TY - JOUR
T1 - Identifying opportunities to develop the science of implementation for community-based non-communicable disease prevention
T2 - A review of implementation trials
AU - Wolfenden, Luke
AU - Reilly, Kathryn
AU - Kingsland, Melanie
AU - Grady, Alice
AU - Williams, Christopher M.
AU - Nathan, Nicole
AU - Sutherland, Rachel
AU - Wiggers, John
AU - Jones, Jannah
AU - Hodder, Rebecca
AU - Finch, Meghan
AU - McFadyen, Tameka
AU - Bauman, Adrian
AU - Rissel, Chris
AU - Milat, Andrew
AU - Swindle, Taren
AU - Yoong, Sze Lin
PY - 2019/1
Y1 - 2019/1
N2 - 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.
AB - 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.
KW - Community settings
KW - Implementation
KW - Non-communicable diseases
KW - Prevention
UR - http://www.scopus.com/inward/record.url?scp=85056989567&partnerID=8YFLogxK
U2 - 10.1016/j.ypmed.2018.11.014
DO - 10.1016/j.ypmed.2018.11.014
M3 - Review article
C2 - 30468794
AN - SCOPUS:85056989567
VL - 118
SP - 279
EP - 285
JO - Preventive Medicine
JF - Preventive Medicine
SN - 0091-7435
ER -