A multi-method process evaluation for a skin cancer prevention diffusion trial.

Area of Science:

• Public Health
• Health Promotion
• Skin Cancer Prevention

Background:

• The Pool Cool program demonstrated efficacy in improving sun protection behaviors and environments at swimming pools.
• Following the efficacy trial, a national diffusion trial was conducted to assess widespread implementation.
• Process evaluation methods evolved to focus on implementation, barriers, facilitators, and sustainability.

Purpose of the Study:

• To describe the process evaluation methods used in the 4-year Pool Cool diffusion trial.
• To assess the widespread implementation, maintenance, and sustainability of the Pool Cool program.
• To identify program features and participant factors that facilitated dissemination.

Main Methods:

• Utilized diverse data collection including training surveys, database tracking, activity logs, emails, and surveys of parents, lifeguards, and pool managers.
• Incorporated process evaluation interviews and site visits for in-depth assessment.
• Focused on evaluating major program components like sun safety lessons, signage, and sunscreen use.

Main Results:

• High levels of implementation were observed for core Pool Cool program components during the diffusion trial.
• Program features such as linkage agents, a packaged program, and adaptable elements facilitated local implementation.
• Factors supporting program maintenance and sustainability across dispersed locations were identified.

Conclusions:

• The Pool Cool program demonstrated successful widespread implementation and sustainability.
• Specific program design elements and support structures were crucial for facilitating adoption and maintenance in diverse settings.
• Process evaluation provided valuable insights into the successful diffusion of a public health intervention.