Identifying opportunities to develop the science of implementation for community-based non-communicable disease prevention: A review of implementation trials

Luke Wolfenden, Kathryn Reilly, Melanie Kingsland, Alice Grady, Christopher M. Williams, Nicole Nathan, Rachel Sutherland, John Wiggers, Jannah Jones, Rebecca Hodder, Meghan Finch, Tameka McFadyen, Adrian Bauman, Chris Rissel, Andrew Milat, Taren Swindle, Sze Lin Yoong

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

Implementation of interventions in community organisations such as schools, childcare centres, and sporting clubs are recommended to target a range of modifiable risks of non-communicable diseases. Poor implementation, however, is common and has contributed to the failure of non-communicable disease interventions globally. This study aimed to characterise experimental research regarding strategies to improve implementation of chronic disease prevention programs in community settings. The review used data collected in three comprehensive systematic reviews undertaken between August 2015 and July 2017. Randomised controlled trials, including cluster design, and non-randomised trials with a parallel control group were included. The data were extracted to describe trial characteristics, implementation strategies employed, implementation outcomes and study quality. Of the 40 implementation trials included in the study, unhealthy diet was the most common risk factor targeted (n = 20). The most commonly reported implementation strategies were educational meetings (n = 38, 95%), educational materials (n = 36, 90%) and educational outreach visits (n = 29, 73%). Few trials were conducted ‘at-scale’ (n = 8, 20%) or reported adverse effects (n = 5, 13%). The reporting of implementation related outcomes; intervention adoption (n = 13, 33%); appropriateness (n = 11, 28%); acceptability (n = 8, 20%); feasibility (n = 8, 20%); cost (n = 3, 8%); and sustainability (n = 2, 5%); was limited. For the majority of trials, risk of bias was high for blinding of study personnel/participants and outcome assessors. Testing of strategies to improve implementation of non-communicable disease prevention strategies in community settings, delivered ‘at-scale’, utilising implementation frameworks, including a comprehensive range of implementation outcomes should be priority areas for future research in implementation science.

Original languageEnglish
Pages (from-to)279-285
Number of pages7
JournalPreventive Medicine
Volume118
DOIs
Publication statusPublished - Jan 2019
Externally publishedYes

Keywords

  • Community settings
  • Implementation
  • Non-communicable diseases
  • Prevention

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    Wolfenden, L., Reilly, K., Kingsland, M., Grady, A., Williams, C. M., Nathan, N., Sutherland, R., Wiggers, J., Jones, J., Hodder, R., Finch, M., McFadyen, T., Bauman, A., Rissel, C., Milat, A., Swindle, T., & Yoong, S. L. (2019). Identifying opportunities to develop the science of implementation for community-based non-communicable disease prevention: A review of implementation trials. Preventive Medicine, 118, 279-285. https://doi.org/10.1016/j.ypmed.2018.11.014