METHODS: A sample of obesity prevention interventions that had been scaled-up or implemented at scale were found using a structured search strategy. Included interventions were mapped against four scale-up pathways and timeframes associated with each stage of the scale-up pathway were identified to determine the time taken to scale-up.
RESULTS: Of the 90 interventions found that were scaled-up to at least a city-wide level, less than half reported a comprehensive research pathway to scale-up and a third did not report any evidence of efficacy or effectiveness prior to scale-up. The time taken to scale-up ranged from 0 to 5 years depending on the pathway taken. Those following a comprehensive pathway took approximately 5 years to scale-up, while interventions that had only one evidence generating step took between 1 and 1.5 years to scale-up. For the remaining interventions, scale-up occurred immediately post-development without evidence generation.
CONCLUSIONS: Our findings indicate that the scale-up of obesity prevention interventions can occur more quickly than previous estimates of 14-17 years. Our findings support previous research that scale-up of interventions occurs through a variety of pathways and often scale-up occurs in absence of prior evidence of effectiveness.
方法:使用结构化搜索策略发现了已按比例扩大或大规模实施的肥胖预防干预措施样本。将纳入的干预措施映射到四个放大途径,并确定与放大途径的每个阶段相关的时间框架,以确定放大所需的时间。
结果:在90项干预措施中,这些干预措施至少扩大到了整个城市的水平,不到一半的人报告了扩大规模的综合研究途径,三分之一的人在扩大规模之前没有报告任何疗效或有效性的证据.根据所采取的途径,扩大规模所需的时间为0至5年。那些遵循全面途径的人需要大约5年的时间才能扩大规模,而只有一个证据生成步骤的干预措施需要1至1.5年才能扩大规模。对于其余的干预措施,在没有证据产生的情况下,开发后立即扩大规模。
结论:我们的研究结果表明,肥胖预防干预措施的推广比以前估计的14-17年更快。我们的发现支持先前的研究,即干预措施的扩大是通过多种途径进行的,并且通常在缺乏有效性的先前证据的情况下进行扩大。