Translation and feasibility testing of the Healthy Habits Happy Homes (4H) Intervention to Scotland (4HS)

  • Jenny gillespie

Student thesis: Doctoral Thesis


Background: Childhood obesity is complex disease that will not be solved with anysingle intervention. There is an inequality in obesity risk for children growing up inthe most deprived communities and research should be undertaken, alongsidemarginalised communities. This thesis reports on the translation and feasibility testingof an existing, pre-school obesity prevention intervention, Healthy Habits HappyHomes (4H) alongside a community marginalised by poverty in Dundee, Scotland(4HS).Methods: Five studies, in the form of two published papers and three manuscripts arepresented, centred around a logic model (LM) and evolving Theory of Change (TOC),conceptualising the study with a systems lens. Three key stages of feasibility studydesign and development were reported and evaluation of process utilised the RE-AIMframework. Mixed methods were utilised in order to characterise families and suitablyreport study outcomes against TOC with each research phase appraised againstMedical Research Council (MRC) core elements.Results: n=8 activities, n=5 short-term outcomes, n=4 intermediate outcomes wereoutlined in a LM presented in study one. The co-produced, translated 4HS wasfeasible to deliver, pragmatic and demonstrated good fidelity to MotivationalInterviewing (MI). Participant families valued home visits and positive, trustingrelationships which facilitated engagement and positive behaviour change. TOCevolved through insights from community stakeholder and offered a reportingmechanism for 4HS outputs that informed 4HS implementation in routine NHSpractice. Conclusions: The 4HS study design and translational processes enabled suitableunderstanding of key contextual factors including participant characteristics,development of appropriate feasibility outcome reporting mechanisms andpreliminary data. When these data are combined it enables consideration of thecontribution the 4HS study makes to the wider, local, childhood obesity system.Integrating 4HS into an existing NHS service was tested during the Covid-19pandemic, leaving it open to a future research and / or practice-based direction
Date of Award8 Jun 2022
Original languageEnglish
Awarding Institution
  • University Of Strathclyde
SponsorsUniversity of Strathclyde
SupervisorJohn Reilly (Supervisor) & Adrienne Hughes (Supervisor)

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