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

Prev Med

School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia; Hunter Medical Research Institute, Newcastle, New South Wales 2300, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, New South Wales 2308, Australia; Hunter New England Population Health, Wallsend, New South Wales 2287, Australia. Electronic address:

Published: January 2019

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.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ypmed.2018.11.014DOI Listing

Publication Analysis

Top Keywords

implementation
14
non-communicable disease
12
disease prevention
12
implementation outcomes
12
n = 8 20%
12
implementation trials
8
strategies improve
8
improve implementation
8
community settings
8
implementation strategies
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!