Structuring Process Evaluation to Forecast Use and Sustainability of an Intervention: Theory and Data From the Efficacy Trial for Lunch Is in the Bag

Background. A cluster-randomized trial at 30 early care and education centers (Intervention = 15, waitlist Control = 15) showed the Lunch Is in the Bag intervention increased parents’ packing of fruits, vegetables, and whole grains in their preschool children’s bag lunches (parent–child dyads = 351 Intervention, 282 Control). Purpose. To examine the utility of structuring the trial’s process evaluation to forecast use, sustainability, and readiness of the intervention for wider dissemination and implementation. Method. Pretrial, the research team simulated user experience to forecast use of the intervention. Multiattribute evaluation of user experience measured during the trial assessed use and sustainability of the intervention. Thematic analysis of posttrial interviews with users evaluated sustained use and readiness for wider dissemination. Results. Moderate use was forecast by the research team. Multiattribute evaluation of activity logs, surveys, and observations during the trial indicated use consis...