Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program

Authors: R. Laws, K. D. Hesketh, K. Ball, C. Cooper, K. Vrljic, K. J. Campbell

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

While there is a growing interest in the field of research translation, there are few published examples of public health interventions that have been effectively scaled up and implemented in the community. This paper provides a case study of the community-wide implementation of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT), an obesity prevention program for parents with infants aged 3–18 months. The study explored key factors influencing the translation of the Program into routine practice and the respective role of policy makers, researchers and implementers.

Methods

Case studies were conducted of five of the eight prevention areas in Victoria, Australia who implemented the Program. Cases were selected on the basis of having implemented the Program for 6 months or more. Data were collected from January to June 2015 and included 18 individual interviews, one focus group and observation of two meetings. A total of 28 individuals, including research staff (n = 4), policy makers (n = 2) and implementers (n = 22), contributed to the data collected. Thematic analysis was conducted using cross case comparisons and key themes were verified through member checking.

Results

Key facilitators of implementation included availability of a pre-packaged evidence based program addressing a community need, along with support and training provided by research staff to local implementers. Partnerships between researchers and policy makers facilitated initial program adoption, while local partnerships supported community implementation. Community partnerships were facilitated by local coordinators through alignment of program goals with existing policies and services. Workforce capacity for program delivery and administration was a challenge, largely overcome by embedding the Program into existing roles. Adapting the Program to fit local circumstance was critical for feasible and sustainable delivery, however balancing this with program fidelity was a critical issue. The lack of ongoing funding to support translation activities was a barrier for researchers continued involvement in community implementation.

Conclusion

Policy makers, researchers and practitioners have important and complementary roles to play in supporting the translation of effective research interventions into practice. New avenues need to be explored to strengthen partnerships between researchers and end users to support the integration of effective public health research interventions into practice.
Appendix
Available only for authorised users
Literature
1.
2.
go back to reference Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007;28:413–33.CrossRefPubMed Glasgow RE, Emmons KM. How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health. 2007;28:413–33.CrossRefPubMed
3.
go back to reference Marchand E, Stice E, Rohde P, Becker CB. Moving from efficacy to effectiveness trials in prevention research. Behav Res Ther. 2011;49(1):32–41.CrossRefPubMed Marchand E, Stice E, Rohde P, Becker CB. Moving from efficacy to effectiveness trials in prevention research. Behav Res Ther. 2011;49(1):32–41.CrossRefPubMed
4.
go back to reference Milat AJ, King L, Bauman A, Redman S. Scaling up health promotion interventions: An emerging concept in implementation science. Health Promot J Austr. 2011;22(3):238.PubMed Milat AJ, King L, Bauman A, Redman S. Scaling up health promotion interventions: An emerging concept in implementation science. Health Promot J Austr. 2011;22(3):238.PubMed
5.
go back to reference Rychetnik L, Bauman A, Laws R, King L, Rissel C, Nutbeam D, Colagiuri S, Caterson I. Translating research for evidence-based public health: Key concepts and future directions. J Epidemiol Community Health. 2012;66(12):1187–92.CrossRefPubMed Rychetnik L, Bauman A, Laws R, King L, Rissel C, Nutbeam D, Colagiuri S, Caterson I. Translating research for evidence-based public health: Key concepts and future directions. J Epidemiol Community Health. 2012;66(12):1187–92.CrossRefPubMed
6.
go back to reference Milat AJ, King L, Bauman AE, Redman S. The concept of scalability: Increasing the scale and potential adoption of health promotion interventions into policy and practice. Health Promot Int. 2013;28(3):285–98.CrossRefPubMed Milat AJ, King L, Bauman AE, Redman S. The concept of scalability: Increasing the scale and potential adoption of health promotion interventions into policy and practice. Health Promot Int. 2013;28(3):285–98.CrossRefPubMed
7.
go back to reference Kohl R, Cooley L. Scaling up - A conceptual and operational framework. Washington DC: International MS; 2003. Kohl R, Cooley L. Scaling up - A conceptual and operational framework. Washington DC: International MS; 2003.
8.
9.
go back to reference Larson CP, Koehlmoos TP, Sack DA. Scaling up zinc treatment of childhood diarrhoea in Bangladesh: Theoretical and practical considerations guiding the SUZY Project. Health Policy Plan. 2012;27(2):102–14.CrossRefPubMed Larson CP, Koehlmoos TP, Sack DA. Scaling up zinc treatment of childhood diarrhoea in Bangladesh: Theoretical and practical considerations guiding the SUZY Project. Health Policy Plan. 2012;27(2):102–14.CrossRefPubMed
10.
go back to reference Victora CG, Barros FC, Assunção MC, Restrepo-Méndez MC, Matijasevich A, Martorell R. Scaling up maternal nutrition programs to improve birth outcomes: a review of implementation issues. Food Nutr Bull. 2012;33(2 Suppl):S6–26.CrossRefPubMed Victora CG, Barros FC, Assunção MC, Restrepo-Méndez MC, Matijasevich A, Martorell R. Scaling up maternal nutrition programs to improve birth outcomes: a review of implementation issues. Food Nutr Bull. 2012;33(2 Suppl):S6–26.CrossRefPubMed
11.
go back to reference Lorig KR, Hurwicz ML, Sobel D, Hobbs M, Ritter PL. A national dissemination of an evidence-based self-management program: A process evaluation study. Patient Educ Couns. 2005;59(1):69–79.CrossRefPubMed Lorig KR, Hurwicz ML, Sobel D, Hobbs M, Ritter PL. A national dissemination of an evidence-based self-management program: A process evaluation study. Patient Educ Couns. 2005;59(1):69–79.CrossRefPubMed
12.
go back to reference Teri L, McKenzie G, Logsdon RG, McCurry SM, Bollin S, Mead J, Menne H. Translation of two evidence-based programs for training families to improve care of persons with dementia. Gerontologist. 2012;52(4):452–9.CrossRefPubMedPubMedCentral Teri L, McKenzie G, Logsdon RG, McCurry SM, Bollin S, Mead J, Menne H. Translation of two evidence-based programs for training families to improve care of persons with dementia. Gerontologist. 2012;52(4):452–9.CrossRefPubMedPubMedCentral
13.
go back to reference Lucas PJ, Curtis-Tyler K, Arai L, Stapley S, Fagg J, Roberts H. What works in practice: User and provider perspectives on the acceptability, affordability, implementation, and impact of a family-based intervention for child overweight and obesity delivered at scale. BMC Public Health. 2014;14:614.CrossRefPubMedPubMedCentral Lucas PJ, Curtis-Tyler K, Arai L, Stapley S, Fagg J, Roberts H. What works in practice: User and provider perspectives on the acceptability, affordability, implementation, and impact of a family-based intervention for child overweight and obesity delivered at scale. BMC Public Health. 2014;14:614.CrossRefPubMedPubMedCentral
14.
go back to reference Fagg J, Chadwick P, Cole TJ, Cummins S, Goldstein H, Lewis H, Morris S, Radley D, Sacher P, Law C. From trial to population: a study of a family-based community intervention for childhood overweight implemented at scale. Int J Obes (Lond). 2014;38:1343–9.CrossRef Fagg J, Chadwick P, Cole TJ, Cummins S, Goldstein H, Lewis H, Morris S, Radley D, Sacher P, Law C. From trial to population: a study of a family-based community intervention for childhood overweight implemented at scale. Int J Obes (Lond). 2014;38:1343–9.CrossRef
15.
go back to reference Campbell KJ, Hesketh KD. Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obes Rev. 2007;8(4):327–38.CrossRefPubMed Campbell KJ, Hesketh KD. Strategies which aim to positively impact on weight, physical activity, diet and sedentary behaviours in children from zero to five years. A systematic review of the literature. Obes Rev. 2007;8(4):327–38.CrossRefPubMed
16.
go back to reference Doak CM, Visscher TLS, Renders CM, Seidell JC. The prevention of overweight and obesity in children and adolescents: A review of interventions and programmes. Obes Rev. 2006;7(1):111–36.CrossRefPubMed Doak CM, Visscher TLS, Renders CM, Seidell JC. The prevention of overweight and obesity in children and adolescents: A review of interventions and programmes. Obes Rev. 2006;7(1):111–36.CrossRefPubMed
17.
go back to reference Laws R, Campbell KJ, Van Der Pligt P, Russell G, Ball K, Lynch J, Crawford D, Taylor R, Askew D, Denney-Wilson E. The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review. BMC Public Health. 2014;14:779.CrossRefPubMedPubMedCentral Laws R, Campbell KJ, Van Der Pligt P, Russell G, Ball K, Lynch J, Crawford D, Taylor R, Askew D, Denney-Wilson E. The impact of interventions to prevent obesity or improve obesity related behaviours in children (0–5 years) from socioeconomically disadvantaged and/or indigenous families: a systematic review. BMC Public Health. 2014;14:779.CrossRefPubMedPubMedCentral
18.
go back to reference Stice E, Shaw H, Marti CN. A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work. Psychol Bull. 2006;132(5):667–91.CrossRefPubMedPubMedCentral Stice E, Shaw H, Marti CN. A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work. Psychol Bull. 2006;132(5):667–91.CrossRefPubMedPubMedCentral
19.
go back to reference Klesges LM, Dzewaltowski DA, Glasgow RE. Review of External Validity Reporting in Childhood Obesity Prevention Research. Am J Prev Med. 2008;34(3):216–23.CrossRefPubMed Klesges LM, Dzewaltowski DA, Glasgow RE. Review of External Validity Reporting in Childhood Obesity Prevention Research. Am J Prev Med. 2008;34(3):216–23.CrossRefPubMed
20.
go back to reference Wolfenden L, Wiggers J, Tursan D'Espaignet E, Bell AC. How useful are systematic reviews of child obesity interventions? Obes Rev. 2010;11(2):159–65.CrossRefPubMed Wolfenden L, Wiggers J, Tursan D'Espaignet E, Bell AC. How useful are systematic reviews of child obesity interventions? Obes Rev. 2010;11(2):159–65.CrossRefPubMed
21.
go back to reference Campbell KJ, Lioret S, McNaughton SA, Crawford DA, Salmon J, Ball K, McCallum Z, Gerner BE, Spence AC, Cameron AJ, et al. A parent-focused intervention to reduce infant obesity risk behaviors: A randomized trial. Pediatrics. 2013;131(4):652–60.CrossRefPubMed Campbell KJ, Lioret S, McNaughton SA, Crawford DA, Salmon J, Ball K, McCallum Z, Gerner BE, Spence AC, Cameron AJ, et al. A parent-focused intervention to reduce infant obesity risk behaviors: A randomized trial. Pediatrics. 2013;131(4):652–60.CrossRefPubMed
22.
go back to reference Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial. BMC Public Health. 2008;8:103.CrossRefPubMedPubMedCentral Campbell K, Hesketh K, Crawford D, Salmon J, Ball K, McCallum Z. The Infant Feeding Activity and Nutrition Trial (INFANT) an early intervention to prevent childhood obesity: Cluster-randomised controlled trial. BMC Public Health. 2008;8:103.CrossRefPubMedPubMedCentral
23.
go back to reference Hesketh KD, Hinkley T, Campbell KJ. Children’s physical activity and screen time: qualitative comparison of views of parents of infants and preschool children. Int J Behav Nutr Phys Act. 2012;9:152.CrossRefPubMedPubMedCentral Hesketh KD, Hinkley T, Campbell KJ. Children’s physical activity and screen time: qualitative comparison of views of parents of infants and preschool children. Int J Behav Nutr Phys Act. 2012;9:152.CrossRefPubMedPubMedCentral
24.
go back to reference Waters E, de Silva-Sanigorski A, Burford B, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell C. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011; (Issue 12):Art. No.: CD001871. doi:10.1002/14651858.CD001871.pub3.). Waters E, de Silva-Sanigorski A, Burford B, Brown T, Campbell KJ, Gao Y, Armstrong R, Prosser L, Summerbell C. Interventions for preventing obesity in children. Cochrane Database Syst Rev. 2011; (Issue 12):Art. No.: CD001871. doi:10.​1002/​14651858.​CD001871.​pub3.).
25.
go back to reference Spence AC, McNaughton SA, Lioret S, Hesketh KD, Crawford DA, Campbell KJ. A health promotion intervention can affect diet quality in early childhood. J Nutr. 2013;143(10):1672–8.CrossRefPubMed Spence AC, McNaughton SA, Lioret S, Hesketh KD, Crawford DA, Campbell KJ. A health promotion intervention can affect diet quality in early childhood. J Nutr. 2013;143(10):1672–8.CrossRefPubMed
26.
go back to reference Cameron AJ, Ball K, Hesketh KD, McNaughton SA, Salmon J, Crawford DA, Lioret S, Campbell KJ. Variation in outcomes of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT) Program according to maternal education and age. Prev Med. 2014;58(1):58–63.CrossRefPubMed Cameron AJ, Ball K, Hesketh KD, McNaughton SA, Salmon J, Crawford DA, Lioret S, Campbell KJ. Variation in outcomes of the Melbourne Infant, Feeding, Activity and Nutrition Trial (InFANT) Program according to maternal education and age. Prev Med. 2014;58(1):58–63.CrossRefPubMed
27.
go back to reference Spence AC, Campbell KJ, Crawford DA, McNaughton SA, Hesketh KD. Mediators of improved child diet quality following a health promotion intervention: The Melbourne InFANT Program. Int J Behav Nutr Phys Act. 2014;11:137.CrossRefPubMedPubMedCentral Spence AC, Campbell KJ, Crawford DA, McNaughton SA, Hesketh KD. Mediators of improved child diet quality following a health promotion intervention: The Melbourne InFANT Program. Int J Behav Nutr Phys Act. 2014;11:137.CrossRefPubMedPubMedCentral
28.
go back to reference Lioret S, Campbell KJ, Crawford D, Spence AC, Hesketh K, McNaughton SA. A parent focused child obesity prevention intervention improves some mother obesity risk behaviors: The Melbourne infant program. Int J Behav Nutr Phys Act. 2012;9:100.CrossRefPubMedPubMedCentral Lioret S, Campbell KJ, Crawford D, Spence AC, Hesketh K, McNaughton SA. A parent focused child obesity prevention intervention improves some mother obesity risk behaviors: The Melbourne infant program. Int J Behav Nutr Phys Act. 2012;9:100.CrossRefPubMedPubMedCentral
29.
go back to reference Yin R. Case Study Research: Design and Methods. London: Sage; 2003. Yin R. Case Study Research: Design and Methods. London: Sage; 2003.
30.
go back to reference Patton M. Qualitative Research & Evaluation Methods. 3rd ed. California: Sage; 2002. Patton M. Qualitative Research & Evaluation Methods. 3rd ed. California: Sage; 2002.
31.
go back to reference Damschroder L, Aron D, Keith R, SR K, Alexander J, Lowery J. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRefPubMedPubMedCentral Damschroder L, Aron D, Keith R, SR K, Alexander J, Lowery J. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.CrossRefPubMedPubMedCentral
32.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
33.
go back to reference Milat AJ, Laws R, King L, Newson R, Rychetnik L, Rissel C, Bauman AE, Redman S, Bennie J. Policy and practice impacts of applied research: A case study analysis of the New South Wales Health Promotion Demonstration Research Grants Scheme 2000–2006. Health Res Policy Syst. 2013;11:5.CrossRefPubMedPubMedCentral Milat AJ, Laws R, King L, Newson R, Rychetnik L, Rissel C, Bauman AE, Redman S, Bennie J. Policy and practice impacts of applied research: A case study analysis of the New South Wales Health Promotion Demonstration Research Grants Scheme 2000–2006. Health Res Policy Syst. 2013;11:5.CrossRefPubMedPubMedCentral
34.
go back to reference Laws RA, Fanaian M, Jayasinghe UW, McKenzie S, Passey M, Davies GP, Lyle D, Harris MF. Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial. BMC Health Serv Res. 2013;13:201.CrossRefPubMedPubMedCentral Laws RA, Fanaian M, Jayasinghe UW, McKenzie S, Passey M, Davies GP, Lyle D, Harris MF. Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial. BMC Health Serv Res. 2013;13:201.CrossRefPubMedPubMedCentral
35.
go back to reference Laws RA, St George AB, Rychetnik L, Bauman AE. Diabetes prevention research: A systematic review of external validity in lifestyle interventions. Am J Prev Med. 2012;43(2):205–14.CrossRefPubMed Laws RA, St George AB, Rychetnik L, Bauman AE. Diabetes prevention research: A systematic review of external validity in lifestyle interventions. Am J Prev Med. 2012;43(2):205–14.CrossRefPubMed
36.
go back to reference Laws RA, Vita P, Venugopal K, Rissel C, Davies D, Colagiuri S. Factors influencing participant enrolment in a diabetes prevention program in general practice: Lessons from the Sydney diabetes prevention program. BMC Public Health. 2012;12:822.CrossRefPubMedPubMedCentral Laws RA, Vita P, Venugopal K, Rissel C, Davies D, Colagiuri S. Factors influencing participant enrolment in a diabetes prevention program in general practice: Lessons from the Sydney diabetes prevention program. BMC Public Health. 2012;12:822.CrossRefPubMedPubMedCentral
37.
go back to reference Laws R, King L, Hardy LL, Milat A, Rissel C, Newson R, Rychetnik L, Bauman AE. Utilization of a population health survey in policy and practice: a case study. Health Res Policy Syst. 2013;11:4.CrossRefPubMedPubMedCentral Laws R, King L, Hardy LL, Milat A, Rissel C, Newson R, Rychetnik L, Bauman AE. Utilization of a population health survey in policy and practice: a case study. Health Res Policy Syst. 2013;11:4.CrossRefPubMedPubMedCentral
38.
go back to reference Rissel C, Laws RA, St George A, Hector DJ, Milat AJ, Baur L. Research to practice: Application of an evidence building framework to a childhood obesity prevention initiative in New South Wales, Australia. Health Promot J Austr. 2012. In Press. Rissel C, Laws RA, St George A, Hector DJ, Milat AJ, Baur L. Research to practice: Application of an evidence building framework to a childhood obesity prevention initiative in New South Wales, Australia. Health Promot J Austr. 2012. In Press.
40.
go back to reference Milat AJ, King L, Newson R, Wolfenden L, Rissel C, Bauman A, Redman S. Increasing the scale and adoption of population health interventions: Experiences and perspectives of policy makers, practitioners, and researchers. Health Res Policy Syst. 2014;12:18.CrossRefPubMedPubMedCentral Milat AJ, King L, Newson R, Wolfenden L, Rissel C, Bauman A, Redman S. Increasing the scale and adoption of population health interventions: Experiences and perspectives of policy makers, practitioners, and researchers. Health Res Policy Syst. 2014;12:18.CrossRefPubMedPubMedCentral
41.
go back to reference Bopp M, Saunders RP, Lattimore D. The tug-of-war: Fidelity versus adaptation throughout the health promotion program life cycle. J Prim Prev. 2013;34(3):193–207.CrossRefPubMed Bopp M, Saunders RP, Lattimore D. The tug-of-war: Fidelity versus adaptation throughout the health promotion program life cycle. J Prim Prev. 2013;34(3):193–207.CrossRefPubMed
42.
go back to reference Castro FG, Barrera Jr M, Martinez Jr CR. The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–5.CrossRefPubMed Castro FG, Barrera Jr M, Martinez Jr CR. The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prev Sci. 2004;5(1):41–5.CrossRefPubMed
43.
go back to reference Griffin SF, Wilcox S, Ory MG, Lattimore D, Leviton L, Castro C, Carpenter RA, Rheaume C. Results from the Active for Life process evaluation: Program delivery fidelity and adaptations. Health Educ Res. 2010;25(2):325–42.CrossRefPubMed Griffin SF, Wilcox S, Ory MG, Lattimore D, Leviton L, Castro C, Carpenter RA, Rheaume C. Results from the Active for Life process evaluation: Program delivery fidelity and adaptations. Health Educ Res. 2010;25(2):325–42.CrossRefPubMed
44.
go back to reference Van Daele T, Van Audenhove C, Hermans D, Van Den Bergh O, Van Den Broucke S. Empowerment implementation: Enhancing fidelity and adaptation in a psycho-educational intervention. Health Promot Int. 2014;29(2):212–22.CrossRefPubMed Van Daele T, Van Audenhove C, Hermans D, Van Den Bergh O, Van Den Broucke S. Empowerment implementation: Enhancing fidelity and adaptation in a psycho-educational intervention. Health Promot Int. 2014;29(2):212–22.CrossRefPubMed
45.
go back to reference Durlak JA, DuPre EP. Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3-4):327–50.CrossRefPubMed Durlak JA, DuPre EP. Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. Am J Community Psychol. 2008;41(3-4):327–50.CrossRefPubMed
46.
go back to reference Backer TE. Finding the balance- Program Fidelity and Adaptations in Substance Abuse Prevention: A State-of-the-Art Review. Rockville: Centre for Substance Abuse Prevention; 2001. Backer TE. Finding the balance- Program Fidelity and Adaptations in Substance Abuse Prevention: A State-of-the-Art Review. Rockville: Centre for Substance Abuse Prevention; 2001.
49.
go back to reference Innvær S, Vist G, Trommald M, Oxman A. Health policy-makers’ perceptions of their use of evidence: A systematic review. J Health Serv Res Policy. 2002;7(4):239–44.CrossRefPubMed Innvær S, Vist G, Trommald M, Oxman A. Health policy-makers’ perceptions of their use of evidence: A systematic review. J Health Serv Res Policy. 2002;7(4):239–44.CrossRefPubMed
50.
go back to reference Purcell EP, Mitchell C, Celestin MD, Evans KR, Haynes V, McFall A, Troyer L, Sanchez MA. Research to Reality (R2R) Mentorship Program: Building Partnership, Capacity, and Evidence. Health Promot Pract. 2013;14(3):321–7.CrossRefPubMed Purcell EP, Mitchell C, Celestin MD, Evans KR, Haynes V, McFall A, Troyer L, Sanchez MA. Research to Reality (R2R) Mentorship Program: Building Partnership, Capacity, and Evidence. Health Promot Pract. 2013;14(3):321–7.CrossRefPubMed
Metadata
Title
Translating an early childhood obesity prevention program for local community implementation: a case study of the Melbourne InFANT Program
Authors
R. Laws
K. D. Hesketh
K. Ball
C. Cooper
K. Vrljic
K. J. Campbell
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3361-x

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue