Background: Public health (PH) decision makers require a coordinated multi-component approach to support evidence-informed decision making (EIDM). Objectives: To evaluate the effectiveness of three knowledge translation and exchange (KTE) strategies in promoting the use, in PH decision making, of the results of seven systematic reviews on healthy body weight promotion among children. Methods: In this randomized controlled trial (RCT), Canadian PH managers were allocated to one of three intervention groups: 1) OR Group (access to an online registry of systematic reviews); 2) TM Group (registry access plus targeted messages); and 3) KB Group (registry access, targeted messages, and knowledge brokering services). The intervention was implemented over one year. Data were collected at baseline, immediately post-intervention, and one year post-intervention. Outcomes included the number of evidence-supported PH interventions provided and a self-reported measure of the use of the review evidence in program decisions. Results: In total 108 of 141 (76%) health departments participated in the study, and 88 (81%) completed the one year follow-up. In the Targeted Messages group most of the statistically significant gains on the number of evidence-supported interventions observed immediately post-intervention had disappeared by the one-year follow-up. The Online Registry group improved slightly and the Knowledge Brokering group improved significantly from immediately post-intervention to follow-up. However, no statistically significant between-group differences were observed at one year follow-up on either measure. Conclusions: The RCT results demonstrate that the positive effect of targeted messages is not maintained without ongoing intervention suggesting that targeted messages need to be maintained over time in order to sustain EIDM. Improvement in the number of evidence-supported programs among those in the Knowledge Brokering group one year following the KTE intervention but not immediately post, suggests that the impact of knowledge brokering takes longer to be observed, but may lead to longer-term sustainability of evidence-informed behaviours