Adam Shoesmith1,2,3, Alix Hall4,5,6,7, Luke Wolfenden4,5,6,7, Rachel C Shelton8, Byron J Powell9, Hannah Brown4,6, Sam McCrabb4,5,6, Rachel Sutherland4,5,6,7, Serene Yoong4,5,6,7, Cassandra Lane4, Debbie Booth10, Nicole Nathan4,5,6,7. 1. School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia. Adam.Shoesmith@health.nsw.gov.au. 2. Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia. Adam.Shoesmith@health.nsw.gov.au. 3. Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia. Adam.Shoesmith@health.nsw.gov.au. 4. School of Medicine and Public Health, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia. 5. Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Wallsend, NSW, 2287, Australia. 6. Priority Research Centre for Health Behaviour, The University of Newcastle, University Drive, Callaghan, 2308, NSW, Australia. 7. Hunter Medical Research Institute, 1/Kookaburra Circuit, New Lambton Heights, 2305, NSW, Australia. 8. Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA. 9. Brown School and School of Medicine, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO, 63130, USA. 10. University Library, Academic Division, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
Abstract
BACKGROUND: Sustainment has been defined as the sustained use or delivery of an intervention in practice following cessation of external implementation support. This review aimed to identify and synthesise factors (barriers and facilitators) that influence the sustainment of interventions (policies, practices, or programmes) in schools and childcare services that address the leading risk factors of chronic disease. METHODS: Seven electronic databases and relevant reference lists were searched for articles, of any design, published in English, from inception to March 2020. Articles were included if they qualitatively and/or quantitatively reported on school or childcare stakeholders' (including teachers, principals, administrators, or managers) perceived barriers or facilitators to the sustainment of interventions addressing poor diet/nutrition, physical inactivity, obesity, tobacco smoking, or harmful alcohol use. Two independent reviewers screened texts, and extracted and coded data guided by the Integrated Sustainability Framework, an existing multi-level sustainability-specific framework that assesses factors of sustainment. RESULTS: Of the 13,158 articles identified, 31 articles met the inclusion criteria (8 quantitative, 12 qualitative, 10 mixed-methods, and 1 summary article). Overall, 29 articles were undertaken in schools (elementary n=17, middle n=3, secondary n=4, or a combination n=5) and two in childcare settings. The main health behaviours targeted included physical activity (n=9), diet (n=3), both diet and physical activity (n=15), and smoking (n=4), either independently (n=1) or combined with other health behaviours (n=3). Findings suggest that the majority of the 59 barriers and 74 facilitators identified to impact on intervention sustainment were similar across school and childcare settings. Factors predominantly relating to the 'inner contextual factors' of the organisation including: availability of facilities or equipment, continued executive or leadership support present, and team cohesion, support, or teamwork were perceived by stakeholders as influential to intervention sustainment. CONCLUSIONS: Identifying strategies to improve the sustainment of health behaviour interventions in these settings requires a comprehensive understanding of factors that may impede or promote their ongoing delivery. This review identified multi-level factors that can be addressed by strategies to improve the sustainment of such interventions, and suggests how future research might address gaps in the evidence base. TRIAL REGISTRATION: This review was prospectively registered on PROSPERO: CRD42020127869 , Jan. 2020.
BACKGROUND: Sustainment has been defined as the sustained use or delivery of an intervention in practice following cessation of external implementation support. This review aimed to identify and synthesise factors (barriers and facilitators) that influence the sustainment of interventions (policies, practices, or programmes) in schools and childcare services that address the leading risk factors of chronic disease. METHODS: Seven electronic databases and relevant reference lists were searched for articles, of any design, published in English, from inception to March 2020. Articles were included if they qualitatively and/or quantitatively reported on school or childcare stakeholders' (including teachers, principals, administrators, or managers) perceived barriers or facilitators to the sustainment of interventions addressing poor diet/nutrition, physical inactivity, obesity, tobacco smoking, or harmful alcohol use. Two independent reviewers screened texts, and extracted and coded data guided by the Integrated Sustainability Framework, an existing multi-level sustainability-specific framework that assesses factors of sustainment. RESULTS: Of the 13,158 articles identified, 31 articles met the inclusion criteria (8 quantitative, 12 qualitative, 10 mixed-methods, and 1 summary article). Overall, 29 articles were undertaken in schools (elementary n=17, middle n=3, secondary n=4, or a combination n=5) and two in childcare settings. The main health behaviours targeted included physical activity (n=9), diet (n=3), both diet and physical activity (n=15), and smoking (n=4), either independently (n=1) or combined with other health behaviours (n=3). Findings suggest that the majority of the 59 barriers and 74 facilitators identified to impact on intervention sustainment were similar across school and childcare settings. Factors predominantly relating to the 'inner contextual factors' of the organisation including: availability of facilities or equipment, continued executive or leadership support present, and team cohesion, support, or teamwork were perceived by stakeholders as influential to intervention sustainment. CONCLUSIONS: Identifying strategies to improve the sustainment of health behaviour interventions in these settings requires a comprehensive understanding of factors that may impede or promote their ongoing delivery. This review identified multi-level factors that can be addressed by strategies to improve the sustainment of such interventions, and suggests how future research might address gaps in the evidence base. TRIAL REGISTRATION: This review was prospectively registered on PROSPERO: CRD42020127869 , Jan. 2020.
Authors: Luke Wolfenden; Nicole K Nathan; Rachel Sutherland; Sze Lin Yoong; Rebecca K Hodder; Rebecca J Wyse; Tessa Delaney; Alice Grady; Alison Fielding; Flora Tzelepis; Tara Clinton-McHarg; Benjamin Parmenter; Peter Butler; John Wiggers; Adrian Bauman; Andrew Milat; Debbie Booth; Christopher M Williams Journal: Cochrane Database Syst Rev Date: 2017-11-29
Authors: Esther Karen Pijl; Yvonne T M Vanneste; Jolanda J P Mathijssen; Frans J M Feron; Angelique E de Rijk Journal: Int J Environ Res Public Health Date: 2022-04-06 Impact factor: 3.390
Authors: Bodil Just Christensen; Sidse Marie Sidenius Bestle; Ellen Trolle; Anja Pia Biltoft-Jensen; Jeppe Matthiessen; Sarah Jegsmark Gibbons; Anne Dahl Lassen Journal: Int J Environ Res Public Health Date: 2022-06-29 Impact factor: 4.614