- Title
- A systematic review of adaptations and effectiveness of scaled-up nutrition interventions
- Creator
- Sutherland, Rachel L.; Jackson, Jacklyn K.; Milat, Andrew J.; Bauman, Adrian E.; Wolfenden, Luke; Lane, Cassandra; McCrabb, Sam; Nathan, Nicole K.; Yoong, Sze Lin; Lum, Melanie; Byaruhanga, Judith; McLaughlin, Matthew; Brown, Alison
- Relation
- NHMRC.APP1150661 http://purl.org/au-research/grants/nhmrc/1150661
- Relation
- Nutrition Reviews Vol. 80, Issue 4, p. 962-979
- Publisher Link
- http://dx.doi.org/10.1093/nutrit/nuab096
- Publisher
- Oxford University Press
- Resource Type
- journal article
- Date
- 2022
- Description
- CONTEXT: Public health nutrition interventions shown to be effective under optimal research conditions need to be scaled up and implemented in real-world settings. OBJECTIVES: The primary aim for this review was to assess the effectiveness of scaled-up public health nutrition interventions with proven efficacy, as examined in a randomized controlled trial. Secondary objectives were to: 1) determine if the effect size of scaled-up interventions were comparable to the prescale effect, and; 2) identify any adaptations made during the scale-up process. DATA SOURCES: Six electronic databases were searched and field experts contacted. STUDY SELECTION: An intervention was considered scaled up if it was delivered on a larger scale than a preceding randomized controlled trial ("prescale") in which a significant intervention effect (P ≤ 0.05) was reported on a measure of nutrition. DATA EXTRACTION: Two reviewers independently performed screening and data extraction. Effect size differences between prescale and scaled-up interventions were quantified. Adaptations to scale-up studies were coded according to the Adaptome model. RESULTS: Ten scaled-up nutrition interventions were identified. The effect size difference between prescale trials and scaled-up studies ranged from -32.2% to 222% (median, 50%). All studies made adaptations between prescale to scaled-up interventions. CONCLUSION: The effects of nutrition interventions implemented at scale typically were half that achieved in prior efficacy trials. Identifying effective scale-up strategies and methods to support retainment of the original prescale effect size is urgently needed to inform public health policy.
- Subject
- adaptation; public health nutrition; scale-up; systematic review
- Identifier
- http://hdl.handle.net/1959.13/1465747
- Identifier
- uon:47364
- Identifier
- ISSN:0029-6643
- Language
- eng
- Reviewed
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