Supporting a systems approach to scaling for all; insights from using the Scaling Scan tool

Agricultural Systems, Journal Year: 2024, Volume and Issue: 217, P. 103927 - 103927

Published: March 21, 2024

Approaches to scaling are persistently linear and focus on a single innovation, an innovator control the process, purpose driven by donor accountability. Alternative approaches that better reflect complexity involved in sustainable development draw systems thinking theory, but hardly used. The Scaling Scan tool facilitates integration of approach broad public. This study draws from almost six years experience using adapting deepen theoretical empirical understanding what is challenges project teams organizations face embrace this. uses data retrieved between 2017 2023 54 workshops where was used scale innovations for development. Data were complemented with literature SWOT analysis understand use, users, user adaptations tool. Scans' context, unintended consequences facilitation collective action important components scaling. Multiple tools have been made users facilitate even more understanding. However, early "the" innovation intrinsic assumption this addresses key root cause or leverage point system risks perpetuate scoring ingredients show tendency familiar disciplines (mostly technical), limiting progression beyond "bigger pilot" engage who required contribute large change, such as market public support. Transitioning challenging because business models research depend high adoption "their" innovations. We find that, there far-reaching implications embracing which not everyone may want can accept. no longer assume complex systemic problems hunger poverty will be solved having innovation. Yet still dominant Sustainable Development Goals. contributes deeper role initiatives aimed at

Language: Английский

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Scale-up influences and definitions of scale-up ‘success’: evidence from globally scaled interventions

Translational Behavioral Medicine, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 1, 2025

Abstract The World Health Organization ExpandNet framework for scaling up contains key recommendations to support the of health interventions globally. Despite being widely used, it is not known how informs intervention scale-up nor ‘successful’ defined. Using data from Scaling Up InTErventions’ study, this paper assessed adoption components using an international sample scaled-up physical activity and nutrition interventions, explored individuals’ definitions ‘success’. An online survey with academic, community, government representatives involved in Survey questions (n = 27) corresponded 32 framework, reflecting four core areas: (i) intervention; (ii) user organization; (iii) resource team; (iv) strategy. Data were analysed descriptively qualitative free-text responses coded thematically. In total, 62 obtained [academia 32), community 20), 10)], corresponding 35 interventions. Only 8% participants reported all during scale-up. Four elements (containing eight themes) underpinned successful scale-up: inputs (e.g., sustained partner buy-in); outputs sustained, quality implementation); outcomes increased equitable reach, improved organization system capacity) and; context mental models, a context-specific construct). There no universal definition We propose ‘successful scale-up’ that could be used as criteria planning evaluation, are applicable other areas public health.

Language: Английский

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Implementation determinants of physical activity interventions in primary health care settings using the TICD framework: a systematic review

BMC Health Services Research, Journal Year: 2023, Volume and Issue: 23(1)

Published: Oct. 11, 2023

Translation into practice of effective physical activity interventions in primary care is difficult, due to a complex interaction implementation determinants. We aimed identify barriers and facilitators four interventions: assessment, counselling, prescription, referral.A systematic review qualitative, quantitative mixed-methods studies published since 2016 was conducted. The "Tailored Implementation for Chronic Diseases" (TICD) framework adapted extract synthesize facilitators.Sixty-two met the inclusion criteria. Barriers (n = 56) 55) were identified across seven domains, related characteristics intervention, individual factors implementers receivers, organizational factors, political social five most frequently reported determinants were: professionals' knowledge skills; intervention feasibility/compatibility with health routine; interventions' cost financial incentives; tools materials; cognitions attitudes. "Social, legal factors" domain least reported. Physical referral influenced by belonging all domains.The broader range professionals, characteristics, available resources A deep understanding local context, particularly emphasis on these determinants, should be considered when preparing an implementation, order contribute designing tailored strategies optimize effectiveness.

Language: Английский

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Systems approaches to scaling up: a systematic review and narrative synthesis of evidence for physical activity and other behavioural non-communicable disease risk factors

International Journal of Behavioral Nutrition and Physical Activity, Journal Year: 2024, Volume and Issue: 21(1)

Published: March 21, 2024

Abstract Background Non-communicable diseases (NCDs) are the leading causes of death worldwide. Systems approaches have potential for creating sustainable outcomes at scale but rarely been used to support up in physical activity/nutrition promotion or NCD prevention more generally. This review aimed to: (i) synthesise evidence on use systems scaling interventions targeting four behavioural risk factors NCDs; and (ii) explore how conceptualised intervention implementation up. Method Seven electronic databases were searched studies published 2016–2021. Eligible targeted least one (physical inactivity, tobacco use, alcohol consumption, diet), described evaluation an planned scaled Studies categorised as having a high , moderate (iii) no approach. A narrative synthesis had operationalised up, following PRISMA guidelines. Results Twenty-one included. Only 19% ( n = 4) explicitly thinking inform design, (targeting all 2, diet 1, 1). Five (‘high use’) implemented with explicit focus relations between system elements changes drive impact scale. (‘moderate considered impacting scale-up processes did not require achieving system-level from outset. Nine (‘no designed work multiple levels among agencies setting, complexity was articulated. We synthesised reported barriers facilitators within each group approaches, methods, frameworks principles Conclusion In activity research, broadly, remains its infancy. For researchers, practitioners policymakers wishing adopt scale, guidance is needed communicate operationalise research practice. Trial registration PROSPERO (CRD42021287265).

Language: Английский

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Scaling up a school-based intervention to increase physical activity and reduce sedentary behaviour in children: protocol for theTransformUshybrid effectiveness–implementation trial

BMJ Open, Journal Year: 2023, Volume and Issue: 13(10), P. e078410 - e078410

Published: Oct. 1, 2023

Introduction Efficacious programmes require implementation at scale to maximise their public health impact. TransformUs is an efficacious behavioural and environmental intervention for increasing primary (elementary) school children’s (5–12 years) physical activity reducing sedentary behaviour within home settings. This paper describes the study protocol of a 5-year effectiveness–implementation trial assess scalability effectiveness programme. Methods analysis A type II hybrid implementation–effectiveness trial, being disseminated all schools in state Victoria, Australia (n=1786). Data are collected using mixed methods system (state government, partner organisations), organisation (school) individual (teacher, parent child) levels. Evaluation based on programme Reach, Effectiveness, Adoption, Implementation Maintenance (RE-AIM) framework. RE-AIM domains measured quasi-experimental, pre/post, non-equivalent group design, baseline, 12 24 months. Effectiveness will be determined subsample 20 (in Victoria) control New South Wales (NSW), Australia), Primary outcomes include organisational (implementation trial), time assessed accelerometers (effectiveness trial). Secondary average moderate vigorous-intensity weekdays during hours, body mass index z-scores waist circumference Linear mixed-effects models fitted compare between participants accounting clustering children schools, confounding random effects. Ethics dissemination The was approved by Deakin University Human Research Committee (HEAG-H 28_2017), Victorian Department Education, NSW Australian Catholic (2017-145R), Melbourne Archdiocese Schools NSW. Partners, schools/teachers parents provide informed signed consent form prior participating. Parents child participate trial. Findings via peer-reviewed publications, scientific conferences, summary reports our organisations, inform education policy practice effective sustainable ways promote reduce behaviours population-wide. Trial registration number Clinical Trials Registration Registry (ACTRN12617000204347).

Language: Английский

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Evaluating Real-World Implementation of INFORM (Improving Nursing Home Care through Feedback on Performance Data): An Improvement Initiative in Canadian Nursing Homes

The Joint Commission Journal on Quality and Patient Safety, Journal Year: 2024, Volume and Issue: 50(8), P. 579 - 590

Published: April 30, 2024

INFORM (Improving Nursing Home Care through Feedback on Performance Data) was a research intervention that equipped nursing home managers with skills to conduct local improvement projects and supported them in improving performance modifiable elements their units. Prior reports have found positive sustained outcomes from intervention. In this article, the authors report findings formative service evaluation of as modified for implementation real-world settings.

Language: Английский

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A mixed-methods process evaluation of a combined physical activity and psychological therapy intervention for socially disadvantaged young people.

Research Square (Research Square), Journal Year: 2024, Volume and Issue: unknown

Published: May 13, 2024

Background: There is a growing body of evidence to suggest that interventions combining physical activity with psychological therapy can improve engagement, retention, and outcomes young people experiencing homelessness (YPEH). However, the challenges associated implementing such remain poorly understood. To address this lack understanding, aim study was evaluate barriers facilitators implementation community-based intervention comprising psychotherapy for YPEH. Methods: A retrospective mixed-methods process evaluation undertaken explore recruitment fidelity, dose delivered, received, intervention. Quantitative data sources included attendance registers, which were analysed using descriptive statistics, qualitative obtained from interviews implementers, focus groups participants, predominantly deductive thematic approach. This subsequently triangulated intervention-fidelity monitoring forms, non-participant observations support interpretation findings. Results: Six participants initially enrolled into study, three achieving >75% attendance. Challenges retention multi-factorial, however, organisational resources (staff transportation) appeared have greatest influence. Implementer forms evidenced fidelity delivered both components (physical psychotherapy) good. Moreover, suggested adaptations did not adversely impact on effectiveness. Dose received by indicative their engagement sessions rather than attendance, including perceived quality received. Contextual identified across individual, organisational, intervention-level domains. Conclusions: Implementation-related factors multiple levels contributed encountered, feasibility or acceptability combined Allowing flexibility necessary as key facilitator delivery positive experiences reported participants. Working stakeholders project inception may be overcoming barriers, could help facilitate scale-up intervention, translation research routine practice.

Language: Английский

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Fundamentos Teóricos de la Gobernanza en la Promoción de la Actividad Física

Ciencia Latina Revista Científica Multidisciplinar, Journal Year: 2024, Volume and Issue: 8(3), P. 1275 - 1300

Published: June 4, 2024

El objetivo de este trabajo es proporcionar los fundamentos teóricos la gobernanza en promoción actividad física, que sirva como marco referencia para formulación e implementación proyectos, programas, planes y políticas públicas destinados a fomentar física nivel comunitario, regional nacional. La metodología implementada se basa una revisión exhaustiva literatura existente sobre analizando principios dimensiones clave propuestos por diversos autores investigadores campo. Este enfoque multidisciplinario busca integrar conocimientos perspectivas diferentes áreas relacionadas con salud pública gobernanza. Los principales hallazgos del incluyen identificación factores cruciales efectiva basadas evidencia, coordinación intersectorial, participación ciudadana, infraestructura adecuada evaluación continua. Además, destaca necesidad desarrollar modelos marcos integrales guíen gobiernos organizaciones estrategias específicas ámbito. Artículo reflexión producto tesis doctoral “Modelo Gobernanza Actividad Física el Distrito Especial Santiago Cali – Colombia”

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Multi-level stakeholders' perspectives on implementation and scaling up community-based health promotion in Germany

Health Promotion International, Journal Year: 2023, Volume and Issue: 38(3)

Published: May 4, 2023

Community-based health promotion has the potential to address existing inequities, although such approaches are scarcely scaled up. For a successful scale up, various stakeholders at different levels and sectors need be involved. The article's aims assess what kind of external support communities for implementation identify facilitators barriers scaling up community-based promotion. Two national digital workshops were conducted in Germany with community level (n = 161) federal state 84). Protocols compiled coded using qualitative content analysis. During first workshop, we revealed 11 themes needs ('Strategic approach', 'Define & compare indicators', 'International human resource', 'Tools Aids', 'External conduction assessment', 'Involvement people difficult life situations', 'Overview actors', 'Moderation', 'Obtain funding', 'Quality assurance/evaluation' support'). Eleven identified ('Assessment evaluation', 'Intersectoral collaboration partnerships', 'Communication', 'Characteristics program', 'Political legal conditions', support', 'Local coordinator', 'Resources', 'Participation', 'Strategic planning/methods' 'Intermediary organization'). results provide practice-based evidence on needed that promote might hinder Germany. In next step, this systematically integrated scientific-based key components development an effective scaling-up concept.The major aim article is describe how German (local, state) from (e.g. health, social or sports) involved develop concept approach focus equity field physical activity Different actors science, policy practice discussed implement approach, situations individuals disadvantages). We 14 Various emphasized improved partnerships across several as well changes current political conditions. Furthermore, role some characteristics organization process also among actors.

Language: Английский

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Factors relating to sustainability and scalability of the ‘Food, Move, Sleep (FOMOS) for Postnatal Mental Health’ program: Qualitative perspectives from key stakeholders across Australia

Health Promotion Journal of Australia, Journal Year: 2023, Volume and Issue: 35(2), P. 393 - 409

Published: June 29, 2023

Abstract Issue Addressed Supporting healthy behaviours (quality diet, physical activity, sleep) through home‐based interventions is feasible to improve postnatal mental health. Involving stakeholders in developing essential for maximising accessibility, implementation and scale‐up. This study aimed identify factors affecting the sustainable scalability of Food, Move, Sleep (FOMOS) Postnatal Mental Health program, including strategies enhance research‐practice translation. Methods Stakeholders ( n = 13) involved promoting eating, health, public health and/or policy participated semi‐structured interviews. Interviews, based on PRACTIS Guide recommendations scale‐up, explored perceptions program design, scalability. Reflexive thematic analysis was undertaken. Identified scale‐up were mapped against Expert Recommendations Implementing Change compendium Guide. Results Individual‐level : Targeting multiple systems (primary, tertiary, community‐based care) entry points (early, mid‐postpartum) uptake important. For equity, screening women hospitals, engaging with community agencies targeting most at‐risk women, suggested. Provider‐level identified future roll‐out (organisations assisting recruitment). Factors impacting sustainability included high demand FOMOS governance around funding; online delivery, connecting partners providers integration into existing services may sustainability. Systems‐level Political support champions perceived important dissemination. Nine addressing uptake, reach, implementation, potential identified. Conclusions a multi‐behaviour intervention, multi‐level strategies, aligned systems, policies initiatives should be considered. So What? paper provides comprehensive list that can used behaviour programs Further, interview schedule, systematically developed Guide, serve as useful resource researchers conducting similar studies future.

Language: Английский

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