Meta-review of implementation determinants for policies promoting healthy diet and physically active lifestyle: application of the Consolidated Framework for Implementation Research

Implementation Science

Katarzyna Brukalo¹  Piotr Romaniuk¹  Juergen M. Steinacker²  Daniel A. Scheller²  Janine Wendt²  Katarzyna Wieczorowska-Tobis³  Anna Banik⁴  Karolina Lobczowska⁴  Aleksandra Luszczynska⁵  Thomas Kubiak⁶  Marie Scheidmeir⁶  Sarah Forberger⁷  Hajo Zeeb⁷  Marleen P. M. Bekker⁸ 

[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 Palliative Medicine, Poznan University of Medical Sciences, Russa Street 55, PL61245, Poznan, Poland;Department of Psychology in Wroclaw, SWPS University of Social Sciences and Humanities, Ostrowskiego Street 30b, PL53238, Wroclaw, Poland;Department of Psychology 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;Johannes Gutenberg University Mainz, Institute of Psychology, Binger Street 14-16, D55122, Mainz, Germany;Leibniz Institute for Prevention Research and Epidemiology – BIPS, Achter Street 30, D28359, Bremen, Germany;Wageningen University and Research, Health and Society Group, Center for Space, Place and Society, P.O. Box 8130, Bode 60, 6700 EW, Wageningen, the Netherlands;

关键词: Policy;    Implementation;    Diet;    Physical activity;    Sedentary behavior;    Barrier;    Facilitator;    Consolidated Framework For Implementation Research;   

DOI  :  10.1186/s13012-021-01176-2

来源: Springer

【 摘 要 】

BackgroundAlthough multiple systematic reviews indicate that various determinants (barriers and facilitators) occur in the implementation processes of policies promoting healthy diet, physical activity (PA), and sedentary behavior (SB) reduction, the overarching synthesis of such reviews is missing. Applying the Consolidated Framework for Implementation Research (CFIR), this meta-review aims to (1) identify determinants that were systematically indicated as occurring during the implementation processes and (2) identify differences in the presence of determinants across reviews versus stakeholder documents on healthy diet/PA/SB policies, reviews/stakeholder documents addressing healthy diet policies versus PA/SB policies targeting any population/setting, and healthy diet/PA/SB policies focusing on school settings.MethodsA meta-review of published systematic scoping or realist reviews (k = 25) and stakeholder documents (k = 17) was conducted. Data from nine bibliographic databases and documentation of nine major stakeholders were systematically searched. Included reviews (72%) and stakeholder documents (100%) provided qualitative synthesis of original research on implementation determinants of policies promoting healthy diet or PA or SB reduction, and 28% of reviews provided some quantitative synthesis. Determinants were considered strongly supported if they were indicated by ≥ 60.0% of included reviews/stakeholder documents.ResultsAcross the 26 CFIR-based implementation determinants, seven were supported by 66.7–76.2% of reviews/stakeholder documents. These determinants were cost, networking with other organizations/communities, external policies, structural characteristics of the setting, implementation climate, readiness for implementation, and knowledge/beliefs of involved individuals. Most frequently, published reviews provided support for inner setting and individual determinants, whereas stakeholder documents supported outer and inner setting implementation determinants. Comparisons between policies promoting healthy diet with PA/SB policies revealed shared support for only three implementation determinants: cost, implementation climate, and knowledge/beliefs. In the case of healthy diet/PA/SB policies targeting school settings, 14 out of 26 implementation determinants were strongly supported.ConclusionsThe strongly supported (i.e., systematically indicated) determinants may guide policymakers and researchers who need to prioritize potential implementation determinants when planning and monitoring the implementation of respective policies. Future research should quantitatively assess the importance or role of determinants and test investigate associations between determinants and progress of implementation processes.Trial registrationPROSPERO, #CRD42019133341

【 授权许可】

CC BY