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Process evaluation of fruit and vegetables distribution interventions in school-based settings: A systematic review.

ABSTRACT: Despite the importance of process evaluation in program evaluations, research has focused primarily on the effectiveness of fruit and vegetables (FVs) distribution interventions on children's consumption, with little attention given to how these interventions achieve their outcomes. Five bibliographic databases (Embase, PubMed, ProQuest, Scopus, and Web of Science Core Collection) were searched in June 2019 for studies of interventions where the main focus was the implementation of distributed FVs to school-aged children as a snack. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the risk of bias within included studies. Data were extracted based on study characteristics and findings. Results identified 24 studies reporting on 11 interventions and 1 policy. The findings of this systematic review indicate that the majority of the studies included limited references to implementation research. Recurring limitations include an absence of an evaluation theoretical framework and the data collection methods used. Also, several factors were identified as informing the success of snack-based FVs distribution programs, including participation of the school community, school characteristics, background knowledge, and parental engagement. Lack of timely FVs delivery, limited funding, inadequate awareness about the program, insufficient teachers' time, and food waste were identified as challenges to successful programming. Findings indicate that distributing FVs to school-aged children as a snack can increase their consumption, but only with proper implementation. Further evaluative research is required to better inform future implementation of snack-based FV distribution interventions in school settings.

SUBMITTER: Ismail MR

PROVIDER: S-EPMC7753971 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Process evaluation of fruit and vegetables distribution interventions in school-based settings: A systematic review.

Ismail Mariam R MR Seabrook Jamie A JA Gilliland Jason A JA

Preventive medicine reports 20201207

Despite the importance of process evaluation in program evaluations, research has focused primarily on the effectiveness of fruit and vegetables (FVs) distribution interventions on children's consumption, with little attention given to how these interventions achieve their outcomes. Five bibliographic databases (Embase, PubMed, ProQuest, Scopus, and Web of Science Core Collection) were searched in June 2019 for studies of interventions where the main focus was the implementation of distributed F ...[more]

PMID: 33364152

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Project description:BackgroundSeveral systematic reviews have been published to investigate the effectiveness of high-intensity interval training (HIIT) in schools. However, there has been limited attention given to understanding the functioning of the intervention processes, which is of paramount importance for interpreting and translating the intervention effectiveness. The aim of this systematic review is to determine the extent to which process evaluation is measured in school-based HIIT interventions and to explore the effects of process evaluation and intervention characteristics on cardiorespiratory fitness (CRF), body composition, muscular strength, and blood pressure.MethodsA comprehensive search was conducted in SPORT Discus (EBSCOhost), Web of Science, Scopus, Medline (Ovid) and Cochrane Central Register of Controlled Trials. The extent to which process evaluation is measured was narratively reported, alongside with the guidance of process evaluation of complex interventions by UK Medical Research Council. Meta-analyses and meta-regressions were conducted to determine the effects of process evaluation and intervention characteristics to the intervention outcomes.ResultsThe literature search identified 77 studies reporting on 45 school-based HIIT interventions. In total, five interventions reported process evaluation in a section or in a separate study, and only one intervention adopted a process evaluation framework. On average, 6 out of 12 process evaluation measures were reported in all interventions. Subgroup analyses did not indicate any beneficial treatment effects for studies with process evaluation group, whereas all pooled data and studies without process evaluation group showed significant improvement for CRF and body composition.ConclusionProcess evaluation is frequently omitted in the literature of school-based HIIT in children and adolescents. Although reporting of process evaluation measures may not directly associate with better intervention outcomes, it allows accurate interpretation of intervention outcomes, thereby enhancing the generalisability and dissemination of the interventions.

Project description:BACKGROUND:Evidence on workplace health promotion interventions at sea is scattered and includes different methodological approaches. The continued focus on lifestyle and health promotion on land-based industries makes it pertinent to evaluate available data from maritime settings to gain systematic knowledge on the field. METHODS:In this systematic review, we systematically searched PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information/Web of Science (ISI/WOS), and SCOPUS up to January 2019 using standard keywords including lifestyle interventions in the maritime setting. Two independent reviewers assessed papers and extracted the data. The quality of included studies was assessed using the Cochrane Risk of Bias tool. Due to significant heterogeneity between studies, the effectiveness of interventions was presented as a qualitative synthesis. RESULTS:After the initial search and refinement based on a total of 4432 records, ten articles met eligibility criteria and were included in the final review. Six studies originated from US maritime settings, 3 studies were conducted on Danish seafarers and one study came from Finland. The main focus of 6 studies was educational interventions including stress management, healthy eating, anti-smoking and anti-drinking sessions, sexual behavior program, and advice about preventive strategies. Four studies described the implementation of interventions, including micro-nutrient supplementation, physical activity, and pharmacotherapy. Follow-up assessments occurred over a time period ranging from 80?days to 2?years. Three studies found a positive though limited effect of structural and/or education interventions in maritime settings. The quality of all included studies was modest. CONCLUSION:Results of this systematic review show that a limited number of studies of lifestyle interventions in the maritime setting exist and that the quality of them is generally modest. Also, most of the interventions identified have failed to demonstrate substantial health benefits for seafarers. Systematic review registration number in PROSPERO: CRD42019134533.

Project description:BackgroundGlobally, many children fail to meet the World Health Organization's physical activity and sedentary behaviour guidelines. Schools are an ideal setting to intervene, yet despite many interventions in this setting, success when delivered under real-world conditions or at scale is limited. This systematic review aims to i) identify which implementation models are used in school-based physical activity effectiveness, dissemination, and/or implementation trials, and ii) identify factors associated with the adoption, implementation and sustainability of school-based physical activity interventions in real-world settings.MethodsThe review followed PRISMA guidelines and included a systematic search of seven databases from January 1st, 2000 to July 31st, 2018: MEDLINE, EMBASE, CINAHL, SPORTDiscus, PsycINFO, CENTRAL, and ERIC. A forward citation search of included studies using Google Scholar was performed on the 21st of January 2019 including articles published until the end of 2018. Study inclusion criteria: (i) a primary outcome to increase physical activity and/or decrease sedentary behaviour among school-aged children and/or adolescents; (ii) intervention delivery within school settings, (iii) use of implementation models to plan or interpret study results; and (iv) interventions delivered under real-world conditions.Exclusion criteria(i) efficacy trials; (ii) studies applying or testing school-based physical activity policies, and; (iii) studies targeting special schools or pre-school and/or kindergarten aged children.Results27 papers comprising 17 unique interventions were included. Fourteen implementation models (e.g., RE-AIM, Rogers' Diffusion of Innovations, Precede Proceed model), were applied across 27 papers. Implementation models were mostly used to interpret results (n?=?9), for planning evaluation and interpreting results (n?=?8), for planning evaluation (n?=?6), for intervention design (n?=?4), or for a combination of designing the intervention and interpreting results (n?=?3). We identified 269 factors related to barriers (n?=?93) and facilitators (n?=?176) for the adoption (n?=?7 studies), implementation (n?=?14 studies) and sustainability (n =?7 studies) of interventions.ConclusionsImplementation model use was predominately centered on the interpretation of results and analyses, with few examples of use across all study phases as a planning tool and to understand results. This lack of implementation models applied may explain the limited success of interventions when delivered under real-world conditions or at scale.Trial registrationPROSPERO (CRD42018099836).

Project description:BACKGROUND:School health systems are increasingly investing in telemedicine platforms to address acute and chronic illnesses. Asthma, the most common chronic illness in childhood, is of particular interest given its high burden on school absenteeism. OBJECTIVE:Conduct a systematic review evaluating impact of school-based telemedicine programs on improving asthma-related outcomes. DATA SOURCES:PubMed, Cochrane CENTRAL, CINAHL, ERIC, PsycINFO, Embase, and Google Scholar. STUDY ELIGIBILITY CRITERIA:Original research, including quasi-experimental studies, without restriction on the type of telemedicine. PARTICIPANTS:School-aged pediatric patients with asthma and their families. INTERVENTIONS:School-based telemedicine. STUDY APPRAISAL AND SYNTHESIS METHODS:Two authors independently screened each abstract, conducted full-text review, assessed study quality, and extracted information. A third author resolved disagreements. RESULTS:Of 371 articles identified, 7 were included for the review. Outcomes of interest were asthma symptom-free days, asthma symptom frequency, quality of life, health care utilization, school absences, and spirometry. Four of 7 studies reported significant increases in symptom-free days and/or decrease in symptom frequency. Five of 6 reported increases in at least one quality-of-life metric, 2 of 7 reported a decrease in at least 1 health care utilization metric, 1 of 3 showed reductions in school absences, and 1 of 2 reported improvements in spirometry measures. LIMITATIONS:Variability in intervention designs and outcome measures make comparisons and quantitative analyses across studies difficult. Only 2 of 7 studies were randomized controlled trials. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS:High-quality evidence supporting the use of school-based telemedicine programs to improve patient outcomes is limited. While available evidence suggests benefit, only 2 comparative trials were identified, and the contribution of telemedicine to these studies' results is unclear.

Project description:BackgroundConsumption of fruit and vegetables is important for health, but is often lower than recommended and tends to be socio-economically patterned with lower consumption in more deprived groups. In 2008, the English Department of Health introduced the Change4Life convenience store programme. This aimed to increase retail access to fresh fruit and vegetables in deprived, urban areas by providing existing convenience stores with a range of support and branded point-of-sale materials and equipment.MethodsWe undertook a mixed-methods study of the Change4Life convenience store programme in the North East of England around two years after initial implementation. Store mapping (n = 87; 100% stores) and systematic in-store observations (n = 74; 85% stores) provided information on intervention fidelity; the variety, purchase price and quality of fresh fruit and vegetables on sale; and purchase price compared to a major supermarket. Ten qualitative interviews with a purposive sample of retailers and other professionals explored experiences of the intervention and provided further insight on quantitative results.ResultsIntervention stores were primarily located in socio-economically disadvantaged areas. Fidelity, in terms of presence of branded materials and equipment, was low and much was not being used as intended. Fresh fruit and vegetables on sale were of high quality and had a purchase price around 10% more than comparable products at a major supermarket. Interviewees were supportive of the health improvement aim of the intervention. Retailers were appreciative of part-funding for chill cabinets and free point-of-sale materials. The intervention suffered from: poor initial and on-going communication between the intervention delivery team and retailers; poor availability of replacement point-of-sale materials; and failure to cement intended links with health workers and community organisations.ConclusionsOverall, intervention fidelity was low and the intervention is unlikely to have had a substantial or long-term effect on customers' consumption of fruit and vegetables.

Project description:IntroductionThe growing interest in networks of interactions is sustained by the conviction that they can be leveraged to improve the quality and efficiency of healthcare delivery systems. Evidence in support of this conviction, however, is mostly based on descriptive studies. Systematic evaluation of the outcomes of network interventions in healthcare settings is still wanting. Despite the proliferation of studies based on Social Network Analysis (SNA) tools and techniques, we still know little about how intervention programs aimed at altering existing patterns of social interaction among healthcare providers affect the quality of service delivery. We update and extend prior reviews by providing a comprehensive assessment of available evidence.Methods and findingsWe searched eight databases to identify papers using SNA in healthcare settings published between 1st January 2010 and 1st May 2022. We followed Chambers et al.'s (2012) approach, using a Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We distinguished between studies relying on SNA as part of an intervention program, and studies using SNA for descriptive purposes only. We further distinguished studies recommending a possible SNA-based intervention. We restricted our focus on SNA performed on networks among healthcare professionals (e.g., doctors, nurses, etc.) in any healthcare setting (e.g., hospitals, primary care, etc.). Our final review included 102 papers. The majority of the papers used SNA for descriptive purposes only. Only four studies adopted SNA as an intervention tool, and measured outcome variables.ConclusionsWe found little evidence for SNA-based intervention programs in healthcare settings. We discuss the reasons and challenges, and identify the main component elements of a network intervention plan. Future research should seek to evaluate the long-term role of SNA in changing practices, policies and behaviors, and provide evidence of how these changes affect patients and the quality of service delivery.

Project description:INTRODUCTION:The effectiveness of complex interventions for the management of musculoskeletal disorders has been estimated in many randomised clinical trials (RCTs). These trials inform which interventions are the most effective, however they do not always inform how an intervention achieved its clinical outcomes, nor how and what elements of an intervention were delivered to patients. Such information is useful for translating findings into clinical practice. A few process evaluation studies have been conducted alongside RCTs and a variety of methods have been used. To gain a better understanding of current practices of process evaluation in RCTs in musculoskeletal disorders, this systematic review is designed to answer the following research question: How are process evaluation of complex interventions tested in RCTs in musculoskeletal disorders being conducted? METHODS AND ANALYSIS:We will systematically search seven electronic databases (MEDLINE, SCOPUS, CINAHL, PsycINFO, EMBASE, Web of Science and Cochrane database) from the date of inception to August 2018 for studies on process evaluation of RCTs on non-surgical and non-pharmacological management of musculoskeletal disorders. We will include qualitative and quantitative studies conducted alongside RCTs, reported with the RCTs or separate studies that assessed interventions for musculoskeletal disorders. Two reviewers will screen abstracts and apply prespecified inclusion criteria to identify relevant studies, extract the data and assess the risk of bias within included studies. We will follow recommendations from the 'Cochrane Qualitative and Implementation Methods Group Guidance Series' when assessing methodological strengths and limitations of included studies. We will use a narrative synthesis to describe findings. ETHICS AND DISSEMINATION:Ethical approval is not required as this review will not collect original data. Findings from this systematic review will be presented at a scientific conference and published in a peer reviewed journal. PROSPERO REGISTRATION NUMBER:CRD42018109600.

Dataset Information

Process evaluation of fruit and vegetables distribution interventions in school-based settings: A systematic review.

Publications

Process evaluation of fruit and vegetables distribution interventions in school-based settings: A systematic review.

Similar Datasets

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