Rationale, Design, and Methods for Process Evaluation in the Childhood Obesity Research Demonstration Project.

OBJECTIVE: The cross-site process evaluation plan for the Childhood Obesity Research Demonstration (CORD) project is described here.
DESIGN: The CORD project comprises 3 unique demonstration projects designed to integrate multi-level, multi-setting health care and public health interventions over a 4-year funding period.
SETTING: Three different communities in California, Massachusetts, and Texas. PARTICIPANTS: All CORD demonstration projects targeted 2-12-year-old children whose families are eligible for benefits under Title XXI (CHIP) or Title XIX (Medicaid). INTERVENTION(S): The CORD projects were developed independently and consisted of evidence-based interventions that aim to prevent childhood obesity. The interventions promote healthy behaviors in children by applying strategies in 4 key settings (primary care clinics, early care and education centers, public schools, and community institutions). MAIN OUTCOME MEASURE(S): The CORD process evaluation outlined 3 main outcome measures: reach, dose, and fidelity, on 2 levels (researcher to provider, and provider to participant). ANALYSIS: The plan described here provides insight into the complex nature of process evaluation for consortia of independently designed multi-level, multi-setting intervention studies. The process evaluation results will provide contextual information about intervention implementation and delivery with which to interpret other aspects of the program.