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BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

CONSORT to community: translation of an RCT to a large-scale community intervention and learnings from evaluation of the upscaled program

Authors: Carly Jane Moores, Jacqueline Miller, Rebecca Anne Perry, Lily Lai Hang Chan, Lynne Allison Daniels, Helen Anna Vidgen, Anthea Margaret Magarey

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

Translation encompasses the continuum from clinical efficacy to widespread adoption within the healthcare service and ultimately routine clinical practice. The Parenting, Eating and Activity for Child Health (PEACH™) program has previously demonstrated clinical effectiveness in the management of child obesity, and has been recently implemented as a large-scale community intervention in Queensland, Australia. This paper aims to describe the translation of the evaluation framework from a randomised controlled trial (RCT) to large-scale community intervention (PEACH™ QLD). Tensions between RCT paradigm and implementation research will be discussed along with lived evaluation challenges, responses to overcome these, and key learnings for future evaluation conducted at scale.

Methods

The translation of evaluation from PEACH™ RCT to the large-scale community intervention PEACH™ QLD is described. While the CONSORT Statement was used to report findings from two previous RCTs, the REAIM framework was more suitable for the evaluation of upscaled delivery of the PEACH™ program. Evaluation of PEACH™ QLD was undertaken during the project delivery period from 2013 to 2016.

Results

Experiential learnings from conducting the evaluation of PEACH™ QLD to the described evaluation framework are presented for the purposes of informing the future evaluation of upscaled programs. Evaluation changes in response to real-time changes in the delivery of the PEACH™ QLD Project were necessary at stages during the project term. Key evaluation challenges encountered included the collection of complete evaluation data from a diverse and geographically dispersed workforce and the systematic collection of process evaluation data in real time to support program changes during the project.

Conclusions

Evaluation of large-scale community interventions in the real world is challenging and divergent from RCTs which are rigourously evaluated within a more tightly-controlled clinical research setting. Constructs explored in an RCT are inadequate in describing the enablers and barriers of upscaled community program implementation. Methods for data collection, analysis and reporting also require consideration. We present a number of experiential reflections and suggestions for the successful evaluation of future upscaled community programs which are scarcely reported in the literature.

Trials registration

PEACH™ QLD was retrospectively registered with the Australian New Zealand Clinical Trials Registry on 28 February 2017 (ACTRN12617000315314).
Literature
1.
Drolet BC, Lorenzi NM. Translational research: understanding the continuum from bench to bedside. Transl Res. 2011;157:1–5.CrossRefPubMed
2.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M, Medical Research Council G. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
3.
4.
World Health Organization, Report of the Commission on Ending Childhood Obesity. 2016. p. i-52.
5.
Golley RK, Perry RA, Magarey A, Daniels L. Family-focused weight management program for five- to nine-year-olds incorporating parenting skills training with healthy lifestyle information to support behaviour modification. Nutrition & Dietetics. 2007;64:144–50.CrossRef
6.
Magarey A, Gehling R, Haigh R, Daniels L. Key elements for the nutrition component of child overweight management interventions in five-to nine-year-old children. Nutrition & Dietetics. 2004;61:183–5.
7.
Magarey AM, Perry RA, Baur LA, Steinbeck KS, Sawyer M, Hills AP, Wilson G, Lee A, Daniels LA. A parent-led family-focused treatment program for overweight children aged 5 to 9 years: the PEACH RCT. Pediatrics. 2011;127:214–22.CrossRefPubMed
8.
9.
10.
11.
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health. 1999;89:1322–7.CrossRefPubMedPubMedCentral
12.
Leslie E, Magarey A, Olds T, Ratcliffe J, Jones M, Cobiac L. Community-based obesity prevention in Australia: background, methods and recruitment outcomes for the evaluation of the effectiveness of OPAL (obesity prevention and lifestyle). Advances in Pediatric Research. 2015:23.
13.
14.
Prochaska JJ, Sallis JF, Long B. A physical activity screening measure for use with adolescents in primary care. Archives of Pediatrics & Adolescent Medicine. 2001;155:554–9.CrossRef
15.
Vidgen HA, Adam M, Gallegos D, Who does nutrition prevention work in Queensland? An investigation of structural and political workforce reforms. Nut Diet. 2017;74(1):88–94.
16.
Davidson K, Vidgen H. Why do parents enrol in a childhood obesity management program?: a qualitative study with parents of overweight and obese children. BMC Public Health. 2017;17:159.CrossRefPubMedPubMedCentral
17.
Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Admin Pol Ment Health. 2011;38:65–76.CrossRef
18.
Proctor EK, Landsverk J, Aarons G, Chambers D, Glisson C, Mittman B. Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health Ment Health Serv Res. 2009;36:24–34.CrossRef
19.
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.
20.
Magarey AM, Daniels LA, Boulton TJ. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. Med J Aust. 2001;174:561–4.PubMed
21.
Magarey AM, Daniels LA. Comparison of Australian and US data on overweight and obesity in children and adolescents. Med J Aust. 2001;175:500–1.PubMed
22.
Magarey AM, Daniels LA, Boulton TJ, Cockington RA. Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord. 2003;27:505–13.CrossRefPubMed
23.
Golan M, Fainaru M, Weizman A. Role of behaviour modification in the treatment of childhood obesity with the parents as the exclusive agents of change. Int J Obes. 1998;22:1217–24.CrossRef
24.
Golan M, Weizman A, Apter A, Fainaru M. Parents as the exclusive agents of change in the treatment of childhood obesity. Am J Clin Nutr. 1998;67:1130–5.PubMed
25.
Israel AC, Guile CA, Baker JE, Silverman WK. An evaluation of enhanced self-regulation training in the treatment of childhood obesity. J Pediatr Psychol. 1994;19:737–49.CrossRefPubMed
26.
Israel AC, Stolmaker L, Andrian CAG. The effects of training parents in general child management-skills on a behavioral weight-loss program for children. Behav Ther. 1985;16:169–80.CrossRef
27.
Wadden TA, Stunkard AJ, Rich L, Rubin CJ, Sweidel G, Mckinney S. Obesity in black-adolescent girls - a controlled clinical-trial of treatment by diet, behavior-modification, and parental support. Pediatrics. 1990;85:345–52.PubMed
28.
Summerbell CD, Ashton V, Campbell KJ, Edmunds L, Kelly S, Waters E. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2003;3:CD001872.
29.
Golan M, Crow S. Targeting parents exclusively in the treatment of childhood obesity: long-term results. Obes Res. 2004;12:357–61.CrossRefPubMed
30.
Gehling RK, Magarey AM, Daniels LA. Food-based recommendations to reduce fat intake: an evidence-based approach to the development of a family-focused child weight management programme. J Paediatr Child Health. 2005;41:112–8.CrossRefPubMed
31.
Golley RK, Magarey AM, Daniels LA. Children's food and activity patterns following a six-month child weight management program. Int J Pediatr Obes. 2011;6:409–14.CrossRefPubMed
32.
Golley RK, Magarey AM, Baur LA, Steinbeck KS, Daniels LA. Twelve-month effectiveness of a parent-led, family-focused weight-management program for prepubertal children: a randomized, controlled trial. Pediatrics. 2007;119:517–25.CrossRefPubMed
33.
Magarey A, Hartley J, Perry R, Golley R. Parenting eating and activity for child health (PEACH™) in the community: (PEACH™ IC): translating research to practice. Public Health Bulletin South Australia. 2011;8:58–61.
34.
Waters E, Salmon J, Wake M, Wright M, Hesketh K. Australian authorised adaptation of the child health questionnaire - the interpretation guide. Parent/proxy form CHQ PF50&PF28. Melbourne: Centre for Community Health, Royal Children's Hospital; 1999.
35.
de Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J. Development of a WHO growth reference for school-aged children and adolescents. Bull World Health Organ. 2007;85:660–7.CrossRefPubMedPubMedCentral
36.
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL. CDC growth charts for the United States: methods and development. Vital Health Stat. 2000;11(2002):1–190.
37.
Freeman JV, Cole TJ, Chinn S, Jones PR, White EM, Preece MA. Cross sectional stature and weight reference curves for the UK, 1990. Arch Dis Child. 1995;73:17–24.CrossRefPubMedPubMedCentral
38.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–3.CrossRefPubMedPubMedCentral
39.
Cole TJ, Flegal KM, Nicholls D, Jackson AA. Body mass index cut offs to define thinness in children and adolescents: international survey. BMJ. 2007;335:194.CrossRefPubMedPubMedCentral
40.
NHMRC, Eat for Health: Australian dietary guidelines, Department of Health and Ageing, editor. 2013, Commonwealth of Australia: Canberra.
41.
Magarey A, Golley R, Spurrier N, Goodwin E, Ong F. Reliability and validity of the Children's dietary questionnaire; a new tool to measure children's dietary patterns. Int J Pediatr Obes. 2009;4:257–65.CrossRefPubMed
42.
Telford A, Salmon J, Jolley D, Crawford D. Reliability and validity of physical activity questionnaires for children: the Children's leisure activities study survey (CLASS). Pediatr Exerc Sci. 2004;16:64–78.CrossRef
43.
Stevens K. Developing a descriptive system for a new preference-based measure of health-related quality of life for children. Qual Life Res. 2009;18:1105–13.CrossRefPubMed
44.
Stevens K. Assessing the performance of a new generic measure of health-related quality of life for children and refining it for use in health state valuation. Appl Health Econ Health Policy. 2011;9:157–69.CrossRefPubMed
45.
Lucas N, Nicholson JM, Maguire B, The longitudinal study of Australian children annual statistical report 2010. 2011, Australian Government, Australian Institute of Family Studies,: Canberra.
46.
Becker MH, Maiman LA, Kirscht JP, Haefner DP, Drachman RH. The health belief model and prediction of dietary compliance: a field experiment. J Health Soc Behav. 1977;18:348–66.CrossRefPubMed
47.
Daddario DK. A review of the use of the health belief model for weight management. Medsurg Nurs. 2007;16:363–6.PubMed
48.
Daniels LA, Magarey A, Battistutta D, Nicholson JM, Farrell A, Davidson G, Cleghorn G. The NOURISH randomised control trial: positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity. BMC Public Health. 2009;9:387.CrossRefPubMedPubMedCentral
Metadata
Title
CONSORT to community: translation of an RCT to a large-scale community intervention and learnings from evaluation of the upscaled program
Authors
Carly Jane Moores
Jacqueline Miller
Rebecca Anne Perry
Lily Lai Hang Chan
Lynne Allison Daniels
Helen Anna Vidgen
Anthea Margaret Magarey
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4907-2

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