OPREVENT2 was a multilevel, multicomponent (MLMC) adult obesity prevention that sought to improve access and demand for healthier food and physical activity opportunities in six Native American communities in the Southwest and Midwest. OPREVENT2 worked with worksites, food stores, schools (grades 2-6), through social media and mailings, and with a local community action committee (CAC), in each of the three intervention communities, and was implemented in six phases. We conducted a process evaluation to assess implementation of each intervention component in terms of reach, dose delivered and fidelity. Implementation of each component was classified as high, medium or low according to set standards, and reported back at the end of each phase, allowing for improvements. The school and worksite components were implemented with high reach, dose delivered and fidelity, with improvement over time. The school program had only moderate reach and dose delivered, as did the social media component. The CAC achieved high reach and dose delivered. Overall, study reach and dose delivered reached a high implementation level, whereas fidelity was medium. Great challenges exist in the consistent implementation of MLMC interventions. The detailed process evaluation of the OPREVENT2 trial allowed us to carefully assess the relative strengths and limitations of each intervention component.

中文翻译：

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在美洲原住民社区实施多层次、多成分的肥胖控制干预措施 (OPREVENT2)：挑战和经验教训。


OPREVENT2 是一种多层次、多成分 (MLMC) 成人肥胖预防方案，旨在改善西南和中西部六个美洲原住民社区对更健康食品和体育活动机会的获取和需求。 OPREVENT2 通过社交媒体和邮件与当地社区行动委员会 (CAC) 合作，在三个干预社区中的每一个社区与工作场所、食品店、学校（2-6 年级）合作，并分六个阶段实施。我们进行了过程评估，以评估每个干预措施的实施情况，包括影响范围、剂量和保真度。根据设定的标准，每个组件的实施被分为高、中或低，并在每个阶段结束时进行报告，以便进行改进。学校和工作场所组件的实施具有高覆盖范围、剂量传递和保真度，并且随着时间的推移不断改进。学校项目的影响范围和剂量都有限，社交媒体部分也是如此。 CAC 实现了高到达率和高剂量输送。总体而言，研究范围和剂量达到了较高的实施水平，而保真度为中等。持续实施 MLMC 干预措施存在巨大挑战。 OPREVENT2 试验的详细过程评估使我们能够仔细评估每个干预措施的相对优势和局限性。