XChange Newsletter: Implementation and Scalability SIG

Hello Implementation and Scalability SIG member!

Welcome from the Chair

If you are like me, you thought the world would look different by now. Yet, I know many of us continue to navigate losses and challenges related to COVID-19. I heard today the summation that 2020 was disorienting, and 2021 is exhausting. I feel that deep down; maybe it resonates for you as well. I hope that as we see the holidays on the horizon there will be time for reflection and restoration for us all.

While we look to a brighter future together, our SIG is pleased to share a newsletter spotlighting our member Karen Lee, announcing the award winners for our SIG for ISBNPA 2021, and featuring new literature, webinar, and events of potential interest with you. Don’t miss key dates for the upcoming ISBNPA 2022 conference - https://annualmeeting.isbnpa.org/key-dates/

Symposia submissions are due November 11th and regular abstracts are due December 7th. My how the time flies!

Dr Taren Swindle

SIG Co-Chair

Member Spotlight: Karen Lee

1. Qualifications and Position

I am a Research Officer with Implementation and Scale-up team at The Australian Prevention Partnership Centre, but based within the Prevention Research Collaboration at the University of Sydney. I am submitting my PhD Thesis in scaling up public health interventions in the coming weeks.

2. What led you to focus your research on I&S?

Shortly after commencing the Masters of Public Health at Usyd, I started a project with Prof. Adrian Bauman AO who introduced me to the area of implementation and scale-up. This project focused on mapping out how scale-up occurred in the real-world using case studies from all over the world. It was an eye opener to the complexities of scale-up and how different it is from what the theoretical frameworks imply that it should be. It also highlighted the fact that many interventions are scaled-up despite not having an evidence base, and while there are many factors for this, I became very interested in understanding why this happens and how further research might be able to better inform decision making on scaling up.

3. What is your main research interest? What do you love about it?

Given that I don’t come from an academic background, I am really interested in bridging that gap between policy making and academia. In particular, I am passionate about helping policy makers and practitioners make more informed decisions about how, when and what to scale-up using research evidence. Furthermore, coming from a health equity point of view, I believe that if we want to improve population health and really effect change in terms of preventing chronic diseases, we must scale-up interventions that work. I love that the thought of the research I do now may have an impact on the population in years to come and affect long term changes to the health of the population.

4. As an ECR researcher what are the biggest barriers to conducting I&S research (other than funding) and how have you overcome this?

There are two main challenges to working in the area of Implementation and Scale-up.

Firstly, scaling up chronic disease prevention interventions is incredibly challenging as it is often considered the ‘poor cousin’ to infectious diseases, but we know that chronic diseases are the biggest contributors to burdens of disease in our population. Therefore, it is important as researchers to demonstrate that the work that we do, can and will make a difference in the long term. We can do this by collaborating with policy makers and to ensure that the research is relevant, timely and well communicate to those that need it. I have found that engaging policy makers and practitioners even at the individual level is helpful. Having those conversations is key to overcoming some of the challenges and it leads to more real world impact.

Secondly, from an academic perspective, the traditional ideals of efficacy and effectiveness studies, and emphasis on discovery still prevails. Studies on implementation and scale-up aren’t seen in the same light as discovery research however, are critical for facilitating scale-up. This is not something that will change overnight but with persistence and ongoing commitment to doing research in implementation and scale-up, I hope that funders start seeing the value in implementation and scale-up studies.

5. Do you have an I&S paper that you would like to share?

I would love to share a paper that is currently in the works, that describes the differences between implementation science and scale-up, as these two terms are often conflated and used interchangeably, but, it’s not quite ready. So, keep an eye out for that if you are interested!

In the meantime, one of the papers I wrote as part of my PhD, I found particularly enlightening as it highlighted the constant struggle between policy and research worlds. The paper entitled “Scaling up population health interventions from decision to sustainability – a window of opportunity? A qualitative view from policy-makers” explores some of the key factors behind how decisions to scale-up are made. It describes, that much like policy windows, similar windows exists for scale-up and even though some interventions are scaled-up without evidence, they are mostly done out of necessity and not deliberate attempts to circumvent the evidence generation process. For me, conducting this study made me realise even more how it important it is for policy makers and researchers to work collaboratively so that when these windows of opportunity for scale-up open, we can work together to make sure the right interventions are selected for scaling up, the ones that will likely effect the most population change.

Selected Recent Publications

Barnes C, McCrabb S, Stacey F, Nathan N, Yoong SL, Grady A, Sutherland R, Hodder R, Innes-Hughes C, Davies M, Wolfenden L. Improving implementation of school-based healthy eating and physical activity policies, practices, and programs: a systematic review. Transl Behav Med. 2021 Jul 29;11(7):1365-1410. doi: 10.1093/tbm/ibab037. PMID: 34080618; PMCID: PMC8320878.

Brown, M. Moodie, H. N. Q. Tran, M. Sultana, K. E. Hunter, R. Byrne, D. Zarnowiecki, AL Seidler, R. Golley, R. Taylor, KD Hesketh, K Matvienko-Sikar. Protocol for the development of Core Outcome Sets for Early intervention trials to Prevent Obesity in CHildren (COS-EPOCH). BMJ Open 2021 Vol. 11 Issue 7 Pages e048104 DOI: 10.1136/bmjopen-2020-048104

Castro O, Vergeer I, Bennie J, Biddle SJH. Feasibility of Reducing and Breaking Up University Students' Sedentary Behaviour: Pilot Trial and Process Evaluation. Front Psychol. 2021 Jun 10;12:661994. doi: 10.3389/fpsyg.2021.661994. PMID: 34177716; PMCID: PMC8222591.

Eisman, A.B., Quanbeck, A., Bounthavong, M. et al. Implementation science issues in understanding, collecting, and using cost estimates: a multi-stakeholder perspective. Implementation Sci 16, 75 (2021). https://doi.org/10.1186/s13012-021-01143-x

Greenhalgh T, Shaw S, Wherton J, Vijayaraghavan S, Morris J, Bhattacharya S, Hanson P, Campbell-Richards D, Ramoutar S, Collard A, Hodkinson I. Real-World Implementation of Video Outpatient Consultations at Macro, Meso, and Micro Levels: Mixed-Method Study. J Med Internet Res. 2018 Apr 17;20(4):e150. doi: 10.2196/jmir.9897. PMID: 29625956; PMCID: PMC5930173.

Koester, M., Bejarano, C.M., Davis, A.M. et al. Implementation contextual factors related to community-based active travel to school interventions: a mixed methods interview study. Implement Sci Commun 2, 94 (2021). https://doi.org/10.1186/s43058-021-00198-7

Korn, A.R., Appel, J., Hammond, R.A. et al. Validation and refinement of the Stakeholder-driven Community Diffusion Survey for childhood obesity prevention. Implementation Sci 16, 91 (2021). https://doi.org/10.1186/s13012-021-01158-4

Lane, C., Reno, K., Predy, M., Carson, V., Wright, C., Morton, K., Naylor, P.J. (2021). A real-world feasibility study of the PLAYshop: a brief intervention to facilitate parent engagement in developing their child’s physical literacy. Pilot and Feasibility Studies. 7(113), doi: 10.1186/s40814-021-00849-5

Moullin, J.C., Sklar, M., Ehrhart, M.G. et al. Provider REport of Sustainment Scale (PRESS): development and validation of a brief measure of inner context sustainment. Implementation Sci 16, 86 (2021). https://doi.org/10.1186/s13012-021-01152-w

Nguyen B, Cranney L, Bellew B, Thomas M. Implementing Food Environment Policies at Scale: What Helps? What Hinders? A Systematic Review of Barriers and Enablers. International Journal of Environmental Research and Public Health. 2021; 18(19):10346. https://doi.org/10.3390/ijerph181910346

Shoesmith, A., Hall, A., Wolfenden, L. et al. Barriers and facilitators influencing the sustainment of health behaviour interventions in schools and childcare services: a systematic review. Implementation Sci 16, 62 (2021). https://doi.org/10.1186/s13012-021-01134-y

Yoong SL, Jackson J, Barnes C, Pearson N, Swindle T, O'Reilly S, et al., 'Changing landscape of nutrition and dietetics research? A bibliographic analysis of top-tier published research in 1998 and 2018', Public Health Nutrition, 24 1318-1327 (2021)

Yoong SL, Jones J, Pearson N, Swindle T, Barnes C, Delaney T, et al., 'An overview of research opportunities to increase the impact of nutrition intervention research in early childhood and education care settings according to the re-aim framework', International Journal of Environmental Research and Public Health, 18 1-19 (2021)

Yoong SL, Hall A, Stacey F, Nathan N, Reilly K, Delaney T, et al., 'An exploratory analysis to identify behavior change techniques of implementation interventions associated with the implementation of healthy canteen policies.', Transl Behav Med, 11 1606-1616 (2021)

Yoong SL, Bolsewicz K, Grady A, Wyse R, Sutherland R, Hodder RK, et al., 'Adaptation of public health initiatives: expert views on current guidance and opportunities to advance their application and benefit', Health education research, 35 243-257 (2020)