A protocol of a pilot randomised trial (Action-RESPOND) to support rural and regional communities with implementing community-based systems thinking obesity prevention initiatives

PLoS One. 2024 May 2;19(5):e0302047. doi: 10.1371/journal.pone.0302047. eCollection 2024.

Abstract

Background: Over a quarter of children aged 2-17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods.

Methods: This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team.

Discussion: By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria.

Publication types

  • Research Support, Non-U.S. Gov't
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Health Promotion / methods
  • Humans
  • Male
  • Pediatric Obesity* / prevention & control
  • Pilot Projects
  • Rural Population*
  • Victoria / epidemiology

Grants and funding

RESPOND is funded through the National Health and Medical Research Council (NHMRC) (APP115572, CIA SA), VicHealth, Nexus Primary Health, Goulburn Valley Primary Care Partnership and Deakin University. Action-RESPOND is also funded through support funds provided to SY as part of a Heart Foundation Future Leader Fellowship (106654). The opinions, analysis, and conclusions in this paper are those of the authors and should not be attributed to the NHMRC, the Victorian Department of Health or the Victorian Department of Education and Training. SY is supported by a Heart Foundation Future Leader Fellowship (106654). The participating communities were not provided with additional funding to implement the actions.