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Table 1 Recommended strategies for promoting parent engagement with HENRY

From: A cluster RCT and process evaluation of an implementation optimisation intervention to promote parental engagement enrolment and attendance in a childhood obesity prevention programme: results of the Optimising Family Engagement in HENRY (OFTEN) trial

  Who What When Rationale Informed by Proposed outcome
1. Local authority commissioner Support managers to perform target behaviours Ongoing from the start of the intervention period Local authority support for HENRY implementation optimisation intervention is likely to influence centre-level practices Ethnography study findings and the implementation science literature (e.g. [35]) Manager performs target behaviours influencing enrolment and attendance
2. Children’s centre manager Hold ‘taster’ sessions prior to each HENRY programme where parents can attend an introductory session where the programme and format are explained Prior to each delivered HENRY programme Potential participants are more likely to engage if they have a greater understanding of what the programme entails Experience of HENRY personnel, ethnography study finding (observation) and the literature (e.g. [36]) Parents have greater understanding of what HENRY is prior to enrolling influencing enrolment attendance
3. Children’s centre manager Increase HENRY training provision for centre staff From the start of the intervention period Some children’s centre staff lack knowledge of the HENRY programme and would benefit from training on the HENRY approach Ethnography study (interviews and observation), experience of team members and the literature (e.g. [37]) Parents are provided with accurate information on what HENRY entails when approached to attend, influencing enrolment and attendance
4. Children’s centre manager [i] Hold HENRY programmes regularly and [ii] plan HENRY programmes far in advance Ongoing from the start of the intervention Some HENRY programmes are planned at short notice which hinders recruitment efforts Ethnography study (informal conversations) and experience of the intervention development team HENRY delivery is normalised and has greater visibility in centres influencing enrolment
5. Children’s centre manager Promote HENRY widely in centres using a range of methods Ongoing from the start of the intervention There is a general lack of awareness of HENRY among visiting parents Ethnography study (observations, informal conversations and parent focus groups) More parents are aware that HENRY programmes are running influencing enrolment
6. Children’s centre manager Allow a mix of referred and self-referred parents to enrol Ongoing from the start of the intervention Delivering programmes to a mix of parents (referred and self-referred) reduces barriers associated with stigma and improves group dynamics Ethnography study (interviews and observations) and the literature (e.g. [38]) Staff approach more parents to attend and HENRY programmes are de-stigmatised influencing enrolment
Group dynamics are improved influencing attendance
7. Children’s centre manager and staff Adopt a whole centre approach to HENRY; whereby [i] HENRY principles are adopted in other programmes and [ii] all staff are involved in the implementation of HENRY Ongoing from the start of the intervention Adopting a whole centre approach to HENRY implementation achieves better outcomes for engagement Ethnography study (observations and informal conversations) and experience of the intervention development team HENRY becomes more normalised and de-stigmatised in centres influencing enrolment
Parents and staff have greater understanding of what programmes entail influencing enrolment and attendance
8. Children’s centre staff Promote HENRY accurately to dispel myths and negative perceptions Ongoing from the start of the intervention Misconceptions around what HENRY entails may deter people from engaging Ethnography study (interviews, observations, focus group and informal interviews) Parents understand what HENRY programme entails and are not put off by common misconceptions (e.g. that HENRY is a healthy eating programme) influencing enrolment and attendance
9. HENRY facilitators Ensure parents feel comfortable when attending the session by [i] considering characteristics of the parents before they attend and [ii] giving them enough time in sessions for group discussion During all HENRY programmes The skills of facilitators are known to influence engagement Ethnography study (observation, focus groups and interviews) and the literature (e.g. [5, 39]) Parents feel comfortable attending (i.e. demonstrate confidence to engage) the session and form social bonds with other members of the group influencing attendance
10. HENRY facilitators Follow up on all parents that miss a session to encourage continued attendance During all HENRY programmes Participants feel valued if they are followed up after missing a session Ethnography study (focus groups) and experience of the intervention development team Parents are motivated to return to programme if a session is missed influencing attendance
11. Previous HENRY participants Encourage friends and family to engage with HENRY Following HENRY programme attendance Parents are more likely to attend a programme if they know someone that has attended before Ethnography study (interviews and focus groups) and the literature (e.g [33, 40]) More parents are approached to enrol that are not already engaged with the centre and are more likely to sign up as they trust word of mouth recommendation influencing enrolment