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Table 1 Analysis of fidelity, feasibility and acceptability of the DiAlert intervention

From: DiAlert: a prevention program for overweight first degree relatives of type 2 diabetes patients: results of a pilot study to test feasibility and acceptability

Category of measurement Instrument and stage (by whom) Topics measured Scale Results
Fidelity measures Checklists Coverage of the role of the trainer and the participants Checklist coverage: yes/no tick box Observations with checklists showed that all modules were delivered. The role of the trainer and the objectives for participants were covered.
-during the intervention sessions(Observers)
Evaluations Engagement of participants Observations Engagement was high, demonstrated by active questioning by participants, active participation at the calorie games, most participants completing the homework assignment and attendance in both group sessions.
-after each group session (Observers and Trainer)
Attrition was low: one participant was absent at the second session.
   Empowerment philosophy Observations The trainer supports the empowerment philosophy during both sessions, see checklist for items of empowerment.
Quotes of participants written down on flip-over sheets Do relatives of T2DM patients have: Quotes of participants Participants have worries about:
1. Relatives (for example ‘worries about my mom/dad/ children’
2. Own health: (for example, ‘I’m afraid of getting diabetes myself’; ‘I think I’m too young to get it [diabetes]!’
-during the first session (Trainer) 1. worries?
2. questions? Quotes of participants Main themes of burning questions:
1. Diabetes causality and its relation to lifestyle (for example, ‘What is the primary cause of T2DM? Does stress affect development of T2DM’, ‘How important is eating healthy food, and what is considered to be healthy?’)
2. Questions about diabetes treatment and complications (for example, ‘Why do some people receive pills and others insulin treatment?’, ‘How can someone prevent getting polyneuropathy?’).
3. interests in relation diabetes prevention? Quotes of participants Categories of reasons to participate:
1. Risk awareness and worry (for example ‘My risk of getting diabetes is high’)
2. Information seeking (for example, ‘How are lifestyle and diabetes risk related?’)
3. Motivation (for example, ‘Stimulates me to improve my exercise behavior’).
Questionnaire - perceptions of worry[13] 1 = totally not worried No significant changes for worry about personal risk and personal control of developing T2DM, for example:
-at baseline
7 = very worried
Indicate your feelings when thinking about chance of getting diabetes: baseline 5.0 ± 1.6; follow-up 5.0 ± 1.6; P = 0.92)
−4 weeks follow-up (Participant)
  - personal control[13] 1 = totally disagree No significant changes for personal control of developing T2DM, for example:
5 = totally agree
I think I have little influence on getting T2DM: baseline 2.5 ± 1.1; follow-up 1.9 ± 1.0; P = 0.08
I can reduce my risk of getting diabetes: baseline 4.3 ± 0.7; follow-up 4.3 ± 1.2; P = 0.92
I think I have little control over my own health: baseline 1.8 ± 0.7; follow-up 1.8 ± 0.7; P = 0.85
- perceived consequences of T2DM[13] 1 = totally disagree Significant increase of perceived consequences of getting T2DM, for example:
5 = totally agree
Major implications for life: baseline 4.2 ± 0.8; follow-up 4.5 ± 0.7; P = 0.04
Major financial implicationsa: baseline 2.9 ± 1.1; follow-up 3.4 ± 1.0; P <0.01
Feasibility measures Questionnaire - which recruitment strategies were appropriate / How did participants knew about the study? Multiple choice including 1 open-ended option. Recruitment through flyers and advertisements n = 14 (66%), announcement on internet n = 3 (14.4%) and via a relative n = 3 (14.4%)
-at baseline (Participant)
Observations - time, duration of the modules/sessions Minutes per module reported on checklist All modules were delivered within 2 × 150 minutes; duration of modules deviated sometimes from planned time.
-during the intervention sessions (Observer)
Questionnaire - length of sessions was good: 1 = totally disagree 90% of the participants evaluated the length of the sessions ‘good’ score ≥3
-follow-up 4  weeks (Participant)
4 = totally agree
Evaluation form - group size Multiple choice: too small, just right, too large All participants evaluated the group size ‘just right’
-at the end of second session (Participant)
Acceptability measures Evaluation form - generic grade for total intervention: (mean ± SD) 1 (lowest grade) 8.0 ± 1.0
-at the end of second session (Participant)
10 (highest grade)
- usefulness of the separate modules (mean ± SD) 1 = very useful Introduction 1.5 ±0.5; Risk factors 1.3 ±0.5; Development of diabetes 1.3 ±0.6; Homework 1.8 ±0.9; Information about physical activity 1.4 ±0.5; Information about diet 1.5 ±0.8; Action plan 1.7 ±0.8; Questions 1.5 ±0.7
5 = totally not useful
Questionnaire - participants manual: instructive and clear 1 = totally disagree Instructive 3.4 ±0.5; clear 3.4 ±0.5
-follow-up 4  weeks (Participant)
4 = totally agree
- action plan: managed to make one and useful 1 = totally disagree Managed to make an action plan 2.8 ±0.5; useful to create a personal action plan 3.1 ±0.6
4 = totally agree
   (mean ± SD)   
  1. SD standard deviation; T2DM type 2 diabetes mellitus.