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BMC Public Health
Published in: BMC Public Health 1/2014

Open Access 01-12-2014 | Study protocol

Effectiveness and implementation of an obesity prevention intervention: the HeLP-her Rural cluster randomised controlled trial

Authors: Catherine B Lombard, Cheryce L Harrison, Samantha L Kozica, Sophia Zoungas, Catherine Keating, Helena J Teede

Published in: BMC Public Health | Issue 1/2014

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Abstract

Background

To impact on the obesity epidemic, interventions that prevent weight gain across populations are urgently needed. However, even the most efficacious interventions will have little impact on obesity prevention unless they are successfully implemented in diverse populations and settings. Implementation research takes isolated efficacy studies into practice and policy and is particularly important in obesity prevention where there is an urgent need to accelerate the evidence to practice cycle. Despite the recognised need, few obesity prevention interventions have been implemented in real life settings and to our knowledge rarely target rural communities.

Methods

Here we describe the rationale, design and implementation of a Healthy Lifestyle Program for women living in small rural communities (HeLP-her Rural). The primary goal of HeLP-her Rural is to prevent weight gain using a low intensity, self-management intervention. Six hundred women from 42 small rural communities in Australia will be randomised as clusters (n-21 control towns and n = 21 intervention towns). A pragmatic randomised controlled trial methodology will test efficacy and a comprehensive mixed methods community evaluation and cost analysis will inform effectiveness and implementation of this novel prevention program.

Discussion

Implementing population interventions to prevent obesity is complex, costly and challenging. To address these barriers, evidence based interventions need to move beyond isolated efficacy trials and report outcomes related to effectiveness and implementation. Large pragmatic trials provide an opportunity to inform both effectiveness and implementation leading to potential for greater impact at the population level. Pragmatic trials should incorporate both effectiveness and implementation outcomes and a multidimensional methodology to inform scale-up to population level. The learnings from this trial will impact on the design and implementation of population obesity prevention strategies nationally and internationally.

Trial registration

ANZ clinical trial registry ACTRN12612000115​831. Date of registration 24/01/2012
Appendix
Available only for authorised users
Literature
1.
Walls HL, Wolfe R, Haby MM, Magliano DJ, de Courten M, Reid CM, McNeil JJ, Shaw J, Peeters A: Trends in BMI of urban Australian adults, 1980–2000. Public Health Nutr. 2010, 13 (5): 631-638. 10.1017/S1368980009991455.CrossRefPubMed
2.
Ball K, Crawford D, Ireland P, Hodge A: Patterns and demographic predictors of 5-year weight change in a multi-ethnic cohort of men and women in Australia. Public Health Nutr. 2003, 6 (3): 269-280.CrossRefPubMed
3.
4.
Lombard C, Deeks A, Jolley D, Ball K, Teede H: A low intensity, community based lifestyle programme to prevent weight gain in women with young children: cluster randomised controlled trial. BMJ. 2010, 341: c3215-10.1136/bmj.c3215.CrossRefPubMedPubMedCentral
5.
Willett W, Manson J, Stampfer M, Colditz G, Rosner B, Speizer F, Hennekens CH: Weight, weight change, and coronary heart disease in women. Risk within the ‘normal’ weight range. J Am Med Assoc. 1995, 273 (6): 461-465. 10.1001/jama.1995.03520300035033.CrossRef
6.
Cleland V, Hume C, Crawford D, Timperio A, Hesketh K, Baur L, Welch N, Salmon J, Ball K: Urban–rural comparison of weight status among women and children living in socioeconomically disadvantaged neighbourhoods. Med J Aust. 2010, 192 (3): 137-140.PubMed
7.
AIHW: Rural, Regional and Remote Health: Indicators Of Health Status And Determinants Of Health Cat. no. PHE 97. 2008, Canberra: AIHW
8.
Lombard CB, Deeks AA, Teede HJ: A systematic review of interventions aimed at the prevention of weight gain in adults. Public Health Nutr. 2009, 12: 2236-2246. 10.1017/S1368980009990577.CrossRefPubMed
9.
Lemmens V, Oenema A, Klepp K, Henriksen HB, Brug J: A systematic review of the evidence regarding efficacy of obesity prevention interventions among adults. Obes Rev. 2008, 9 (5): 446-455. 10.1111/j.1467-789X.2008.00468.x.CrossRefPubMed
10.
Hill J: Understanding and addressing the epidemic of obesity: an energy balance perspective. Endocr Rev. 2006, 27 (7): 750-761. 10.1210/er.2006-0032.CrossRefPubMed
11.
Peters DH, Adam T, Alonge O, Agyepong IA, Tran N: Implementation research: what it is and how to do it. BMJ. 2013, 347: f6753-CrossRefPubMed
12.
Glasgow RE, Vinson C, Chambers D, Khoury MJ, Kaplan RM, Hunter C: National institutes of health approaches to dissemination and implementation science: current and future directions. Am J Public Health. 2012, 102 (7): 1274-1281. 10.2105/AJPH.2012.300755.CrossRefPubMedPubMedCentral
13.
Carroll KM, Rounsaville BJ: Bridging the gap: a hybrid model to link efficacy and effectiveness research in substance abuse treatment. Psychiatr Serv. 2003, 54 (3): 333-339.CrossRefPubMedPubMedCentral
14.
Hanley JA, Negassa A, Edwardes MD, Forrester JE: Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol. 2003, 157 (4): 364-375. 10.1093/aje/kwf215.CrossRefPubMed
15.
Lombard C, Deeks A, Jolley D, Teede HJ: Preventing weight gain: the baseline weight related behaviors and delivery of a randomized controlled intervention in community based women. BMC Public Health. 2009, 9 (2): 10-1186/1471-2458-9-2
16.
Harrison CL, Lombard CB, Strauss BJ, Teede HJ: Optimizing healthy gestational weight gain in women at high risk of gestational diabetes: a randomized controlled trial. Obesity (Silver Spring). 2013, 21 (5): 904-909. 10.1002/oby.20163.CrossRef
17.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M: Developing and evaluating complex interventions: the new medical research council guidance. BMJ. 2008, 337: a1655-10.1136/bmj.a1655.CrossRefPubMedPubMedCentral
18.
Ryan RM, Deci EL: Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000, 55 (1): 68-78.CrossRefPubMed
19.
Haase AT, Fox K, Thorp H, Lewis G: Rationale and development of the physical activity counselling intervention for a pragmatic TRial of Excercse and Depression in the UK. Ment Health Phys Activ. 2010, 3: 85-91. 10.1016/j.mhpa.2010.09.004.CrossRef
20.
21.
Government Aust: Australian dietary guidelines. Edited by: Dept Health. 2013, Canberra: NHMRC, 11-100.
22.
Hodge A, Patterson AJ, Brown WJ, Ireland P, Giles G: The Anti Cancer Council of Victoria FFQ: relative validity of nutrient intakes compared with weighed food records in young to middle-aged women in a study of iron supplementation. Aust N Z J Public Health. 2000, 24 (6): 576-583. 10.1111/j.1467-842X.2000.tb00520.x.CrossRefPubMed
23.
van der Ploeg HP, Tudor-Locke C, Marshall AL, Craig C, Hagstromer M, Sjostrom M, Bauman A: Reliability and validity of the international physical activity questionnaire for assessing walking. Res Q Exerc Sport. 2010, 81 (1): 97-101. 10.1080/02701367.2010.10599632.CrossRefPubMed
24.
Latimer L: Self-efficacy scale for weight loss among multi-ethnic women of lower income: a psychometric evaluation. J Nutr Educ Behav. 2011, 43 (4): 279-283. 10.1016/j.jneb.2010.09.007.CrossRefPubMedPubMedCentral
25.
Glasgow RE: Translating research to practice: lessons learned, areas for improvement, and future directions. Diabetes Care. 2003, 26 (8): 2451-2456. 10.2337/diacare.26.8.2451.CrossRefPubMed
Metadata
Title
Effectiveness and implementation of an obesity prevention intervention: the HeLP-her Rural cluster randomised controlled trial
Authors
Catherine B Lombard
Cheryce L Harrison
Samantha L Kozica
Sophia Zoungas
Catherine Keating
Helena J Teede
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2014
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-14-608

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