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A sense of scale: Exploring ways to implement effective prevention


Project title: The effectiveness of strategies to scale the implementation of community chronic disease interventions

Start date: April 2016
Estimated end date: May 2017

What is the issue?

Evidence-based chronic disease prevention initiatives need to be implemented at a population level (‘at scale’) to maximise their benefits. However, little evidence is available to guide policy makers and practitioners in scaling up projects in key community settings such as childcare services, schools, workplaces or sporting clubs – the places with access to large numbers of children or adults, often for long periods, where prevention initiatives may be implemented.

Without implementation at scale, effective health promoting interventions are unable to benefit public health. Implementing interventions at scale is recommended internationally, and is included in chronic disease prevention strategies across the globe.

How is the project addressing the issue?

This project seeks to address the need for an up-to-date, comprehensive synthesis of strategies to implement chronic disease prevention programs, practices or policies, and particularly those conducted at scale.

We will conduct a series of systematic reviews of trials assessing the impact of strategies to implement policies, practices or programs targeting smoking, nutrition, alcohol, physical activity or obesity, implemented in childcare services, schools, workplaces and sporting clubs. These reviews, which will be published by the Cochrane Collaboration, will aim to identify the:

  • Effectiveness of implementation support strategies (such as training, performance feedback, opinion leaders, etc) in improving the implementation of setting-based chronic disease prevention programs or police
  • Effectiveness of such support strategies delivered at scale (defined as more than 50 organisational units/workplaces, schools, etc)
  • Impact of such strategies on chronic disease risks (tobacco and alcohol use, diet, physical activity or weight status).

What are the expected outcomes?

The comprehensive program of work will provide high quality and timely evidence that we believe will make an important contribution to the science of implementation at scale, and importantly to health policy and practice internationally.

Expected outcomes include:

  • New knowledge regarding the effectiveness of strategies in achieving implementation at scale
  • Opportunities for early career researchers and students to learn rigorous systematic review methods and develop expertise in implementation science
  • Publications in high-impact journals, including the Cochrane Database of systematic reviews.

Updated February 2017

Project lead:

Associate Professor Luke Wolfenden, University of Newcastle

Project team:

  • Professor Adrian Bauman, University of Sydney
  • Ms Kathy Chapman, Cancer Council NSW
  • Ms Karen Gillham, Hunter New England Population Health
  • Ms Melanie Kingsland, University of Newcastle
  • Dr Andrew Milat, NSW Ministry of Health
  • Professor Chris Rissel, NSW Ministry of Health
  • Professor John Wiggers, University of Newcastle
  • Dr Christopher Williams, University of Newcastle
  • Dr Sze Yoong,  University of Newcastle

The research will provide policy makers and practitioners with evidence regarding the effectiveness of models of scaling effective interventions that can be used in planned program roll-outs.

  • Submission of reviews is underway
2016