop user guides to ensure participants’ familiarity with Zoom
- Facilitate the coordination and availability of essential resources to support online instruction
- Conduct intervention session rehearsals to optimize sound, lighting, and camera positioning prior to intervention delivery
The NEW Soul study’s evaluation plan, based on Saunders and colleagues, contained three primary measures:
- Dose delivered: Answers the question, “What proportion of the intervention was actually delivered as intended?” Measured on 4 unannounced weeks of classes using a checklist of 8 sections regarding class components
- Dose received: Answers the question, “To what extent were participants exposed to program components?” Measured using participant attendance reports, number of podcasts and newsletters downloaded by participants, and engagement on private Facebook group pages
- Satisfaction: Answers the question, “How satisfied were the participants with the intervention components?” Measured through the completion of anonymous surveys by participants after classes
Summary of Findings:
- The study team successfully shifted delivery modality of the intervention
- The study team maintained the planned meeting schedule of classes for participants during the shift (ie, bi-weekly and monthly)
- Dose delivered scores were higher in person than online
- Attendance was higher during in person classes compared to online classes
- Engagement with podcasts, newsletters, and Facebook groups was low among all participants
- Participants rated in person and online class sessions favorably
- Participants rated helpfulness of information in class higher in person compared to online
Based on the study’s findings, the authors suggest:
- Online platforms can be used to develop and implement lifestyle interventions with effectiveness comparable to in person programs
- When redesigning in person interventions for online delivery, teams may need to adjust the timing and sequencing of class activities
- Process evaluation should be incorporated into both online and in person interventions to assess program implementation and overall success
- Researchers and practitioners must remain flexible to address their community’s needs and adapt to evolving secular trends
Read the full article in the Journal of Public Health Management and Practice.
John Bernhart is a faculty member in the Arnold School of Public Health at the University of South Carolina. He completed his postdoctoral fellowship with the NEW Soul study.