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Table 3 Intervention integrity checklist for the PAC intervention

From: Parents as Agents of Change (PAC) in pediatric weight management: The protocol for the PAC randomized clinical trial

Group Leader #1: __________________________________ Date (dd/mm/yyyy): ________________
Group Leader #2: __________________________________ Rater: ___________________________
Content – Are the following content items addressed in the session? Yes No
(Note: Details to be included by investigators; content items vary session-to-session)   
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Content – Did leaders follow the manual content throughout the session?   
(Rater: Please read along in the manual during session to evaluate adherence to content).   
Additional comments:   
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Group Process Foundations Leader 1 Leader 2
  Yes No Yes No
Leader linked parent experiences to individual factors (e.g., linked the impact of parent, child preferences on experiences).     
Leader linked parent experiences to family factors (e.g., linked the impact of family members on parent experiences).     
Leader linked parent experiences to environmental factors (e.g., linked the role of community and available resources on parent experiences).     
Leader made links between thoughts, feelings and behaviours.     
Leader reflected questions back to group.     
Leader answered questions directly.     
Leader shared personal anecdotes/stories in response to parents sharing their experiences.