Table 5.
Adaptations to the Bright Bodies program since initial randomized controlled trial, 2007-2018
| Implementation Year | Adaptation | Were Adaptations Planned?1 | What Was Modified?1 | Description and Reasons for Adaptation | What Was the Goal?1 |
|---|---|---|---|---|---|
| Efforts to increase engagement and motivation | |||||
| 2007 | Completion certificates | Planned/Proactive | Implementation and scale-up activities | Prizes for “biggest loser” (2 for younger group and 2 for older group) were discontinued. Instead, all participants received completion certificates at the end of each session. | Increase engagement; reduce cost; increase satisfaction |
| 2008 | Bright Bodies “Bucks” | Planned/Proactive | Implementation and scale-up activities | Introduced 3-4 raffle prizes throughout session. Sought to increase recognition of all participants who demonstrated progress and not just “best” outcomes. Bright Bodies “bucks” for raffle drawing were earned for a variety of activities demonstrating engagement with the program (e.g., attendance; submitting physical activity logs) | Increase engagement; reduce cost; increase satisfaction |
| 2013 | Brief exercise class added to orientation | Planned/Proactive | Content (lengthening/extending) | Brief exercise class added in response to perceived eagerness of participants to start exercise during orientation class. | Increase engagement; increase retention |
| 2013 | Inclusion of more games in physical activity curriculum | Unplanned/Reactive | Content (adding elements; removing elements) | In response to request by participants and goal of increasing participant “ownership” in the program, more interactive games were added to the physical activity classes. | Increase engagement and satisfaction; improve fit with participants |
| 2015 | Inclusion of siblings | Unplanned/Reactive | Contextual (population) | Siblings including those without overweight/obesity permitted to attend program in response to families’ requests. Sought to improve retention and family-based practice. | Increase retention; improve feasibility; improve fit with recipients; increase satisfaction |
| 2016 | More modifications included during exercise instruction | Planned/Proactive | Content (tailoring/tweaking/refining) | Modifications for varying fitness levels shown more frequently during class to accommodate all participants and prevent injuries. | Improve fit with recipients |
| Pragmatic changes | |||||
| 2009 | Increased use of trainees as staff | Unplanned/Reactive | Contextual (personnel) | Utilized more nutrition and exercise physiology students in response to: (1) high volume of requests for precepting trainees from local universities; and (2) decreased funding for seasoned staff. | Reduce cost |
| 2009 | Restructured group levels from 4 levels to 2 (Beginner/Intermediate) | Unplanned/Reactive | Contextual (format) | In response to group size and experienced staff shortages, combined Intermediate I, Intermediate II, and Advanced groups to one group, Intermediate/Advanced. | Improve feasibility; reduce cost |
| Updates to curriculum | |||||
| Ongoing | Curriculum updates | Planned/Proactive | Content (tailoring/tweaking/refining; adding elements; condensing/shortening; substituting; removing or skipping elements; reordering of intervention elements or modules; changes in packaging or materials) | Nutrition and behavior modification topics added annually to address new topics of interest and keep material current with pediatric weight management literature (e.g., “Break the Fast with Breakfast”; “Stress Management for the Stress Eater”) | Improve effectiveness or outcomes; increase engagement; address cultural factors |