Frameworks for implementation of policies promoting healthy nutrition and physically active lifestyle: systematic review

International Journal of Behavioral Nutrition and Physical Activity

Krzysztof Kaczmarek¹  Piotr Romaniuk¹  Juergen M. Steinacker²  Daniel A. Scheller²  Janine Wendt²  Biljana Meshkovska³  Agnieszka Neumann-Podczaska⁴  Katarzyna Wieczorowska-Tobis⁴  Thomas Kubiak⁵  Marie Scheidmeir⁵  Sarah Forberger⁶  Hajo Zeeb⁶  Anna Banik⁷  Karolina Lobczowska⁷  Aleksandra Luszczynska⁸ 

[1] Department of Health Policy, School of Health Sciences in Bytom, Medical University of Silesia in Katowice, 18 Piekarska Street, PL41902, Bytom, Poland;Department of Internal Medicine, Division of Sports and Rehabilitation Medicine, University Hospital Ulm, Leimgrubenweg 14; D89075, Ulm, Germany;Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, PO Box 1046, Blindern, 0316, Oslo, Norway;Department of Palliative Medicine, Poznan University of Medical Sciences, Russa Street 55, PL61245, Poznan, Poland;Institute of Psychology, Johannes Gutenberg University Mainz, Binger Street 14-16, D55122, Mainz, Germany;Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achter Street 30, D28359, Bremen, Germany;Psychology Department in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, PL53238, Wroclaw, Poland;Psychology Department in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, PL53238, Wroclaw, Poland;Melbourne Centre for Behavior Change, Melbourne School of Psychological Sciences, University of Melbourne, Redmond Barry Building, Parkville Campus, 3010, Melbourne, VIC, Australia;

关键词: Theory;    Framework;    Policy;    Implementation;    Nutrition;    Diet;    Physical activity;    Sedentary behavior;    Systematic review;   

DOI  :  10.1186/s12966-021-01242-4

来源: Springer

【 摘 要 】

BackgroundPolicy frameworks focusing on policy implementation may vary in terms of their scope, included constructs, relationships between the constructs, and context factors. Although multiple policy implementation frameworks exist, the overarching synthesis characterizing differences between the frameworks is missing. This study investigated frameworks guiding implementation of policies aiming at healthy nutrition, physical activity promotion, and a reduction of sedentary behavior. In particular, we aimed at examining the scope of the frameworks and the content of included constructs (e.g., referring to implementation processes, determinants, or implementation evaluation), the level at which these constructs operate (e.g., the individual level, the organizational/community level), relationships between the constructs, and the inclusion of equity factors.MethodsA systematic review (the PROSPERO registration no. CRD42019133251) was conducted using 9 databases and 8 stakeholder websites. The content of 38 policy implementation frameworks was coded and analyzed.ResultsAcross the frameworks, 47.4% (18 in 38) addressed three aims: description of the process, determinants, and the evaluation of implementation. The majority of frameworks (65.8%; 25 in 38) accounted for constructs from three levels: individual, organizational/community, and the system level. System-level constructs were included less often (76.3%; 29 in 38) than individual-level or organizational/community-level constructs (86.8% [33 in 38 frameworks] and 94.7% [36 in 38 frameworks] respectively). The majority of frameworks (84.2%, 32 in 38) included at least some sections that were solely of descriptive character (a list of unassociated constructs); 50.0% (19 in 38) included sections of prescriptive character (general steps of implementation); 60.5% (23 in 38) accounted for explanatory sections (assuming bi- or uni-directorial associations). The complex system approach was accounted for only in 21.1% (8 in 38) of frameworks. More than half (55.3%; 21 in 38) of frameworks did not account for any equity constructs (e.g., socioeconomic status, culture).ConclusionsThe majority of policy implementation frameworks have two or three aims (combining processes, determinants and/or the evaluation of implementation), include multi-level constructs (although the system-level determinants are less frequently included than those from the individual- or organizational/community-level), combine sections of purely descriptive character with sections accounting for prescriptive and/or explanatory associations, and are likely to include a little or no equity constructs.RegistrationPROSPERO, #CRD42019133251.

【 授权许可】

CC BY