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.

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


PACE (Research Lead Nicole Nathan)

SWAPIT (Research Lead: Rachel Sutherland)