Evidence map›Paper›PMID 42734936›Full record

ArticleTranslational behavioral medicine2026

Process evaluation of a digital school-based intervention: lessons learned from the Health4Life study.

Katrina E Champion, Lauren A Gardner, Bridie Osman, Siobhan O'Dean, Emily Hunter, Louise Thornton, Cath Chapman, Tim Slade, Nyanda McBride, Courtney Stewart and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Translational behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Katrina E ChampionThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-8319-9366
Lauren A GardnerThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-8592-6691
Bridie OsmanThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-4286-6844
Siobhan O'DeanThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
Emily HunterThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-5495-6962
Louise ThorntonThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-7705-833X
Cath ChapmanThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
Tim SladeThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-1725-9188
Nyanda McBrideNational Drug Research Institute, enAble Institute, Faculty of Health Science, Curtin University, Perth, WA, Australia.ORCID 0000-0003-1714-6631
Courtney StewartNational Drug Research Institute, enAble Institute, Faculty of Health Science, Curtin University, Perth, WA, Australia.
Matthew SunderlandThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.
Leanne HidesSchool of Psychology, The University of Queensland, St Lucia, QLD, Australia.
Steve AllsopNational Drug Research Institute, enAble Institute, Faculty of Health Science, Curtin University, Perth, WA, Australia.
David R LubansHunter Medical Research Institute, New Lambton Heights, NSW, Australia.ORCID 0000-0002-0204-8257
Belinda ParmenterSchool of Health Sciences, University of New South Wales, Sydney, NSW, Australia.ORCID 0000-0001-8013-5658
Bonnie SpringDepartment of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.ORCID 0000-0003-0692-9868
Lyra EganThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0003-0922-4396
Scarlett SmoutThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-5879-442X
Maree TeessonThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-6744-463X
Nicola C NewtonThe Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-6305-2623

Funding

Paul Ramsay Foundation and the Australian National Health and Medical Research CouncilUniversity of Sydney Horizon Fellowship
6 · The paper itself

Abstract

backgroundProcess evaluations of preventive health interventions are essential for enhancing their implementation and impact. PURPOSE: This study presents the process evaluation of Health4Life, a digital school-based program designed to modify multiple health risk behaviors among adolescents.

methodsData were derived from a cluster randomized controlled trial in 71 Australian secondary schools from 2019 to 2022, including data from 2085 students and 118 teachers. Based on the Medical Research Council guidance for process evaluations this study explored three key questions: (i) Was the Health4Life intervention delivered and received as intended? (ii) How did participants respond? and (iii) What contextual factors influenced implementation? Fidelity, dose and exposure to intervention components were assessed through teacher self-report and website analytics. Participant responsiveness included student and teacher acceptability, and factors associated with a positive program evaluation (i.e. students' ratings of enjoyment, relevance, and utility). Contextual factors relating to schools and the intervention were assessed via teacher-reported open-ended feedback. The Consolidated Framework for Implementation Research (CFIR) was applied to support interpretation of findings.

resultsFidelity to the online modules was high based on teacher self-report, but the dose received by students was moderate (62% full dose), and use of the supplementary components varied. Program acceptability was high, with most students (73%) and teachers (84%) rating Health4Life favorably overall. Key factors associated with a positive student evaluation were identifying as female, and having higher baseline knowledge of health risk behaviors, greater self-control and higher socioeconomic advantage. Qualitative data identified key contextual barriers and facilitators relating to program design, technology and school contextual issues.

conclusionsThese findings provide valuable insights to support the ongoing refinement and broader implementation of Health4Life. A set of recommendations are proposed to inform the future development, implementation, and evaluation of digital health interventions in school environments. CLINICAL TRIAL INFORMATION: The Health4Life study was pre-registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619000431123).

Indexed as

Health BehaviorHealth PromotionSchool Health ServicesAdolescentAustraliaFemaleHumansMaleProgram EvaluationRandomized Controlled Trials as TopicSchoolsStudentsimplementationinterventionpreventionrisk behaviorsschool-based

Identifiers

PMID42734936
PMCPMC13573580

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.