Strategies to improve the implementation of policies, practices or programmes in sporting organisations targeting poor diet, physical inactivity, obesity, risky alcohol use or tobacco use: a systematic review

Abstract

ObjectivesThe primary aim for this review is to determine the effectiveness of strategies to improve the implementation of policies, practices or programmes in sporting organisations. The secondary aims are to describe the cost or cost-effectiveness and adverse effects of such strategies and to examine the effects of those implementation strategies on individual’s diet, physical activity, obesity, alcohol use or tobacco use.MethodsWe conducted searches of academic databases (eg, MEDLINE, EMBASE and CENTRAL), trial registers and hand searches of selected journals. Studies were included if they were conducted at a sporting venue; described a strategy to improve implementation of policies, practices or programmes focusing on one or more health risks (diet, physical inactivity, obesity, alcohol or tobacco use), and included a parallel control group. Two authors independently screened citations and extracted data. The results of included studies were synthesised narratively.ResultsOf the 5926 citations screened three studies met the inclusion criteria. Two studies were randomised controlled trials. Two studies sought to improve the implementation of nutrition-related policy and practices and one study sought to improve implementation of alcohol-related policy and practices. Each study reported improvement in at least one measure of policy or practice implementation. Two studies reported individual-level outcomes and found a reduction in excessive alcohol consumption and an increase in purchase of fruits and vegetables at the sports club ground. Two studies assessed club revenue as a potential adverse effect, neither reported significant between-group differences on these measures.ConclusionThere is a sparse evidence base regarding the effectiveness of strategies to improve the implementation of policies, practices or programmes targeting chronic disease risk factors in sporting clubs. While all studies reported some improvements in implementation, for some multistrategic implementation strategies it is difficult to determine the extent to which such effects are generalisable.PROSPERO registration numberCRD42016039490.

Use of implementation science in tobacco control intervention studies in the USA between 2000 and 2020: a scoping review protocol

“…A systematic review was conducted of studies that reported implementation strategies for a range of chronic disease prevention interventions, with control groups, and among the three studies that met their inclusion criteria, none focused on tobacco-related interventions. 24 A recent scoping review 25 described targeted populations and settings for tobacco control interventions, and found cessation interventions were the most common topics of systematic reviews. The authors suggested that the focus on cessation reflects an incomplete approach to tobacco control as recommended by the WHO.…”

Health Promoting School Interventions in Latin America: A Systematic Review Protocol on the Dimensions of the RE-AIM Framework

“…Considering these gaps, studies in countries and contexts of social, economic, and political vulnerabilities that impact young population’s health need to be encouraged and summarized [ 1 , 2 , 5 , 6 , 10 , 25 , 26 ]. In particular, Latin American countries have peculiar political, economic, and social contexts that are different from countries in other regions in which interventions based on HPS-WHO are carried out (mainly North America and Europe), which fact may influence both children and adolescents’ health and how policies and interventions regarding school health promotion are implemented.…”

What happens once a program has been implemented? A call for research investigating strategies to enhance public health program sustainability

“…We recently sought to assess the effectiveness of implementation strategies in sustaining improvements in implementation of non‐communicable prevention policies or practices in community settings. We examined all trials included in a series of systematic reviews funded by The Australian Prevention Partnership Centre 4,8–10 . The reviews included trials (randomised and non‐randomised) with a parallel control group that examined the impact of an implementation strategy on the fidelity of implementation of a policy or practice by a school, childcare centre, workplace or sporting venue.…”

“…The reviews included trials (randomised and non‐randomised) with a parallel control group that examined the impact of an implementation strategy on the fidelity of implementation of a policy or practice by a school, childcare centre, workplace or sporting venue. Studies of policies or practices that targeted diet, physical activity, obesity, tobacco or alcohol use were eligible 4,8–10 . Consistent with definitions used in previous reviews, sustained implementation was defined as sustaining a statistically significant intervention effect on a measure of implementation fidelity achieved post‐intervention for at least three months thereafter.…”

“…Of the 108 full texts examined, we did not find any trials that met our inclusion criteria. That is, not a single trial identified across four comprehensive reviews 4,8–10 reported a significant effect on at least one implementation outcome post‐intervention and further assessed if such effects were maintained at a longer‐term follow up. We also re‐analysed data collected as part of a bibliographic study of all 1,648 manuscripts published in 10 leading public health journals in 2013 and failed to identify any trials assessing the sustainability of program implementation 11 .…”