Translation and feasibility testing of the Healthy Habits Happy Homes (4H) Intervention to Scotland (4HS)

Rights statement
Awarding institution
  • University of Strathclyde
Date of award
  • 2022
Thesis identifier
  • T16305
Person Identifier (Local)
  • 201665568
Qualification Level
Qualification Name
Department, School or Faculty
  • Background: Childhood obesity is complex disease that will not be solved with any single intervention. There is an inequality in obesity risk for children growing up in the most deprived communities and research should be undertaken, alongside marginalised communities. This thesis reports on the translation and feasibility testing of an existing, pre-school obesity prevention intervention, Healthy Habits Happy Homes (4H) alongside a community marginalised by poverty in Dundee, Scotland (4HS). Methods: Five studies, in the form of two published papers and three manuscripts are presented, centred around a logic model (LM) and evolving Theory of Change (TOC), conceptualising the study with a systems lens. Three key stages of feasibility study design and development were reported and evaluation of process utilised the RE-AIM framework. Mixed methods were utilised in order to characterise families and suitably report study outcomes against TOC with each research phase appraised against Medical Research Council (MRC) core elements. Results: n=8 activities, n=5 short-term outcomes, n=4 intermediate outcomes were outlined in a LM presented in study one. The co-produced, translated 4HS was feasible to deliver, pragmatic and demonstrated good fidelity to Motivational Interviewing (MI). Participant families valued home visits and positive, trusting relationships which facilitated engagement and positive behaviour change. TOC evolved through insights from community stakeholder and offered a reporting mechanism for 4HS outputs that informed 4HS implementation in routine NHS practice. Conclusions: The 4HS study design and translational processes enabled suitable understanding of key contextual factors including participant characteristics, development of appropriate feasibility outcome reporting mechanisms and preliminary data. When these data are combined it enables consideration of the contribution the 4HS study makes to the wider, local, childhood obesity system. Integrating 4HS into an existing NHS service was tested during the Covid-19 pandemic, leaving it open to a future research and / or practice-based direction
Advisor / supervisor
  • Gibson, Ann-Marie
  • Reilly, John
  • Hughes, Adrienne
Resource Type
Date Created
  • 2021
Embargo Note
  • This thesis is currently under moratorium due to a 3rd party copyright issue. If you are the author of this thesis, please contact the Library to resolve this issue.