Systematic review, process evaluation and knowledge translation of community interventions to tackle a 'wicked problem': food insecurity

Oral
2016 Seoul
Kristjansson E1, Dubois A2, Lawrence M3, Burns C4, Thomson H5, Liberato S6, Wingrove K7, Szijarto B8, Svensson K8, Welch V9, Armstrong R10, Barnett BM11, Hossain A12, Platts J13, Labelle P11, Milley P8, Aguilera Donoso JP11
1Centre for Research on Educational and Community Services, School of Psychology, University of Ottawa, Canada
2Faculty of Health Sciences, University of Ottawa, Canada
3School of Exercise and Nutrition Science, Deakin University, Australia
4Charles Stuart University, Bathrust, Australia
5University of Glasgow, Scotland
6Menzies University, Australia
7Deakin University, Australia
8Faculty of Education, University of Ottawa, Canada
9Bruyere Research Institute, University of Ottawa, Canada
10Cochrane Public Health, Australia
11University of Ottawa, Canada
12University of Ottawa Heart Institute, Canada
13School of Psychology, University of Ottawa, Canada

Background:

Food security is an important social determinant of health and basic human rights. Yet even in developed countries, millions of people suffer from food insecurity, with consequences for individual and societal health. Community Food Security (CFS) involves a systems approach to sustainable interventions. Herein, we report on a systematic review and process evaluation of CFS interventions. This CIHR-funded integrated knowledge translation (KT) project involves 20 experts from academia, public policy and health and food security coalitions, from Canada, Scotland and Australia. The aim is evidence-based decision-making on CFS.

Objectives:

To conduct a systematic review and process evaluation of interventions for Community Food Security. To work with our partners to design and implement a KT plan.

Methods:

We involved knowledge users (KU) from the start; they helped shape our review questions, PICO, search parameters and KT strategy. Primary outcomes are household food security, dietary intake and physical, mental and social health. We searched 13 electronic databases from 1980 to July 2015; we also handsearched. Data from included studies were extracted using Cochrane guidelines. We conducted meta-analyses where possible. The process evaluation is ongoing. We drew from systems approaches to KT and Outcome Mapping concepts to identify who we need to involve and other frameworks to think about depth and style of involvement. We are monitoring these efforts with a developmental evaluation.

Results:

We identified 24,213 records.After screening titles and abstracts, we included 353 papers to review full text (ongoing). Studies of food subsidies, pricing incentives, healthy corner stores, collective kitchens, community gardens and farmer's market interventions are included. We report on the effects of each intervention and assess explanatory variables. Interviews with KUs affirmed they were happy with their involvement; their input was sought and valued and the amount of contract was just right (see summary).

Conclusion:

Evidence from this review has important implications for food security policy and programs; our KUs will ensure its dissemination.