Background: Targeting health risk behaviours in children is an important aspect of chronic disease prevention, as heath behaviours established in childhood are likely to track into adulthood. Schools are an attractive setting for the implementation of child-focused chronic disease prevention interventions. However, many recommended prevention interventions are not adopted or implemented by schools, despite government mandates to do so. Studying the effectiveness of strategies designed to improve implementation, and why these strategies succeed or fail, provides critical information for future improved adoption and use of recommended practices.
We are conducting two systematic reviews to assess the effectiveness of implementation strategies for school-based chronic disease prevention policies, programs or practices (interventions).
Objectives: To describe and discuss conceptual and practical challenges encountered in conducting an implementation review for public health.
Methods: Data concerning the conceptual and practical difficulties encountered in the conduct of the reviews has been systematically captured and will be presented as a case study.
Results: The reviews are currently underway. The key challenge encountered has been distinguishing ‘ intervention strategies to support implementation’ from the ‘intervention’ to be implemented. The issue is exemplified by whether health behaviour interventions, which do not primarily aim to influence implementation constitute implementation. Undoubtedly, the implementation strategy and the ‘intervention’ should be considered when interpreting our findings as they both have an effect on outcome. However, the naming function for the ’intervention’ in the Cochrane framework potentially adds further complexity to this situation.
Conclusions: An extensive account of these conceptual and practical challenges will be presented at the 2015 Cochrane Colloquium.