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Chen J, Davies A, Tran P, Gronau R, Rangan A, Allman-Farinelli M, Porykali S, Oge R, Porykali B. Health and Nutrition Promotion Programs in Papua New Guinea: A Scoping Review. Nutrients 2024; 16:1999. [PMID: 38999748 PMCID: PMC11243307 DOI: 10.3390/nu16131999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/04/2024] [Accepted: 06/20/2024] [Indexed: 07/14/2024] Open
Abstract
There is a rising prevalence of non-communicable diseases (NCDs) in Papua New Guinea (PNG), adding to the disease burden from communicable infectious diseases and thus increasing the burden on the healthcare system in a low-resource setting. The aim of this review was to identify health and nutrition promotion programs conducted in PNG and the enablers and barriers to these programs. Four electronic databases and grey literature were searched. Two reviewers completed screening and data extraction. This review included 23 papers evaluating 22 health and nutrition promotion programs, which focused on the Ottawa Charter action areas of developing personal skills (12 programs), reorienting health services (12 programs) and strengthening community action (6 programs). Nineteen programs targeted communicable diseases; two addressed NCDs, and one addressed health services. Enablers of health promotion programs in PNG included community involvement, cultural appropriateness, strong leadership, and the use of mobile health technologies for the decentralisation of health services. Barriers included limited resources and funding and a lack of central leadership to drive ongoing implementation. There is an urgent need for health and nutrition promotion programs targeting NCDs and their modifiable risk factors, as well as longitudinal study designs for the evaluation of long-term impact and program sustainability.
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Affiliation(s)
- Juliana Chen
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Alyse Davies
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Phyllis Tran
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ryley Gronau
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Anna Rangan
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Shelina Porykali
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia
| | - Robin Oge
- National Capital District Provincial Health Authority, Port Moresby 121, Papua New Guinea
| | - Bobby Porykali
- Aboriginal and Torres Strait Islander Health Program, George Institute for Global Health, Sydney, NSW 2000, Australia
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia
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Birgel V, Decker L, Röding D, Walter U. Community capacity for prevention and health promotion: a scoping review on underlying domains and assessment methods. Syst Rev 2023; 12:147. [PMID: 37608344 PMCID: PMC10464111 DOI: 10.1186/s13643-023-02314-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 08/08/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND Building community capacity is an essential health promotion approach, which refers to the characteristics of communities that affect their ability to identify and address social and public health problems. Despite general agreement about certain capacity domains and frameworks, there is no comprehensive and consistent assessment of community capacity. Therefore, the aim of this scoping review is to identify the domains and methods used to assess community capacity related to community-based prevention and health promotion. METHODS A scoping search was performed on 06/02/2022 via PubMed, Web of Science, and Science Direct, with supplemental searches via Google Scholar. The review included studies published in English from 1990 to 2022 that explicitly described how community capacity was assessed in health promotion and prevention interventions. Furthermore, studies had to meet at least two of the three following criteria for capacity assessment: a theoretical foundation, a participatory approach, or a field test of the assessment tool. RESULTS From 4779 records, 38 studies were included after applying exclusion criteria. Nineteen studies used mixed, eleven qualitative and eight quantitative methods to assess community capacity. The various domains used to assess community capacity were identified and reassembled into nine comprehensive domains: community participation, knowledge and skills, resources, leadership, community power, sense of community, collaboration, critical awareness and problem-solving, and community structure. The review also identified four sub-domains, which include commitment, communication, shared values and goals, and sustainability. DISCUSSION This scoping review provides an overview of the domains and methods used to assess community capacity, which can facilitate the development of a comprehensive approach to capacity assessment in future research.
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Affiliation(s)
- Vera Birgel
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, Hannover, 30625, Germany.
| | - Lea Decker
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Dominik Röding
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
| | - Ulla Walter
- Hannover Medical School, Institute for Epidemiology, Social Medicine and Health System Research, Carl-Neuberg-Str. 1, Hannover, 30625, Germany
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Martin E, Snowdon W, Moadsiri A, Volavola S, Bell C. Pacific Healthy Islands Vision: success factors and challenges faced by health promotion programs. Health Promot Int 2023; 38:daac002. [PMID: 35700446 PMCID: PMC10269115 DOI: 10.1093/heapro/daac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The World Health Organization's (WHO) Western Pacific Regional Office developed the biennial Healthy Islands Recognition Awards (HIA) in 2009 to reinforce the Healthy Islands vision and encourage countries to continue to innovate and demonstrate effective and efficient ways of promoting and protecting population health. This research aimed to identify characteristics of and challenges for successful health promotion in the Pacific. The research was undertaken to develop practical guidance for other groups in the Pacific Islands interested in supporting Healthy Islands. We used a qualitative case study to review 2013 and 2015 HIA awardees from eight Pacific Island countries and territories using a set of questions drawn from the HIA application criteria. In 2015-2016, 35 key informant interviews and a review of program documents were undertaken. This was followed by a workshop with representatives from three HIA awardees to further develop recommendations. We reviewed eight programs targeting healthy eating, physical activity, healthy settings and sanitation. Using evidence, careful planning, building capacity, developing partnerships, strengthening and reorientating networks, ensuring accountability and conducting evaluation were keys to the success of healthy islands projects. Considering the local setting and community was perhaps the most crucial theme amongst the programs examined. Challenges included funding and capacity constraints, maintaining commitment and prioritisation, maintaining communication and coordination and technical challenges. Success factors, challenges and recommendations aligned well with mainstream health promotion literature, although some important distinctions exist. Further research is needed to guide successful health promotion practice in the Pacific.
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Affiliation(s)
- Erik Martin
- School of Medicine, Deakin University, Geelong, Australia
| | - Wendy Snowdon
- Division of Pacific Technical Support, World Health Organization, Suva, Fiji
| | - Ada Moadsiri
- Division of Pacific Technical Support, World Health Organization, Suva, Fiji
| | - Saula Volavola
- Division of Pacific Technical Support, World Health Organization, Suva, Fiji
| | - Colin Bell
- School of Medicine, Deakin University, Geelong, Australia
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Peralta LR, Cinelli RL, Cotton W, Morris S, Galy O, Caillaud C. The Barriers to and Facilitators of Physical Activity and Sport for Oceania with Non-European, Non-Asian (ONENA) Ancestry Children and Adolescents: A Mixed Studies Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11554. [PMID: 36141832 PMCID: PMC9517198 DOI: 10.3390/ijerph191811554] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/09/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Participation in sport and physical activity (PA) leads to better overall health, increased life expectancy, and decreased mortality rates across the lifespan; however, there may be a range of individual, family, and community factors that influence PA participation among ONENA children and adolescents residing in the 22 Pacific Island Countries and Territories (PICT) and Australia. This review aimed to synthesise existing quantitative and qualitative literature regarding barriers to and facilitators of PA and sport among ONENA youth. METHODS The literature was systematically searched to include studies reporting barriers to and facilitators of PA and sports participation among ONENA children and adolescents aged 0-18 years residing in the 22 PICT and Australia. Using a pre-established taxonomy based on the social-ecological model, a deductive analysis was performed. Quality appraisal was performed using the mixed methods appraisal tool. RESULTS Of 1388 articles, 14 studies were included, with 128 ONENA children and adolescent participants across the four qualitative studies; 156,581 ONENA children and adolescents across the seven quantitative studies; 801 parents, children, and adolescents in one quantitative study; and 642 parents in two quantitative studies. Of the 14 included studies, none were based in Australia and only 10 of the 22 PICT were reported as the participants' residence: Palau, New Zealand, Tonga, Cook Islands, Kiribati, Samoa, Solomon Islands, Tuvalu, Vanuatu, and Fiji. Four studies reported barriers, and another four studies reported facilitators of PA and sport, with the remaining studies reporting both barriers and facilitators. Overall, there were more barriers reported (30 in total) than facilitators (27 in total). CONCLUSIONS Research in this area is lacking, with ONENA youth living in Australia and 12 PICT not represented. Overall, there were a larger number of facilitators experienced at individual and interpersonal levels, while barriers were highest at the community level, with the policy level having facilitators and barriers equally represented. Programs that offer PA and sport participation options with embedded SDT-informed strategies for all family members; that are accessible through existing transport and related social, cultural, and physical infrastructure; and that are committed to communities through formal co-design partnerships are needed, to enhance the PA and sport participation of ONENA youth residing in PICT.
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Affiliation(s)
- Louisa R. Peralta
- School of Education and Social Work, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Renata L. Cinelli
- Faculty of Education and Arts, Australian Catholic University, Strathfield, NSW 2135, Australia
| | - Wayne Cotton
- School of Education and Social Work, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Sarah Morris
- Sydney Conservatorium of Music, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, NSW 2006, Australia
| | - Olivier Galy
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- Interdisciplinary Laboratory for Research in Education, University of New Caledonia, Nouméa 98800, New Caledonia
| | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- Faculty of Medicine & Health, The University of Sydney, Sydney, NSW 2006, Australia
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Essay AM, Schlechter CR, Mershon CA, Fial AV, Ellison J, Rosenkranz RR, Dzewaltowski DA. A scoping review of whole-of-community interventions on six modifiable cancer prevention risk factors in youth: A systems typology. Prev Med 2021; 153:106769. [PMID: 34416222 DOI: 10.1016/j.ypmed.2021.106769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/09/2021] [Accepted: 08/15/2021] [Indexed: 12/28/2022]
Abstract
Whole-of-community interventions delivered across entire geospatial areas show promise for improving population health for youth cancer prevention. The aims of this scoping review were to synthesize the whole-of-community intervention literature on six modifiable risk factors in youth for cancer prevention (alcohol use, diet, obesity, physical activity, sun exposure, tobacco use) and to develop and apply a typology describing the inclusion of fundamental control system functional characteristics. A systematic search was conducted in PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus for studies published to the end of 2019. Eligible studies included a geospatially defined whole-of-community intervention; youth 0-18 years; and at least one of the six cancer risk factor outcomes. An iterative process was undertaken to create a typology describing the functions for whole-of-community interventions guided by systems theory, and the typology was used to code the included interventions. A total of 41 interventions were included. Most interventions (43.9%) assessed multiple cancer risk factors. Few interventions provided fundamental functions necessary for community system coordination: sensor, controller, effector. Although communities are a patchwork quilt of microsystems where individuals interact in geographically bounded places nested within larger whole systems of influence, a control systems approach has not been used to frame the literature. Whole-of-community interventions can be characterized by the fundamental system functions necessary for coordinating population health improvement. Future whole-of-community intervention efforts should draw on fundamental knowledge of how systems operate and test whether adoption of the key functions is necessary for whole-of-community population health improvement.
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Affiliation(s)
- Ann M Essay
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA.
| | - Chelsey R Schlechter
- Department of Population Health Sciences, Huntsman Cancer Institute, Center for Health Outcomes and Population Equity (HOPE), University of Utah, 2000 Cir of Hope Dr, Salt Lake City, UT 84112, USA.
| | - Carrie A Mershon
- Department of Kinesiology, Kansas State University, Natatorium 8, 920 Denison Ave, Manhattan, KS 66506, USA.
| | - Alissa V Fial
- Raynor Memorial Libraries, Marquette University, 1355 W Wisconsin Ave, Milwaukee, WI 53233, USA.
| | - Jennie Ellison
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA
| | - Richard R Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 245 Justin Hall, 1324 Lovers Lane, Manhattan, KS 66506, USA.
| | - David A Dzewaltowski
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE 68198-4365, USA.
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Beckerman-Hsu JP, Aftosmes-Tobio A, Gavarkovs A, Kitos N, Figueroa R, Kalyoncu ZB, Lansburg K, Yu X, Kazik C, Vigilante A, Leonard J, Torrico M, Jurkowski JM, Davison KK. Communities for Healthy Living (CHL) A Community-based Intervention to Prevent Obesity in Low-Income Preschool Children: Process Evaluation Protocol. Trials 2020; 21:674. [PMID: 32703293 PMCID: PMC7376736 DOI: 10.1186/s13063-020-04571-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Process evaluation can illuminate barriers and facilitators to intervention implementation as well as the drivers of intervention outcomes. However, few obesity intervention studies have documented process evaluation methods and results. Community-based participatory research (CBPR) requires that process evaluation methods be developed to (a) prioritize community members' power to adapt the program to local needs over strict adherence to intervention protocols, (b) share process evaluation data with implementers to maximize benefit to participants, and (c) ensure partner organizations are not overburdened. Co-designed with low-income parents using CBPR, Communities for Healthy Living (CHL) is a family-centered intervention implemented within Head Start to prevent childhood obesity and promote family well-being. We are currently undertaking a randomized controlled trial to test the effectiveness of CHL in 23 Head Start centers in the greater Boston area. In this protocol paper, we outline an embedded process evaluation designed to monitor intervention adherence and adaptation, support ongoing quality improvement, and examine contextual factors that may moderate intervention implementation and/or effectiveness. METHODS This mixed methods process evaluation was developed using the Pérez et al. framework for evaluating adaptive interventions and is reported following guidelines outlined by Grant et al. Trained research assistants will conduct structured observations of intervention sessions. Intervention facilitators and recipients, along with Head Start staff, will complete surveys and semi-structured interviews. De-identified data for all eligible children and families will be extracted from Head Start administrative records. Qualitative data will be analyzed thematically. Quantitative and qualitative data will be integrated using triangulation methods to assess intervention adherence, monitor adaptations, and identify moderators of intervention implementation and effectiveness. DISCUSSION A diverse set of quantitative and qualitative data sources are employed to fully characterize CHL implementation. Simultaneously, CHL's process evaluation will provide a case study on strategies to address the challenges of process evaluation for CBPR interventions. Results from this process evaluation will help to explain variation in intervention implementation and outcomes across Head Start programs, support CHL sustainability and future scale-up, and provide guidance for future complex interventions developed using CBPR. TRIAL REGISTRATION ClinicalTrials.gov, NCT03334669 . Registered on October 10, 2017.
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Affiliation(s)
- Jacob P Beckerman-Hsu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA
| | - Alyssa Aftosmes-Tobio
- Boston College School of Social Work, McGuinn Hall Room 115, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA
| | - Adam Gavarkovs
- Institute of Health Policy, Management and Evaluation & Wilson Centre, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Nicole Kitos
- Massachusetts Department of Public Health, Boston, MA, 02115, USA
| | - Roger Figueroa
- Division of Nutritional Sciences, Cornell University, 244 Garden Ave, Ithaca, NY, 14853, USA
| | - Z Begum Kalyoncu
- Nutrition and Dietetics Department, Atilim University, Kizilcasar Mahallesi, Incek Golbasi, 06830, Ankara, Turkey
| | - Kindra Lansburg
- Action for Boston Community Development, 178 Tremont Street, Boston, MA, 02111, USA
| | - Xinting Yu
- Departments of Medicine, Brigham and Women's Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02115, USA
| | - Crystal Kazik
- Community Action Agency of Somerville, 66 Union Square, Somerville, MA, 02143, USA
| | - Adrienne Vigilante
- Community Action Agency of Somerville, 66 Union Square, Somerville, MA, 02143, USA
| | - Jessie Leonard
- Community Action Agency of Somerville, 66 Union Square, Somerville, MA, 02143, USA
| | - Merieka Torrico
- Action for Boston Community Development, 178 Tremont Street, Boston, MA, 02111, USA
| | - Janine M Jurkowski
- Department of Health Policy, Management & Behavior, University at Albany School of Public Health, 1 University Place, Rensselaer, NY, 12144, USA
| | - Kirsten K Davison
- Boston College School of Social Work, McGuinn Hall Room 115, 140 Commonwealth Ave, Chestnut Hill, MA, 02467, USA.
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van Herwerden LA, Palermo C, Reidlinger DP. Capacity assessment in public health community interventions: a systematic review. Health Promot Int 2020; 34:e84-e93. [PMID: 30212870 DOI: 10.1093/heapro/day071] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The importance of building capacity in community interventions is well recognized. There is general agreement about the determinants of capacity and a range of existing capacity frameworks, however there is limited evidence or consistency in practice around assessing capacity in community interventions. The aim of this review was to describe how capacity is assessed in community interventions. A systematic review of the literature across four databases (MEDLINE, CINAHL, PsycINFO and Sociological Abstracts) was performed. Studies in English from 2000 to 2017, that explicitly described how capacity building processes were assessed in community interventions in healthy populations, were included. All types of empirical study designs were eligible. From 2596 records, after exclusion criteria were applied, 19 studies were included describing 12 different capacity assessment frameworks or tools. Seventeen studies assessed capacity processes by measuring individual capacity domains in community interventions. The most common capacity domains used to assess capacity were leadership, resources, partnerships and intelligence. The majority (n = 15) of studies used qualitative or mixed methods designs to measure capacity. Nine studies assessed capacity prospectively over time; three before/after and six multiple times during the intervention. Five studies assessed capacity retrospectively. The findings suggest that capacity assessment may need to remain context specific and flexible in order to capture the ever-changing nature of capacity building over time. Future research should explore the utility of theoretical adaptive capacity assessment guidelines that direct researchers and practitioners when describing capacity assessment in community interventions.
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Affiliation(s)
- Louise A van Herwerden
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Claire Palermo
- Department of Nutrition, Dietetics and Food, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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de Medeiros ER, Rebouças DGDC, Paiva ACDS, do Nascimento CPA, Silva SYBE, Pinto ESG. Studies evaluating of health interventions at schools: an integrative literature review. Rev Lat Am Enfermagem 2018; 26:e3008. [PMID: 30020339 PMCID: PMC6053286 DOI: 10.1590/1518-8345.2463.3008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 01/04/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to identify and analyze the available evidence on the strategies used in the studies evaluating health interventions at school. METHOD this is an integrative review searching in LILACS, CINAHL, CUIDEN, ScienceDirect, and PubMed. From the pre-defined inclusion and exclusion criteria, there were 121 articles chosen to compose the sample. RESULTS english studies (97.5%), with a quantitative approach (80.2%), related to the interventions carried out in the Region of the Americas (54.6%) and the European Region (23.1%) predominated. For the most part, they are interventions as programs (70.2%), interested in evaluating results (73.5%) from the value judgment (83.4%). Prevalence of interventions focused on efficacy, effects or impact, and activities carried out on interventions were focused on physical activity, healthy eating, sexual and reproductive health, mental health, and use of tobacco, alcohol, and other drugs. They are worked through activities of clinical monitoring, health promotion and disease prevention. CONCLUSION the evidence indicates that the evaluations of health interventions in the school focus the results produced in programs through the judgment of value. The topics most addressed were healthy eating, physical activity, prevention of alcohol and other drugs, among others.
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Affiliation(s)
- Eliabe Rodrigues de Medeiros
- Doctoral student, Departamento de Enfermagem, Universidade Federal
do Rio Grande do Norte, Natal, RN, Brazil. Bolsista do Conselho Nacional de
Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Danielle Gonçalves da Cruz Rebouças
- Cardiology and Hemodynamics Specialist, Specialization student in
Public Health: Oncology Nursing, Escola da Assembleia Legislativa do Rio Grande do
Norte, Natal, RN, Brazil
| | - Alany Carla de Sousa Paiva
- Occupational Health Nursing Specialist, Specialization student in
Higher Education Teaching, Escola de Saúde, Universidade Potiguar, Natal, RN,
Brazil
| | - Camila Priscila Abdias do Nascimento
- Emergency and Trauma Nursing Specialist, Specialization student in
Public Health, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP,
Brazil
| | | | - Erika Simone Galvão Pinto
- PhD, Professor Adjunto, Departamento de Enfermagem, Universidade
Federal do Rio Grande do Norte, Natal, RN, Brazil
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Tackling the Consumption of High Sugar Products among Children and Adolescents in the Pacific Islands: Implications for Future Research. Healthcare (Basel) 2018; 6:healthcare6030081. [PMID: 30002327 PMCID: PMC6163880 DOI: 10.3390/healthcare6030081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 07/04/2018] [Accepted: 07/11/2018] [Indexed: 12/17/2022] Open
Abstract
The Pacific Islands are experiencing an obesity epidemic with a rate of overweight and obesity as high as 80% among adults in some Pacific Island nations. Children and adolescents in the region are also affected by overweight and obesity, which is alarming due to the increased likelihood of remaining overweight as an adult. Research supports an association between poor diet and an increased risk of obesity and development of non-communicable diseases (NCDs). Excess consumption of free sugars is associated with poorer overall diet quality and increased risk of weight gain, chronic inflammation and dental caries. Traditional diets in the Pacific Islands are being supplemented with processed, high-sugar foods and beverages; thus, there is a clear need for effective interventions promoting positive dietary behaviors in the region. School and community based interventions offer an opportunity to promote positive behavior change among children and adolescents. This review aims to evaluate interventions targeting the consumption of high-sugar products in this population in the Pacific Islands.
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Implementation and scale up of population physical activity interventions for clinical and community settings: the PRACTIS guide. Int J Behav Nutr Phys Act 2018; 15:51. [PMID: 29884236 PMCID: PMC5994105 DOI: 10.1186/s12966-018-0678-0] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/15/2018] [Indexed: 01/07/2023] Open
Abstract
Background Few efficacious physical activity interventions are successfully translated and sustained in practice. We propose a practical guide for researchers to increase the likelihood of successful implementation and scale up of physical activity interventions in practice contexts. The guide is based on two principles: (i) differences between the research and practice context can be addressed during intervention development and implementation planning by focusing on system, delivery personnel, and intervention characteristics; and (ii) early planning for implementation barriers and facilitators can improve subsequent translation into practice. Methods From the published literature, we identified evidence of strategies to improve research-practice translation, along with narrative descriptions of different approaches to addressing translational challenges. These, along with constructs taken from widely cited implementation outcome, process, and mechanistic models were collated and inform the guide. Results The resultant PRACTIS guide (PRACTical planning for Implementation and Scale-up) comprised the following four iterative steps: Step 1) Characterize the parameters of the implementation setting; Step 2) Identify and engage key stakeholders across multiple levels within the delivery system(s); Step 3) Identify contextual barriers and facilitators to implementation, and; Step 4) Address potential barriers to effective implementation. Conclusions A lack of practical guidance for researchers on how to effectively plan implementation and scale up of physical activity interventions prevents us moving quickly from evidence to action. We recommend that intervention development and adaptation for broad and sustained implementation be prioritized early in intervention planning and include active engagement from delivery organizations and stakeholders. The PRACTIS guide is also relevant for clinical and public health researchers in other areas of prevention. Electronic supplementary material The online version of this article (10.1186/s12966-018-0678-0) contains supplementary material, which is available to authorized users.
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Whelan J, Love P, Millar L, Allender S, Bell C. Sustaining obesity prevention in communities: a systematic narrative synthesis review. Obes Rev 2018; 19:839-851. [PMID: 29603583 DOI: 10.1111/obr.12675] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/04/2018] [Accepted: 01/09/2018] [Indexed: 01/01/2023]
Abstract
Obesity is a global problem for which sustainable solutions are yet to be realized. Community-based interventions have improved obesity-related behaviours and obesity in the short term. Few papers have explored how to make the interventions and their intended outcomes sustainable. The aim of this paper is to identify factors that contribute to the sustainability of community-based obesity prevention interventions and their intended outcomes. A systematic narrative synthesis review was conducted of published community-based obesity prevention interventions to identify factors contributing to intervention sustainability. Data extracted were included study authors' perspectives of intervention success and sustainability. Eighty-one papers met the inclusion criteria, and from these we identified ten factors that contribute to sustainability: resourcing, leadership, workforce development, community engagement, partnerships, policy, communications, adaptability, evaluation and governance. This review of community-based obesity prevention interventions gives rise to optimism that sustainable change is possible. We propose a framework to help practitioners build sustainability into their interventions and report on them so that others can also benefit.
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Affiliation(s)
- J Whelan
- Deakin University, Geelong, Australia, Global Obesity Centre, School of Medicine
| | - P Love
- Deakin University, Geelong, Australia, School of Exercise and Nutrition Sciences
| | - L Millar
- Victoria University, Melbourne, Australia, Australian Health Policy Collaboration
| | - S Allender
- Deakin University, Geelong, Australia, Global Obesity Centre, School of Health and Social Development
| | - C Bell
- Deakin University, Geelong, Australia, Global Obesity Centre, School of Medicine
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12
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Webster J, Pillay A, Suku A, Gohil P, Santos JA, Schultz J, Wate J, Trieu K, Hope S, Snowdon W, Moodie M, Jan S, Bell C. Process Evaluation and Costing of a Multifaceted Population-Wide Intervention to Reduce Salt Consumption in Fiji. Nutrients 2018; 10:nu10020155. [PMID: 29385758 PMCID: PMC5852731 DOI: 10.3390/nu10020155] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 01/08/2023] Open
Abstract
This paper reports the process evaluation and costing of a national salt reduction intervention in Fiji. The population-wide intervention included engaging food industry to reduce salt in foods, strategic health communication and a hospital program. The evaluation showed a 1.4 g/day drop in salt intake from the 11.7 g/day at baseline; however, this was not statistically significant. To better understand intervention implementation, we collated data to assess intervention fidelity, reach, context and costs. Government and management changes affected intervention implementation, meaning fidelity was relatively low. There was no active mechanism for ensuring food companies adhered to the voluntary salt reduction targets. Communication activities had wide reach but most activities were one-off, meaning the overall dose was low and impact on behavior limited. Intervention costs were moderate (FJD $277,410 or $0.31 per person) but the strategy relied on multi-sector action which was not fully operationalised. The cyclone also delayed monitoring and likely impacted the results. However, 73% of people surveyed had heard about the campaign and salt reduction policies have been mainstreamed into government programs. Longer-term monitoring of salt intake is planned through future surveys and lessons from this process evaluation will be used to inform future strategies in the Pacific Islands and globally.
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MESH Headings
- Costs and Cost Analysis
- Cyclonic Storms
- Diet, Healthy/economics
- Diet, Healthy/ethnology
- Diet, Sodium-Restricted/economics
- Diet, Sodium-Restricted/ethnology
- Fast Foods/adverse effects
- Fast Foods/analysis
- Fast Foods/economics
- Fiji
- Focus Groups
- Food Industry/economics
- Food, Preserved/adverse effects
- Food, Preserved/analysis
- Food, Preserved/economics
- Health Knowledge, Attitudes, Practice/ethnology
- Health Plan Implementation/economics
- Health Promotion/economics
- Humans
- Hypertension/economics
- Hypertension/ethnology
- Hypertension/etiology
- Hypertension/prevention & control
- Information Dissemination
- Nutrition Surveys/economics
- Patient Compliance/ethnology
- Program Evaluation
- Public-Private Sector Partnerships/economics
- Sodium Chloride, Dietary/adverse effects
- Sodium Chloride, Dietary/analysis
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Affiliation(s)
- Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
- School of Public Health, the University of Sydney, Sydney, NSW 2006, Australia.
| | - Arti Pillay
- Pacific Research Centre for the Prevention of Obesity and Noncommunicable Diseases (C-POND), Fiji National University, Nasinu, Fiji.
| | - Arleen Suku
- Pacific Research Centre for the Prevention of Obesity and Noncommunicable Diseases (C-POND), Fiji National University, Nasinu, Fiji.
| | - Paayal Gohil
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
- School of Public Health, the University of Sydney, Sydney, NSW 2006, Australia.
| | | | - Jillian Wate
- Pacific Research Centre for the Prevention of Obesity and Noncommunicable Diseases (C-POND), Fiji National University, Nasinu, Fiji.
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
- School of Public Health, the University of Sydney, Sydney, NSW 2006, Australia.
| | - Silvia Hope
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia.
| | - Wendy Snowdon
- Global Obesity Centre, Deakin University, Geelong, VIC 3216, Australia.
| | - Marj Moodie
- Deakin Health Economics, Centre for Population Health Research, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia.
- Global Obesity Centre, Deakin University, Geelong, VIC 3216, Australia.
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Colin Bell
- Global Obesity Centre, Deakin University, Geelong, VIC 3216, Australia.
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13
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van der Kleij RMJJ, Crone MR, Reis R, Paulussen TGWM. Critical stakeholder determinants to the implementation of intersectoral community approaches targeting childhood obesity. HEALTH EDUCATION RESEARCH 2016; 31:697-715. [PMID: 27923861 DOI: 10.1093/her/cyw047] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 09/23/2016] [Indexed: 06/06/2023]
Abstract
Several intersectoral community approaches targeting childhood obesity (IACOs) have been launched in the Netherlands. Translation of these approaches into practice is however arduous and implementation. We therefore studied the implementation of five IACOs in the Netherlands for one-and-a-half years. IACO implementation was evaluated via an adapted version of the MIDI questionnaire, consisting of 18 theory-based constructs. A response rate of 62% was obtained. A hierarchical multivariate linear regression model was used to analyse our data; the final regression model predicted 65% of the variance in adherence. Higher levels of self-efficacy, being an implementer embedded in community B, and having more than 1 year of experience with IACO implementation were associated with higher degrees of adherence. Formal ratification of implementation by management and being prescribed a higher number of activities were related to lower degrees of adherence. We advise that, when designing implementation strategies, emphasis should be placed on the enhancement of professionals' self-efficacy, limitation of the number of activities prescribed and allocation of sufficient time to get acquainted and experienced with IACO implementation. Longitudinal studies are needed to further evaluate interaction between and change within critical determinants while progressing through the innovation process.
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Affiliation(s)
- R M J J van der Kleij
- Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - M R Crone
- Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - R Reis
- Public Health and Primary Care, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
- Amsterdam Institute for Social Science Research, University of Amsterdam, The Netherlands
- The Children s Institute, School of Child and Adolescent Health, University of Cape Town, South Africa
| | - T G W M Paulussen
- Research Group Lifestyle, Netherlands Organisation for Applied Scientific Research, ZL, 2316 Leiden, The Netherlands
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14
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Ivanova O, Cordova-Pozo K, Segura ZE, Vega B, Chandra-Mouli V, Hindin MJ, Temmerman M, Decat P, De Meyer S, Michielsen K. Lessons learnt from the CERCA Project, a multicomponent intervention to promote adolescent sexual and reproductive health in three Latin America countries: a qualitative post-hoc evaluation. EVALUATION AND PROGRAM PLANNING 2016; 58:98-105. [PMID: 27347640 PMCID: PMC4987454 DOI: 10.1016/j.evalprogplan.2016.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 04/16/2016] [Accepted: 06/03/2016] [Indexed: 06/06/2023]
Abstract
The Community-Embedded Reproductive Health Care for Adolescents (CERCA) Project was implemented in Bolivia, Ecuador and Nicaragua (2011-2014) to test the effectiveness of interventions preventing teenage pregnancies. As the outcome evaluation showed limited impact, a post-hoc process evaluation was carried out to determine if and how CERCA's design, implementation, monitoring and evaluation affected the results. We did a document analysis and conducted 18 in-depth interviews and 21 focus group discussions with stakeholders and beneficiaries. Transcripts were analyzed using directed content analysis. Data showed that CERCA sensitized stakeholders and encouraged the discussion on this sensitive issue. In terms of design, a strong point was the participatory approach; a weak point was that the detailed situation analysis was completed too late. In terms of implementation, a strong point was that multifaceted activities were implemented; a weak point was that the activities were not pilot tested for feasibility/acceptability and evolved substantially throughout the Project. In terms of monitoring, strong points were that regular monitoring kept the Project on track administratively/financially; a weak point was that monitoring indicators did not change as the intervention package changed. In terms of evaluation, weak points were the substantial attrition rate and narrow focus on adolescents. This study provides recommendations for future projects.
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Affiliation(s)
- Olena Ivanova
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
| | | | | | - Bernardo Vega
- University of Cuenca (UC), Av. 12 de Abril y Agustín Cueva, Cuenca, Ecuador.
| | - Venkatraman Chandra-Mouli
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
| | - Michelle J Hindin
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
| | - Marleen Temmerman
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
| | - Peter Decat
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
| | - Sara De Meyer
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
| | - Kristien Michielsen
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
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15
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van der Kleij MR, Crone M, Reis R, Paulussen T. Unravelling the factors decisive to the implementation of EPODE-derived community approaches targeting childhood obesity: a longitudinal, multiple case study. Int J Behav Nutr Phys Act 2016; 13:98. [PMID: 27596066 PMCID: PMC5011896 DOI: 10.1186/s12966-016-0423-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 08/18/2016] [Indexed: 12/25/2022] Open
Abstract
Background Implementation of intersectoral community approaches often fails due to a translational gap between the approach as intended and the approach as implemented in practice. Knowledge about the implementation determinants of such approaches is needed to facilitate future implementation processes. Methods The implementation of five EPODE-derived intersectoral community approaches was studied longitudinally. Semi-structured interviews were held with 189 community stakeholders from four sectors to elucidate which determinants influenced implementation, and if an to which extent determinants differed across communities, sectors and over time. A framework approach was used to analyze our data. Results Twenty-two key determinants of implementation were identified. Facilitators named were mostly proximal (stakeholder level), and barriers were mostly distal (context level). Key determinants varied greatly across sectors and over time, especially between the educational & health care sector and the private, welfare & sports sector. Only ‘perceived importance of IACO goals’ was identified as an universal implementation facilitator. Conclusions Striking differences in determinants were found across sectors and over time. Also, stakeholders expressed that possibilities to adapt the approach to the local context were needed to improve implementation. We therefore propose to develop sector- and time specific leads for implementation, which should be approved and amended (over time) by stakeholders. This so-called ‘mutual adaptation’ allows for the use of both scientific insights and practice-based knowledge, enabling program management and community stakeholders to collaboratively improve their implementation efforts.
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Affiliation(s)
- Maria Rianne van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Postbus 9600 zone V-0-P, Leiden, 2300 RC, The Netherlands. .,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.
| | - Mathilde Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Postbus 9600 zone V-0-P, Leiden, 2300 RC, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands
| | - Ria Reis
- Department of Public Health and Primary Care, Leiden University Medical Center, Postbus 9600 zone V-0-P, Leiden, 2300 RC, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.,The Children's Institute, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.,Amsterdam Institute for Social Science Research, University of Amsterdam, Amsterdam, The Netherlands
| | - Theo Paulussen
- Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.,TNO Innovation for Life, Expertise Centre Child Health, Leiden, The Netherlands
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16
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van der Kleij R, Coster N, Verbiest M, van Assema P, Paulussen T, Reis R, Crone M. Implementation of intersectoral community approaches targeting childhood obesity: a systematic review. Obes Rev 2015; 16:454-72. [PMID: 25824957 DOI: 10.1111/obr.12273] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 01/19/2015] [Accepted: 02/05/2015] [Indexed: 10/23/2022]
Abstract
The implementation of intersectoral community approaches targeting childhood obesity (IACO) is considered challenging. To help overcome these challenges, an overview of the evidence to date is needed. We searched four databases to identify papers that reported on the determinants of successful implementation of IACOs, resulting in the inclusion of 25 studies. We appraised study quality with the Crowe Critical Appraisal Tool and the Quality Framework; reported implementation outcome indicators were reviewed via narrative synthesis. Quality of included studies varied. The most frequently reported indicators of implementation success were fidelity and coverage. Determinants related to the social-political context and the organization were most often cited as influencing implementation, in particular, 'collaboration between community partners', 'the availability of (human) resources' and 'time available for implementation'. The association between determinants and implementation variability was never explicated. We conclude that although some insights into the effective implementation of IACOs are present, more research is needed. Emphasis should be placed on elucidating the relationship between determinants and implementation success. Research should further focus on developing a 'golden standard' for evaluating and reporting on implementation research. These actions will improve the comparison of study outcomes and may constitute the cumulative development of knowledge about the conditions for designing evidence-based implementation strategies.
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Affiliation(s)
- R van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands
| | - N Coster
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - M Verbiest
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - P van Assema
- Department of Health Promotion, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - T Paulussen
- Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.,TNO Leiden, Leiden, The Netherlands
| | - R Reis
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands.,Amsterdam Institute for Social Science Research, University of Amsterdam, The Netherlands
| | - M Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.,Academic Workplace (AWP) Public Health Zuid-Holland Noord, Leiden, The Netherlands
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