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- Title
systematic review of adaptations and effectiveness of scaled-up nutrition interventions.
- Authors
Sutherland, Rachel L; Jackson, Jacklyn K; Lane, Cassandra; McCrabb, Sam; Nathan, Nicole K; Yoong, Sze Lin; Lum, Melanie; Byaruhanga, Judith; McLaughlin, Matthew; Brown, Alison; Milat, Andrew J; Bauman, Adrian E; Wolfenden, Luke
- Abstract
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. Systematic Review Registration PROSPERO registration no.CRD42020149267.
- Subjects
PSYCHOLOGY information storage &; retrieval systems; CINAHL database; MEDICAL information storage &; retrieval systems; INFORMATION storage &; retrieval systems; MEDICAL databases; NUTRITION; SYSTEMATIC reviews; EFFECT sizes (Statistics); PUBLIC health; PHYSIOLOGICAL adaptation; MEDLINE; HEALTH promotion
- Publication
Nutrition Reviews, 2022, Vol 80, Issue 4, p962
- ISSN
0029-6643
- Publication type
Article
- DOI
10.1093/nutrit/nuab096