A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia

Vidgen, Helen A., Love, Penelope V., Wutzke, Sonia E., Daniels, Lynne A., Rissel, Chris E., Innes-Hughes, Christine and Baur, Louise A. 2018, A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia, Implementation science, vol. 13, no. 109, doi: 10.1186/s13012-018-0801-2.

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Title A description of health care system factors in the implementation of universal weight management services for children with overweight or obesity: case studies from Queensland and New South Wales, Australia
Author(s) Vidgen, Helen A.
Love, Penelope V.ORCID iD for Love, Penelope V. orcid.org/0000-0002-1244-3947
Wutzke, Sonia E.
Daniels, Lynne A.
Rissel, Chris E.
Innes-Hughes, Christine
Baur, Louise A.
Journal name Implementation science
Volume number 13
Issue number 109
Total pages 15
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2018-08-07
ISSN 1748-5908
1748-5908
Keyword(s) Child health
Health service
Implementation
Obesity management
Universal care
Upscale
Weight management
Summary BACKGROUND: The prevalence of childhood obesity poses an urgent global challenge. The World Health Organization (WHO) Commission on Ending Childhood Obesity recommends the provision of appropriate family-based, lifestyle weight management services through universal health care to support families of children with overweight or obesity; however, there are few examples of their implementation 'at scale'. The purpose of this research was to compare and contrast the impact of system and organisational factors on the implementation of childhood obesity management services within two Australian States (New South Wales and Queensland) to comprehensively describe their influence on the achievement of the WHO recommendation. METHODS: Purposeful stratified sampling was used to select health service study sites (n = 16) representative of program implementation (none, discontinued, repeated) and geographic location within each State. Within each health service site, staff involved in program delivery, co-ordination and management roles participated (n = 39). An additional 11 staff involved in implementation at State level also participated. The Consolidated Framework for Implementation Research (CFIR) was used to develop interview scripts. Telephone interviews were recorded and transcribed. Transcripts were thematically coded and scored according to CFIR constructs and rating rules to identify enablers and barriers to implementation according to sample characteristics. RESULTS: New South Wales achieved ongoing implementation; Queensland did not. Enablers included a quality evidence-based program, State government recognition of the urgency of the health issue and a commitment to address it, formally appointed and funded internal implementation leaders, strong communication and reporting at all levels. Barriers included the complexity of the health issue, in particular a lack of clear roles and responsibilities for local health service delivery, inadequate ongoing funding and challenges in meeting the diverse needs of families. CONCLUSIONS: This research is an important progression of the evidence base in relation to the translation of childhood obesity management trials into routine health service delivery. Understanding enablers and barriers to program implementation 'at scale' is imperative to inform future planning and investment by Australia and WHO member states to meet their commitment to deliver childhood weight management services as part of universal health coverage.
Language eng
DOI 10.1186/s13012-018-0801-2
Field of Research 11 Medical and Health Sciences
08 Information and Computing Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2018, The Authors
Persistent URL http://hdl.handle.net/10536/DRO/DU:30118004

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