A narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland

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dc.contributor.authorCroyden, Debbie L
dc.contributor.authorVidgen, Helen A
dc.contributor.authorEsdaile, Emma
dc.contributor.authorHernandez, Emely
dc.contributor.authorMagarey, Anthea Margaret
dc.contributor.authorMoores, Carly J
dc.contributor.authorDaniels, Lynne Allison
dc.date.accessioned2018-03-27T04:40:06Z
dc.date.available2018-03-27T04:40:06Z
dc.date.issued2018-03-13
dc.date.updated2018-03-20T04:36:59Z
dc.descriptionThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
dc.description.abstractBackground: PEACH QLD translated the PEACH Program, designed to manage overweight/obesity in primary school-aged children, from efficacious RCT and small scale community trial to a larger state-wide program. This paper describes the lessons learnt when upscaling to universal health coverage. Methods: The 6-month, family-focussed program was delivered in Queensland, Australia from 2013 to 2016. Its implementation was planned by researchers who developed the program and conducted the RCT, and experienced project managers and practitioners across the health continuum. The intervention targeted parents as the agents of change and was delivered via parent-only group sessions. Concurrently, children attended fun, non-competitive activity sessions. Sessions were delivered by facilitators who received standardised training and were employed by a range of service providers. Participants were referred by health professionals or self-referred in response to extensive promotion and marketing. A pilot phase and a quality improvement framework were planned to respond to emerging challenges. Results: Implementation challenges included engagement of the health system; participant recruitment; and engagement. A total of 1513 children (1216 families) enrolled, with 1122 children (919 families) in the face-to-face program (105 groups in 50 unique venues) and 391 children (297 families) in PEACH Online. Self-referral generated 68% of enrolments. Unexpected, concurrent and, far-reaching public health system changes contributed to poor program uptake by the sector (only 56 [53%] groups delivered by publicly-funded health organisations) requiring substantial modification of the original implementation plan. Process evaluation during the pilot phase and an ongoing quality improvement framework informed program adaptations that included changing from fortnightly to weekly sessions aligned with school terms, revision of parent materials, modification of eligibility criteria to include healthy weight children and provision of services privately. Comparisons between pilot versus state-wide waves showed comparable prevalence of families not attending any sessions (25% vs 28%) but improved number of sessions attended (median?=?5 vs 7) and completion rates (43% vs 56%). Conclusions: Translating programs developed in the research context to enable implementation at scale is complex and presents substantial challenges. Planning must ensure there is flexibility to accommodate and proactively manage the system changes that are inevitable over time
dc.identifier.citationCroyden, D. L., Vidgen, H. A., Esdaile, E., Hernandez, E., Magarey, A., Moores, C. J., & Daniels, L. (2018). A narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-5237-8
dc.identifier.doihttps://doi.org/10.1186/s12889-018-5237-8
dc.identifier.issn1471-2458
dc.identifier.urihttps://doi.org/10.1186/s12889-018-5237-8
dc.identifier.urihttp://hdl.handle.net/2328/37827
dc.language.isoenen
dc.oaire.license.condition.licenseCC-BY
dc.publisherBioMed Central
dc.rights© The Author(s) 2018
dc.rights.holderThe Author(s)
dc.subjectChild
dc.subjectOverweight
dc.subjectObesity
dc.subjectImplementation
dc.subjectUp-scaling
dc.subjectTranslational research
dc.subjectHealth system
dc.subjectHealth service
dc.titleA narrative account of implementation lessons learnt from the dissemination of an up-scaled state-wide child obesity management program in Australia: PEACH™ (Parenting, Eating and Activity for Child Health) Queensland
dc.typeArticleen
local.contributor.authorOrcidLookupMagarey, Anthea Margaret: https://orcid.org/0000-0002-1214-2124en_US
local.contributor.authorOrcidLookupMoores, Carly J: https://orcid.org/0000-0003-0762-7482en_US
local.contributor.authorOrcidLookupEsdaile, Emma: https://orcid.org/0000-0002-9166-1001
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