2.6. Outcome Measures and Data Analysis
RECRUITMENT
To meet the project aims, a comprehensive evaluation, based on the RE-AIM model, was planned [Implementation/Adoption: Barriers and facilitators to embedding the program into existing services for delivery were interrogated, with examination of study records for timelines and MMH system interactions. Further, senior author (JW) led a discussion with the project team about the facilitators and barriers to the adoption of a digital program within the MMH systems. These discussion data were analyzed thematically. Reach: The proportion of women willing to take part in the txt4two program and their representativeness, compared to the broader MMH population. A comparison of the study population’s demographics and anthropometrics (age, education level, and ppBMI) was compared with the wider MMH public-hospital population during the study period. Participation rates were also calculated from MMH activity data during the study period. Effectiveness: In changing appropriate maternal GWG, fruit and vegetable intake and diet quality, and changing physical activity levels, as measured for women enrolled in the txt4two intervention, compared with: (a) the prospective control group who did not to receive txt4two (as the program was not implemented in the clinic when the women were recruited), but completed two surveys, and (b) between modalities of the introductory session of the txt4two program (i.e., F2F, Group F2F, or telehealth). All women were sent a URL via text message to a survey hosted by Survey Monkey at baseline and 36 weeks’ gestation. The survey requested socio-demographic, (age, education, income, aboriginal and/or Torres Strait Islander status), pregnancy, and anthropometric characteristics and dietary quality and physical activity via valid questionnaires. Women were asked their height, pre-pregnancy weight, current weight, and weeks of pregnancy in the baseline survey and current weight and weeks of pregnancy at the follow-up survey. Women in the txt4two group also answered questions about their program experience in the follow-up survey. Dietary quality was assessed with the fat and fiber behaviour questionnaire (FFBQ) [Physical activity was assessed using pregnancy physical activity questionnaire (PPAQ) [Women’s engagement with the program, including preference for initial modality and uptake of, retention in, and engagement with the program. Preference for initial goal-setting modality (dietetic F2F, dietetic led workshop/HSP, dietetic telehealth); recruitment (women engaged in program/women offered enrolment) was recorded by the program manager via survey and project database. 