Implementation science
Global Centre for Preventive Health and NutritionImplementation science involves the systematic uptake of research findings and other evidence-based practices and applies it across all areas of research. Evidence shows that only 14% of research is translated into practice, and it takes an average of 17 years for this to happen. Our implementation science research program aims to change that.
Implementation—the strategies used or steps taken to enact an intervention—is a core component of almost every practice or policy project. Often though, there is not enough attention and priority given to ensuring optimal implementation of evidence-informed practice. Research is often designed without practice in mind, and research findings are not well implemented in the real-world. Our implementation science approach bridges this gap between knowledge provided by evidence and on-ground practice.
Implementation science is an inter-disciplinary field. We use theories, models and frameworks to guide intervention design. Our implementation scientists assist both practitioners and researchers to find the best theoretical approach. We pair this with the most relevant implementation strategies and methods to design and evaluate any innovation.
By evaluating implementation steps and mechanisms separately to outcomes, we can determine both the success of the intervention and which optimal strategies to use in implementation.
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Grampians Health (Horsham)
We have been engaged by Grampians Health (Horsham) to implement the Victorian Government Healthy Choices Guidelines for health services in the hospital café. This task is difficult because many food suppliers do not travel to rural and remote communities. By using the Consolidated Framework for Implementation Research to guide the assessment of the problem and potential solutions, we have identified new and existing stakeholders who can provide local regional solutions.
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The Systems Thinking Approach for Retail Transformation (START) map
The START map summarises the complex steps related to making healthy changes in food outlets. The map can be used by health promoters to plan healthy changes for food outlets in local government, schools, sports and recreation centres, and hospitals. It will identify key changes that will increase customer healthy food choices.
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Learning health systems approach to optimise implementation of prevention programs
We developed an online database that allows stakeholders to monitor implementation of priority practices and related barriers, reported by early childhood education and care services in real time. Such a system will allow tailoring of strategies to assess barriers as they arise and evolve throughout the implementation process.
Our current approaches assess barriers to implementation of nutrition and physical activity programs within the childcare sector typically at the early stages of implementation.
This can result in the selection of implementation strategies that only address barriers at a certain point in time. We need to better understand and track how these barriers may change over time so that we can tailor our support.
Learn more about the project here.
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Tiny Bites
Tiny Bites is a digital health program designed to support childcare services and parents to implement recommended infant feeding practices. Over 18 months, childcare services that receive the Tiny Bites program are provided with access to an online portal that includes:
- self-assessment
- action planning
- webinars
- educational resources.
Health promotion officers will also support services to update their infant feeding policies and communication with parents through meetings and support calls. Parents will receive tailored, time-dependent text messages and monthly newsletters about infant feeding, and will include links to additional resources and webinars hosted on the Grow and GO toolbox.
Tiny Bites is designed as a scalable and innovative way to enhance the partnership between childcare providers and parents to improve child weight trajectory and nutrition. If effective, this model can be used nationally to inform child health outcomes.
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Identification and prioritisation of key healthy eating and physical activity indicators in childcare
Early childhood and education care settings are important public health settings to improve child health. This program of work aimed to find the most important indicators for healthy eating and physical activity that may need implementation investment and ongoing monitoring.
The team at the National Centre of Implementation Science carried out the following:
- A systematic review of healthy eating and physical activity guidelines for childcare services to identifying existing recommendations
- Four systematic reviews to examine the impact of healthy eating and physical activity interventions
- A mapping approach to collate interventions with evidence of impact
- A survey with childcare services to assess the implementation of recommendations and perceptions of barriers, scalability and sustainability.
Based on this process, we identified several healthy eating and physical activity strategies that are likely to result in the highest impact if implemented.
Related publications: Implementation Gaps and Priorities – NCOIS – National Centre of Implementation Science
Selected healthy eating indicators: Australia’s Food Environment Dashboard
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Action-RESPOND
Action-RESPOND is a sub-study of the larger NHMRC-funded Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND) program.
RESPOND applied system science methods while supporting 10 rural and regional communities in the Ovens Murray and Goulburn Valley regions to co-design relevant, tailored and effective child health programs.
Action-RESPOND focused specifically on understanding implementation of those co-developed programs in whole of communities. We applied an implementation science framework to address barriers to implementation. This included capacity building in implementation, and using system science methods to understand adaptation and implementation mechanisms. Strategies were primarily delivered via facilitation provided by an implementation coach, who had worked within the communities and had in-depth knowledge of the local context.
Action-RESPOND seeks to understand the impact of such approaches on how to support whole of community implementation. Through Action-RESPOND, we better understand and describe the process of moving from ‘action maps’ to embedded implementation.