Lisa Williams J, Wallace Carolyn, Filipponi Teresa
Department of Community Nutrition and Dietetics, Cardiff and Vale University Health Board, Cardiff, UK.
Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK.
J Hum Nutr Diet. 2025 Feb;38(1):e70008. doi: 10.1111/jhn.70008.
Nutrition Skills for Life (NSFL) provides training and support for communities and organisations to implement Community Nutrition Interventions (CNIs) that meet identified needs. To inform future NSFL evaluation, this scoping review, using a realist approach sought to determine the underpinning initial programme theory (IPT) for how CNIs support socioeconomically disadvantaged (SED) communities to access a healthy diet, as detailed in the protocol doi.org/10.17605/OSF.IO/D56FK.OSF.IO/D56FK.
Reporting standards for realist syntheses (RAMESES) and scoping reviews (PRISMA-ScR) were used. Four electronic databases and grey literature were searched. Of the 1920 documents identified, 45 were included in the analysis. Data relating to Context, Mechanism and Outcomes were extracted and presented as C-M-O configurations (CMOCs). Documents were assessed for relevance to the research question and usefulness in terms of their contribution towards the IPT.
The IPT, underpinned by the Ottawa Charter for Health Promotion, comprises 17 consolidated CMOCs. These are narratively discussed as follows: understanding community needs; consistent nutrition messages; knowledgeable, skilled, confident practitioners/facilitators and practising new skills.
Realist research and analysis of CMOCs provided a deeper understanding of how CNIs can be implemented to support SED communities in accessing a healthy diet. Interventions 'worked' when they acknowledged and addressed identified barriers to healthy eating, provided reliable, trusted, easy-to-understand nutrition messages, were delivered by confident, knowledgeable practitioners, and facilitated strategies such as meal preparation. Further realist evaluation to refine the IPT could inform the evaluation of other complex public health interventions.
“生活营养技能”（NSFL）为社区和组织提供培训与支持，以实施满足特定需求的社区营养干预措施（CNIs）。为指导未来的NSFL评估，本范围综述采用现实主义方法，旨在确定CNIs如何支持社会经济弱势（SED）社区获取健康饮食的基础初始项目理论（IPT），详情见协议doi.org/10.17605/OSF.IO/D56FK.OSF.IO/D56FK。
采用现实主义综合报告标准（RAMESES）和范围综述报告标准（PRISMA-ScR）。检索了四个电子数据库和灰色文献。在识别出的1920篇文献中，45篇被纳入分析。提取了与背景、机制和结果相关的数据，并以C-M-O配置（CMOCs）呈现。评估文献与研究问题的相关性以及对IPT的贡献的有用性。
以《渥太华促进健康宪章》为基础的IPT包括17个整合的CMOCs。以下是对这些内容的叙述性讨论：了解社区需求；一致的营养信息；知识渊博、技能娴熟、自信的从业者/促进者以及实践新技能。
对CMOCs进行现实主义研究和分析，能更深入地理解如何实施CNIs以支持SED社区获取健康饮食。当干预措施承认并解决已确定的健康饮食障碍、提供可靠、可信且易于理解的营养信息、由自信且知识渊博的从业者实施，并促进诸如膳食准备等策略时，干预措施就能“发挥作用”。进一步进行现实主义评估以完善IPT，可为其他复杂公共卫生干预措施的评估提供参考。
