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Barnes C, Jones J, Wolfenden L, Robertson K, Seidler AL, Norman J, Budgen P, Mattingly M, Piliskic C, Moorhouse L, Mozina J, Plaskett J, McDermott S, Darney S, Vuong C, Douglass N, McDonnell K, Sutherland R. A collaborative network trial to evaluate the effectiveness of implementation strategies to maximize adoption of a school-based healthy lunchbox program: a study protocol. Front Public Health 2024; 12:1367017. [PMID: 38601495 PMCID: PMC11004312 DOI: 10.3389/fpubh.2024.1367017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 03/12/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction An important impediment to the large-scale adoption of evidence-based school nutrition interventions is the lack of evidence on effective strategies to implement them. This paper describes the protocol for a "Collaborative Network Trial" to support the simultaneous testing of different strategies undertaken by New South Wales Local Health Districts to facilitate the adoption of an effective school-based healthy lunchbox program ('SWAP IT'). The primary objective of this study is to assess the effectiveness of different implementation strategies to increase school adoption of the SWAP across New South Wales Local Health Districts. Methods Within a Master Protocol framework, a collaborative network trial will be undertaken. Independent randomized controlled trials to test implementation strategies to increase school adoption of SWAP IT within primary schools in 10 different New South Wales Local Health Districts will occur. Schools will be randomly allocated to either the intervention or control condition. Schools allocated to the intervention group will receive a combination of implementation strategies. Across the 10 participating Local Health Districts, six broad strategies were developed and combinations of these strategies will be executed over a 6 month period. In six districts an active comparison group (containing one or more implementation strategies) was selected. The primary outcome of the trial will be adoption of SWAP IT, assessed via electronic registration records captured automatically following online school registration to the program. The primary outcome will be assessed using logistic regression analyses for each trial. Individual participant data component network meta-analysis, under a Bayesian framework, will be used to explore strategy-covariate interactions; to model additive main effects (separate effects for each component of an implementation strategy); two way interactions (synergistic/antagonistic effects of components), and full interactions. Discussion The study will provide rigorous evidence of the effects of a variety of implementation strategies, employed in different contexts, on the adoption of a school-based healthy lunchbox program at scale. Importantly, it will also provide evidence as to whether health service-centered, collaborative research models can rapidly generate new knowledge and yield health service improvements. Clinical trial registration This trial is registered prospectively with the Australian New Zealand Clinical Trials Registry (ACTRN12623000558628).
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Affiliation(s)
- Courtney Barnes
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Jannah Jones
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Katie Robertson
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
| | - Anna Lene Seidler
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
| | - Jennifer Norman
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
- School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, NSW, Australia
| | - Pip Budgen
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Warrawong, NSW, Australia
| | - Megan Mattingly
- Health Promotion, Murrumbidgee Local Health District, Albury, NSW, Australia
| | - Carla Piliskic
- Health Promotion Unit, Population Health, Nepean Blue Mountains Local Health District, Penrith, NSW, Australia
| | - Lisa Moorhouse
- Health Equity, Promotion and Prevention Service, South Eastern Sydney Local Health District, Darlinghurst, NSW, Australia
| | - Jennifer Mozina
- Population Health, Southern NSW Local Health District, Queanbeyan, NSW, Australia
| | - Jennifer Plaskett
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Sarah McDermott
- Centre for Population Health, Western Sydney Local Health District, North Parramatta, NSW, Australia
| | - Sara Darney
- Western NSW Health Promotion, Western NSW Local Health District, Dubbo, NSW, Australia
| | - Cecilia Vuong
- Health Promotion Service, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Nina Douglass
- Health Promotion Service, Central Coast Local Health District, Gosford, NSW, Australia
| | - Kara McDonnell
- Population Health Promotion, Northern Sydney Local Health District, Brookvale, NSW, Australia
| | - Rachel Sutherland
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- Population Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- National Centre of Implementation Science, University of Newcastle, Callaghan, NSW, Australia
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Elliott K, Norman J, Wardle K, Budgen P, Callahan H, Camilleri M, Romeo A, Trinh K, Okely A, Kariippanon KE. Feasibility, acceptability and potential efficacy of a virtual physical activity program in primary and secondary schools in New South Wales, Australia: A quasi-experimental study. Health Promot J Austr 2023; 34:70-84. [PMID: 36088579 PMCID: PMC10087342 DOI: 10.1002/hpja.662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 01/27/2023] Open
Abstract
ISSUE ADDRESSED Child and youth participation in physical activity (PA) is fundamental for healthy development and obesity prevention. Government policy requires schools to offer 150 minutes of PA each week, however compliance is low. Race around Australia (RAA) is a New South Wales (NSW) Department of Education, virtual PA program aimed at assisting schools in meeting the PA guidelines. METHODS A pre- and post-intervention, quasi-experimental study was conducted using a mixed-methods approach comprising teacher interviews, a student questionnaire and a 1.6 kilometre (km) timed run. Data were collected from April to September 2021 among students and teachers in Grades 5 to 8, from 10 schools in NSW, Australia. RESULTS The analytical sample included data from 918 students and 17 teachers. The RAA program was deemed feasible and acceptable in primary schools, whereas there were several systemic and intrapersonal barriers to implementation success for secondary schools. In primary schools, RAA increased PA opportunities and the 1.6 km timed runs revealed a statistically significant treatment by time effect in favour of the intervention group for cardiorespiratory fitness (-36.91 seconds, 95% CI [-63.14, -10.68], P = .006). CONCLUSIONS RAA has demonstrated feasibility and potential efficacy in improving cardiorespiratory fitness. We recommend that program refinement be made to deliver an intervention that addresses the unique barriers of the secondary school setting through a multi-level ecological approach. SO WHAT?: Despite evident benefits, implementation of PA initiatives in the school setting reveals many challenges. Stronger consideration of the Health Promotion with Schools Framework is evidently needed.
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Affiliation(s)
- Kayla Elliott
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jennifer Norman
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.,Health Promotion Service, Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, New South Wales, Australia.,School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Karen Wardle
- Health Promotion Service, South Western Sydney Local Health District, NSW Government Department of Health, Liverpool, Australia
| | - Pip Budgen
- Health Promotion Service, Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, New South Wales, Australia
| | - Hayley Callahan
- Health Promotion Service, Illawarra Shoalhaven Local Health District, NSW Health, Warrawong, New South Wales, Australia
| | - Michelle Camilleri
- Health Promotion Service, South Western Sydney Local Health District, NSW Government Department of Health, Liverpool, Australia
| | - Alannah Romeo
- Health Promotion Service, South Western Sydney Local Health District, NSW Government Department of Health, Liverpool, Australia
| | - Katie Trinh
- Health Promotion Branch, Wellbeing SA, Adelaide, South Australia, Australia
| | - Anthony Okely
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Katharina E Kariippanon
- Early Start, School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
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