Institute for Health Transformation, Global Centre for Preventive Health and Nutrition, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia.
National Centre of Implementation Science, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
PLoS One. 2024 May 2;19(5):e0302047. doi: 10.1371/journal.pone.0302047. eCollection 2024.
Over a quarter of children aged 2-17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods.
This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team.
By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria.
澳大利亚超过四分之一的 2-17 岁儿童超重或肥胖，而在偏远地区和农村地区的这一比例更高。系统思维方法旨在支持社区制定和实施针对肥胖环境、政治、社会文化和个体决定因素交织的、适合当地情况的解决方案，有潜力改善这一状况。然而，据报道，这些举措在实施方面存在挑战，通过纳入实施科学方法，可能会加强这些挑战。
本试验性随机对照试验方案概述了一种多组分实施策略（Action-RESPOND）的制定和拟议评估，旨在增加基于社区的系统思维儿童肥胖预防计划的实施。该干预的目标是维多利亚州东北部的十个农村和地区社区（或作为分配单位的地方政府区域），这些社区是全系统干预（RESPOND）的参与者。Action-RESPOND 以该干预为基础，通过评估向五个社区提供额外实施策略相对于常规护理的影响来进行。多组分实施策略的制定以促进健康服务实施研究行动（PARIHS）框架为指导，由七种实施策略组成，主要通过“促进”方法实施。实施策略旨在确保实施的举措是：i）基于证据，ii）满足社区的具体需求，iii）适合当地情况。这些策略还旨在通过以下方式提高社区的实施能力：iv）提高健康促进团队的实施知识和技能，v）培养领导力，vi）提供物质资源，vii）营造社区文化，以推动实施。将在基线和随访时使用社区内关键代表的调查和研究团队内部记录，评估策略的可行性、可接受性、潜在影响和成本。
通过利用现有的基于社区的全系统干预措施，Action-RESPOND 为收集有关如何在维多利亚州的农村和地区社区应用实施和系统科学方法来支持肥胖预防的试点可行性和早期经验数据提供了独特的机会。
