Protocol for the measurement of changes in knowledge and engagement in the stepped wedge cluster randomised trial for childhood obesity prevention in Australia: (Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND))

Whelan, Jillian; Strugnell, Claudia; Allender, Steven; Korn, Ariella R.; Brown, Andrew; Orellana, Liliana; Hayward, Joshua; Brown, Vicki; Bell, Colin; Moodie, Marj; Peeters, Anna; Nichols, Melanie

doi:10.1186/s13063-020-04692-6

Cited by 13 publications

(38 citation statements)

References 30 publications

(29 reference statements)

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“…Building on previously reported community-based approaches to obesity prevention [ 9 , 11 ], the Global Obesity Centre (GLOBE) at Deakin University has been trialling CBSD to empower communities for childhood obesity prevention since 2014 [ 21 ]. Two recent trials include the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) [ 22 ] and Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND) [ 23 ]. These are stepped wedge randomised control trials implemented over 4 years in regional Victoria, Australia; with five intervention communities implementing the intervention in year 1, and the other five communities in year 2.…”

Section: Methodsmentioning

confidence: 99%

“…Communities in WHO STOPS (potential population reach 125,000) and RESPOND (potential population reach 213,600) were geographically bounded by local government areas, with the option of refinement of boundaries (i.e., by splitting a geographical area into two or more communities) based on community feedback. The outcomes of WHO STOPS are reported elsewhere [ 22 ] and the RESPOND trial is underway [ 23 ]. The third study, Yarriambiack – Creating Healthy, Active, Nourished Generations (YCHANGe), potential population reach 7026) was a whole of community obesity prevention initiative implemented in rural Victoria, Australia.…”

Section: Methodsmentioning

confidence: 99%

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The Public Health 12 framework: interpreting the ‘Meadows 12 places to act in a system’ for use in public health

et al. 2022

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Background Systems science approaches have demonstrated effectiveness in identifying underlying drivers of complex problems and facilitating the emergence of potential interventions that are locally tailored, feasible, sustainable and evidence informed. Despite the potential usefulness of system dynamics simulation modelling and other systems science modelling techniques in guiding implementation, time and cost constraints have limited its ability to provide strong guidance on how to implement complex interventions in communities. Guidance is required to ensure systems interventions lead to impactful systems solutions, implemented utilising strategies from the intersecting fields of systems science and implementation science. To provide cost-effective guidance on how and where to implement in systems, we offer a translation of the ‘Meadows 12 places to act in a system’ (Meadows 12) into language useful for public health. Methods This translation of Meadows 12 was informed by our experience in working with 31 communities across two complex large scale randomised control trials and one large whole of community case study. These research projects utilised systems science and implementation science to co-create childhood obesity prevention interventions. The team undertaking this translation comprised research academics, implementation specialists and practitioners, practice-based researchers and a systems dynamicist. Our translation of each of the Meadows 12 levels to act in the system maintains the fidelity and nuance of the 12 distinct levels. We provide examples of each level of the Public Health 12 framework (PH12) drawn from 31 communities. All research was conducted in Victoria, Australia between 2016 and 2020. Results PH12 provides a framework to guide both research and practice in real world contexts to implement targeted system level interventions. PH12 can be used with existing implementation science theory to identify relevant strategies for implementation of these interventions to impact the system at each of the leverage points. Conclusion To date little guidance for public health practitioners and researchers exists regarding how to implement systems change in community-led public health interventions. PH12 enables operationalisation Meadows 12 systems theory into public health interventions. PH12 can help research and practice determine where leverage can be applied in the system to optimise public health systems level interventions and identify gaps in existing efforts. Trial registration WHO STOPS: ANZCTR: 12616000980437. RESPOND: ANZCTR: 12618001986268p.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

The Public Health 12 framework: interpreting the ‘Meadows 12 places to act in a system’ for use in public health

et al. 2022

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“…This theory of change builds on 20 years of experience working with >120 communities 7 with illustrative examples from 3 community-based trials. 5,19,23 Methods from system dynamics 24 were used to create a model representing the theory of change for successful, sustained CBI over time. Known as stock and flow diagrams, these models identify the structures of cause and effect within a system that drive system behavior, with an emphasis on accumulation, time delays, and feedback loops.…”

Section: Development Of the Theory Of Change Modelmentioning

confidence: 99%

“…Vignettes were drawn from community-based trials of systems thinking to preventing obesity in Victoria, Australia. These were Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHOSTOPS), 5,12 Reflexive Evidence & Systems interventions to Prevent Obesity & Non-communicable Disease (RESPOND), 23 and Yarriambiack−Creating, Healthy, Active Nourished Generations. 19 Vignettes were chosen to illustrate the theory of change model.…”

Section: Case Studiesmentioning

confidence: 99%

A Theory of Change for Community-Based Systems Interventions to Prevent Obesity

Brown

Whelan

Bolton

et al. 2022

American Journal of Preventive Medicine

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Introduction: Applying systems science in public health trials is a recent innovation in childhood obesity prevention. This paper aims to use systems science conventions to propose a theory of change for community-based interventions aiming to build capacity and use exemplars from systems science for obesity prevention to describe how this approach works.Methods: Participants were community-based researchers. A dynamic hypothesis was created in workshops conducted in 2020 and 2021 by identifying variables critical to building community capacity for systems thinking. These were used to develop stock and flow diagrams representing individual causal relationships, feedback loops, and the overall theory of change.Results: The resultant model identified 9 stocks and 4 pairs of central balancing and reinforcing feedback loops. These represented building commitment through relationships, mutual learning, strengthening collaboration, and embedding capacity. The model is described using examples from 3 trials involving 25 communities across Victoria, Australia. Conclusions:This nonlinear and practice-based model illustrates the process of community-based obesity prevention. The model integrates >20 years of community-based intervention implementation experience, providing an overarching theory of how such interventions work to create change and prevent obesity.

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“…Child-level data used in this study were collected as part of the baseline measurements for two large-scale system-based obesity prevention interventions. 31 32 The evaluations have been described previously 33 and were conducted in the same way in both study regions. In brief, in the 2015 (South-West region) and 2016 (Goulburn Valley region) data collection periods, all primary schools (government, independent and catholic) were invited to participate.…”

Section: Participantsmentioning

confidence: 99%

Is the physical activity environment surrounding primary schools associated with students’ weight status, physical activity or active transport, in regional areas of Victoria, Australia? A cross-sectional study

et al. 2021

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ObjectivesTo explore whether the physical activity (PA) environment (walkability, greenspace and recreational facilities) surrounding regional primary schools is associated with children’s PA levels, active transport and weight status. Limited research on this topic has been conducted outside of major cities.DesignCross-sectional ecological study using baseline data from two large-scale obesity prevention interventions.SettingEighty (n=80) primary schools across two regional areas in Victoria, Australia.ParticipantsStudents aged 8–13 years (n=2144) attending participating primary schools.Outcome measuresMeasured weight status (body mass index z-score, proportion overweight/obese) and self-reported PA behaviours (meeting PA recommendations and active travel behaviour).ResultsWhen adjusted for student and school demographics, students had significantly increased odds of using active transport to or from school when the school neighbourhood was more walkable (OR 1.21 (95% CI 1.09 to 1.35), had a greater number of greenspaces (OR 1.35 (95% CI 1.20 to 1.53)) and a greater number of recreational facilities (OR 1.18 (95% CI 1.07 to 1.31)). A higher cumulative PA environment score was also associated with a higher proportion of children using active transport (OR 1.33 (95% CI 1.28 to 1.51)). There were no significant associations between the PA environment measures and either weight status or meeting the PA recommendations in adjusted models.ConclusionsThis study is the first of its kind exploring school neighbourhood environments and child weight status and PA in regional areas of Australia. It highlights the potential of the environment surrounding primary schools in contributing to students’ active travel to and from school. Further research with the use of objective PA measurement is warranted in regional areas that have been under-researched.Trial registration numberAustralian New Zealand Clinical Trials Registry (ANZCTR.org.au) identifier 12616000980437; Results.

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Protocol for the measurement of changes in knowledge and engagement in the stepped wedge cluster randomised trial for childhood obesity prevention in Australia: (Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND))

Cited by 13 publications

References 30 publications

The Public Health 12 framework: interpreting the ‘Meadows 12 places to act in a system’ for use in public health

The Public Health 12 framework: interpreting the ‘Meadows 12 places to act in a system’ for use in public health

A Theory of Change for Community-Based Systems Interventions to Prevent Obesity

Is the physical activity environment surrounding primary schools associated with students’ weight status, physical activity or active transport, in regional areas of Victoria, Australia? A cross-sectional study

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