Process evaluation

Triangulation of the analysis of the intervention logs, focus groups, and case report forms will be used to describe and examine adherence and delivery of all three arms in order to refine the intervention for the full-scale trial. Intervention logs will be rated against the adherence checklist by members of the study team, to identify implementation fidelity and any potential contamination between arms. The focus groups will be transcribed verbatim and thematically analysed [75] using NVivo software. The findings from the focus groups with REPs and MHSWs will be synthesised with the intervention logs and independent observations of the sessions to explore adherence to training content and importantly to offer explanations for adherence and non-adherence. The findings from the focus groups with the young people will be considered along with the fidelity information from intervention logs and observations and quantitative adherence data (i.e. proportions of sessions attended and average heart rate). This will identify necessary modifications to the intervention for the main trial and to generate hypothetical propositions of the circumstances of successful delivery in the main trial.

We will examine reasons for declining to participate in the study and any demographic patterns amongst decliners to facilitate reach and representativeness of our recruitment strategy in the main trial. With reference to particular groups and local strategies outlined by Active Partnerships, recruitment strategies will be reviewed to aid our interpretation of recruitment figures for hard to reach groups of young people, which will then inform any recommended changes to recruitment strategy in the full-scale trial. This analysis will enable us to identify contextual factors that may affect adoption, delivery, and maintenance of the intervention.