From trials to communities: implementation and scale-up of health behaviour interventions

Health Research Policy and Systems

Research

Heather McKay¹  Sharleen Gonzalez²  Sam McCrabb³  Luke Wolfenden³  Alix Hall³  Rachel Sutherland³  Adrian Bauman⁴  Andrew Milat⁵ 

[1] Department of Family Practice, Faculty of Medicine, University of British Colombia, Vancouver, Canada;School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 2308, Callaghan, NSW, Australia;School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 2308, Callaghan, NSW, Australia;Hunter New England Population Health, Hunter New England Local Health District, Locked Bag 10, 2287, Wallsend, NSW, Australia;School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 2308, Callaghan, NSW, Australia;School of Public Health, University of Sydney, 2006, Sydney, NSW, Australia;School of Public Health, University of Sydney, 2006, Sydney, NSW, Australia;NSW Ministry of Health, St Leonards, NSW, Australia;

关键词: Public health intervention;    Implementation;    Scale-up;    Dissemination strategies;    Population health;    Adaptations;   

DOI  :  10.1186/s12961-023-01027-0

 received in 2021-08-04, accepted in 2023-07-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundTo maximise their potential benefits to communities, effective health behaviour interventions need to be implemented, ideally ‘at scale’, and are often adapted as part of this. To inform future implementation and scale-up efforts, this study broadly sought to understand (i) how often health behaviour interventions are implemented in communities, (ii) the adaptations that occur; (iii) how frequency it occurred ‘at scale’; and (iv) factors associated with ‘scale-up’.MethodsA cross-sectional survey was conducted of corresponding authors of trials (randomised or non-randomised) assessing the effects of preventive health behaviour interventions. Included studies of relevant Cochrane reviews served as a sampling frame. Participants were asked to report on the implementation and scale-up (defined as investment in large scale delivery by a (non)government organisation) of their intervention in the community following trial completion, adaptations made, and any research dissemination strategies employed. Information was extracted from published reports of the trial including assessments of effectiveness and risk of bias.ResultsAuthors of 104 trials completed the survey. Almost half of the interventions were implemented following trial completion (taking on average 19 months), and 54% of those were adapted prior to doing so. The most common adaptations were adding intervention components, and adapting the intervention to fit within the local service setting. Scale-up occurred in 33% of all interventions. There were no significant associations between research trial characteristics such as intervention effectiveness, risk of bias, setting, involvement of end-user, and incidence of scale-up. However the number of research dissemination strategies was positively associated to the odds of an intervention being scaled-up (OR = 1.50; 95% CI: 1.19, 1.88; p < 0.001).ConclusionsAdaptation of implemented trials is often undertaken. Most health behaviour interventions are not implemented or scaled-up following trial completion. The use of a greater number of dissemination strategies may increase the likelihood of scaled up.

【 授权许可】

CC BY   
© The Author(s) 2023

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