Mixed Methods Evaluation of the “Train the Trainer” Model for Delivering Core “Making Every Contact Count” (MECC) Training

INTRODUCTION: The current study aimed to evaluate the regional implementation of the Train the Trainer (TtT) model to deliver Making Every Contact Count (MECC, an opportunistic and person-centred approach to the promotion of health and well-being) training across the North East and North Cumbria. METHODS: A mixed methods evaluation included secondary data from pre- and post-MECC TtT training survey evaluations and cascade behaviour of MECC trainers, qualitative semi-structured interviews with individuals who were eligible for the MECC TtT programme (n = 21) analysed according to the Theoretical Domains Framework (TDF), content analysis of the existing MECC TtT programme to identify behaviour change techniques (BCTs) and intervention functions (IFs), and a strategic behavioural analysis to identify the extent to which the current programme addressed the behavioural problem. RESULTS: Only 4.4% of MECC trainers who completed the post-survey evaluation reported a cascade of core MECC training following the TtT programme. MECC TtT training significantly improved knowledge but not confidence or motivation of trainees to deliver the MECC training. However, motivation and confidence post-training significantly predicted intention to cascade. Neither mode of delivery nor post-training knowledge significantly predicted intention to cascade. Six key TDF domains were identified as key barriers and facilitators to the cascade of core MECC training: Environmental Context and Resources, Knowledge, Social Influences, Beliefs about Consequences, Skills, and Intentions. MECC TtT training only sufficiently addressed the key TDF domain skills. CONCLUSIONS: A targeted approach to recruitment to the regional MECC TtT programme should be adopted to ensure trainees have top-down and peer support, previous MECC knowledge and delivery within their role, and experience of delivering training. Otherwise, additional support is needed for MECC trainers.