Rolling with Resistance: Expand, Connect, Thrive Acceptability and Feasibility and Participant Perspectives on how to Impact Change

Abstract

Introduction: Effective interventions to increase positive health behaviors (PHB; e.g., healthy eating, exercise, stress management) in adolescence are vital; yet, PHB-promoting interventions have been less effective in minority populations. We aimed to evaluate the feasibility, acceptability, and preliminary outcomes of the Expand, Connect, Thrive (ECT) program, a PHB intervention for minority, low-SES adolescents.
Methods: Forty-eight adolescents (56% female, ages 10-14 years; 17% Hispanic, 56% Haitian/Creole) participated in the pilot ECT program at a school-based health clinic. Half of the sample was randomly assigned to receive motivational interviewing (MI) sessions. Adolescents were assessed at baseline, post-intervention, and 3- and 6-months follow-up regarding their self-reported eating behaviors, physical activity, and coping skills. Focus groups were conducted to determine next steps.
Results: The ECT program demonstrated strong attendance and retention. Adolescents’ reported satisfaction with the program; 75% rated the quality as “Excellent” or “Good” and about 73% indicated they would recommend the ECT program to a friend. Repeated measures MANOVA revealed that participants reported significantly less sedentary behaviors at post-intervention, compared to pre-intervention. No other main effects were seen and no differences emerged between those who did and did not receive MI. Focus groups indicated that the intervention could be more individually tailored, foster more adolescent ownership, integrate real-world applications, and facilitate more environmental support following the intervention.
Discussion: The ECT program provides a strong foundation on which future interventions within this at-risk population can build. Future interventions and studies can utilize focus group data as a guide for development of effective interventions.