Table 1 Implementation outcomes

Stakeholders: acceptability, feasibility, appropriateness, and sustainability

(1) Select scales of the Annual Survey of Evidence-Based Programs [113] (α > .75)

Survey (ST)

(2) FCU4Health Stakeholder Survey: 11 open-ended questions, adapted from the Treatment Acceptability Rating Form, related to the relevance of the FCU4Health for obesity management, barriers and facilitators of the delivery of the program, and feasibility of this program from the perspective of stakeholders

(3) Program Sustainability Assessment Tool [114]: 8 domains (e.g., funding stability, organizational capacity) with 5 items each (e.g., “The program has sustained funding”) are rated on a 7-point Likert scale (1 = little or no extent, 7 = a very great extent) (α = .88)

Caregivers: acceptability and appropriateness

(1) FCU4Health Caregiver Acceptability Interview, designed for and used in our pilot feasibility trial [50], consists of 11 open-ended questions pertaining to the relevance of the program components to the family’s efforts to manage weight, the acceptability of the program and its components, and the barriers and facilitators of participation

Interview (CG)

(2) Treatment Acceptability Rating Form-Revised Short [115,116,117], adapted for FCU4Health: 10 items (e.g., “How likely is FCU4Health to make permanent improvements in your child’s health behaviors?”) rated on a 7-point Likert scale (1 = not at all, 7 = very) (α = .92) [115]

Survey (CG)

Reach

1- or 2-month sampling period to more closely approximate the number of families that require a service at any given point [63]

EHR data

Family service participation

(1) FCU4Health activities checklist (FACL) [118] (see description in the “Methods” section)

Administrative data  and Survey (CO)

(2) Community Resources: Engagement and Adequacy (CREA): adapted from an existing care coordination measure to assess the extent to which families engaged in community resources (e.g., emergency care, well-child visits, recreational and nutrition programs, mental healthcare, school services, financial services) and if help was needed to obtain the resource and whether those resources met their needs. Response options are as follows: “I didn’t need help”; “I needed help, but didn’t find it”; “I tried this, but it didn’t work”; “I’m still getting help”; and “I got help, and it worked”

 Survey (CG)

(3) Dosage of Engagement in Community Resources (DECR) [119]: created for this study to assess the amount of time spent in activities to support health behaviors assessed by asking the number of times among 7 response options (e.g., “once a month,” “2–3 times a week,” “2 times every day”) and then the duration of each instance of teach activity using a drop-down menu of min (e.g., 30) to h (e.g., 1, 3, and 8 h or more)

Fidelity

(1) COACH observational rating system [54]: 5 dimensions of observable in-session coordinator skills: conceptual accuracy; observant and responsive to the families’ contexts and needs; actively structures session to optimize effectiveness; carefully teaches and provides corrective feedback; hope and motivation are generated. Each dimension contains exemplars (prescribed behaviors) and non-exemplars (proscribed behaviors) and is rated on a 9-point scale: 1–3 (needs work); 4–6 (competent work); 7–9 (excellent work) (ICC ≥ .73) [120]. Variability in fidelity ratings to feedback sessions have been associated with long-term changes in parenting skills and child behavioral outcomes [53,54,55]

Observational

(2) Automated coding of fidelity is being developed within this study (aim 2b)

Automated coding

Costs and health economics

(1) Cost capture survey [57]

Survey (ST)

(2) FCU4Health activities checklist (FACL) [118] (see description in the “Methods” section)

Survey (CO)

(3) Electronic budgets

Administrative data

(4) Health plan claims data

Administrative data