STREAM 4: ‘Optimising the Implementation of Interventions’

Executive Sponsors: Luke Wolfenden,  Adrian Bauman, Chris Doran, Hopin Lee;   Stream Leads: Nicole Nathan, Penny Reeves

Q4. How can strategies to implement chronic disease prevention interventions in community settings be optimised?

The establishment of an ‘implementation laboratory’ for the development and testing of chronic disease prevention interventions in community settings has shown to be an effective mechanism for generating effective evidence-based strategies. Implementation labs provide an infrastructure for ongoing experimentation to rapidly improve, or ‘optimise’, the impact of implementation strategies through ‘radical incrementalism’, a process in which a series of improvements (identified via ongoing experimentation) are enacted one after the other, resulting in cumulative improvements in service implementation. Optimising implementation strategies in this way requires assessment of their effectiveness, cost and causal mechanisms.

Optimisation approach: We will utilise an established implementation laboratory to ‘optimise’ the implementation of a) dietary guidelines in childcare, and b) activity policy in schools through a series of RCTs. A series of sequential randomised trials will be conducted over a number of phases. Each phase will be up to 12 months. Assessment of effectiveness, cost, mechanism of action, and acceptability will be undertaken for each trial to inform the implementation strategy tested in subsequent phases and determine the point of ‘optimisation’.

Research AREAS:

PACE (Research Lead Nicole Nathan)
Series of RCTs to optimise implementation of a mandatory physical activity policy in schools.

SWAPIT (Research Lead: Rachel Sutherland)
Optimising the Dissemination of a healthy school lunchbox program.

TRIAL ANALYSIS 
Economic analyses of CRE trials: Two economic analyses are planned for each trial.
Theoretically grounded mediation analyses are planned of each trial.

PUBLISHED PAPER SUMMARIES:

PACE (Research Lead Nicole Nathan)

• How effective are physical activity interventions when they are scaled-up: a systematic review
• Multi-strategy intervention increases school implementation and maintenance of a mandatory physical activity policy: outcomes of a cluster randomised controlled trial
• Exploring the effect of a school‐based cluster‐randomised controlled trial to increase the scheduling of physical activity for primary school students on teachers’ physical activity
• Implementation of a School Physical Activity Policy Improves Student Physical Activity Levels: Outcomes of a Cluster-Randomized Controlled Trial
  Also, find more information about Physically Active Children in Education (PACE) projects here.

SWAPIT (Research Lead: Rachel Sutherland)

• A cross-sectional study to determine the energy density and nutritional quality of primary school lunchboxes
• Multicomponent mHealth-Based Intervention (SWAP IT) to Decrease the Consumption of Discretionary Foods Packed in School Lunchboxes: Type I Effectiveness–Implementation Hybrid Cluster Randomized Controlled Trial
• Effectiveness of Technology-Enabled Knowledge Translation Strategies in Improving the Use of Research in Public Health: Systematic Review