Nov 16, 2018 - Research -> practice: 17 years ... Day 1: Preventing Childhood Obesity. 4-5 May ... years. Day 2 Consensus Meeting Participants & Facilitators ...
Setting the agenda in childhood obesity prevention: Co-production of research priorities and facilitators and barriers to knowledge translation Marita Hennessy1, Molly Byrne1, Rachel Laws2, Jenny Mc Sharry1, Grace O’Malley3,4, Caroline Heary5 1Health
Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland; 2IPAN, Deakin University, Australia; 3Division of Population Health Sciences, Royal College of Surgeons of Ireland, Dublin, Ireland; 4Association for the Study of Obesity on the Island of Ireland5; School of Psychology, NUI Galway, Galway, Ireland
@MaritaHennessy @hbcrg ICBM 2018, 16 November 2018 Obesity Prevention and Risk Accross the Lifespan
Background Childhood obesity
Research to practice
• Worldwide, significant public health challenge
• Research -> practice: 17 years
• 41 million children funded research policy-relevant; greatest potential public health benefit, ensuring efficient and equitable use of limited resources • No gold-standard approach
Use of research evidence by public health decision-makers • Barriers • • • • •
Lack of relevant research Decisions-makers’ perceptions of evidence Their skills and opportunity to use it The culture and competing demands surrounding decision-making Practical constraints such as time and cost
• Facilitators
• Access to and improved dissemination of relevant research • Promoting collaboration between policymakers and research staff
Understanding the specific barriers & facilitators to the use of research evidence in obesity prevention may help in improving the uptake of research into policy/practice
Aims 1. Identify and prioritise policy-relevant knowledge gaps for research in childhood obesity prevention…by leveraging the collective expertise of a wide range of stakeholders including: • Researchers • Policymakers • Clinicians • Educators
2. Identify barriers and facilitators to knowledge translation in childhood obesity prevention
Methodology • Nominal Group Technique used during multi-stakeholder workshops over a two-day national obesity conference in May 2017
• Participants: Anyone attending the conference eligible to participate on day 1 – closed consensus meeting on day 2, by invitation only
• NGT = consensus method used to generate potential solutions or answers to a question which can then be agreed upon and/or prioritised • Strengths
• Balanced participation • Results can be obtained quickly • Convenient - participants only attend a single session
Day 1 Workshop Facilitators
Annual Conference 2017 Day 1: Preventing Childhood Obesity 4-5 May 2017, University College Dublin View recordings at tinyurl.com/ASOI2017 Dr Phil Jennings Health Service Executive
Dr Ellinor Olander City University of London (UK)
A/Prof Paulina Nowicka Karolinska Institutet (Sweden)
Dr Grace O’Malley Temple Street Children’s University Hospital (Ireland)
Prof Sarah Redsell Anglia Ruskin University (UK)
Prof Mary Rudolf Barr Ilan University (Israel)
Dr Rachel Laws Deakin University (Australia)
Sarah O’Brien Health Service Executive
Prof Pinki Sahota Leeds Beckett University (UK)
Research prioritisation overview Day 1 workshop: 10 nominal groups (n=77)
Stage 1: Silent generation of ideas/research gaps
Stage 2: Round robin discussion
Stage 3: Clarification of ideas
Stage 4: Ranking of research gaps (Round 1)
Q: What topics/questions are important to focus on in future research on the prevention of childhood obesity?
Day 2 consensus meeting: (n=14)
Stage 5: Discussion of 26-ranked gaps & further development of ideas: 7 merged / removed and 2 added
Note: Similar process used for identification of barriers and facilitators – but consensus not sought
Stage 6: Ranking of 20 research gaps (Round 2)
Stage 9: Calculation of second group ranking
Stage 7: Calculation of first group ranking, feedback and discussion
RESEARCH PRIORITIES Ranked list of 20 research priorities
Stage 8: Re-ranking of 20 research gaps (Round 3)
Participants Day 1 Research prioritisation • n=77, 70F • 91% participation rate • 88% based in Ireland • Academics (40%), clinicians (38%), health service managers (16%) and other (6%) Barriers and facilitators • n=68, 61F • 80% participation rate
Day 2 Consensus Meeting Participants & Facilitators
Day 2 • n= 14/21 individuals/org reps, 1M • 67% participation rate • Academics/researchers (6), HPs (3), early years/community-based practitioners (2), policymakers (2), health service manager (1) • 289 years’ experience, range: 5-42, mean= 21 years
Top 10 priorities for childhood obesity prevention research Rank Round 3 (Final round) 1
Evaluate (including economic evaluation) current programmes to inform practice and policy
2
How to change culture towards addressing the determinants of health (Health in All Policies)
3
Implementation science: process (study of methods to promote the uptake of research findings into routine healthcare in clinical, organisational or policy contexts)
4
How to integrate obesity prevention into existing service structures
5
How to enhance opportunities for habitual physical activity, including free play and active travel
6
Interventions to reduce the gap between children (social backgrounds)
7
Understanding resilience to the development of obesity
8
How to support and engage parents
9
How to integrate obesity prevention approaches into education settings
10
Cost benefit analysis of increased support for 0-5 years
Top 5 research priorities across the 3 rounds Rank
Round 3 (Final round)
Round 2
Round 1
1
Evaluate (including economic Evaluate current programmes to evaluation) current programmes to inform practice and policy inform practice and policy
Implementation science
2
How to change culture towards addressing the determinants of health (Health in All Policies)
Implementation science: process
Evaluate current programmes and policy to upscale
3
Implementation science: process
How to change culture towards addressing the determinants of health (Health in All Policies)
4
How to integrate obesity prevention into existing service structures
Interventions to reduce the gap between children (social backgrounds)
3a: Supporting health professionals to support parents 3b: Whole system approach using co-creation for intervention development
5
How to enhance opportunities for habitual physical activity, including free play and active travel*
How to support and engage parents
Support for parents - correct message
Barriers 1 Limited funding & resources for prevention
Facilitators 1 Involving key stakeholders from the start
1 The food industry
2 Engagement with your target group. For socially isolated groups, someone to interpret the message (Active engagement with target of your message from the outset; may require someone else to deliver the message to socially excluded groups)
1 (Lack of) Priority (at policy/service level)
2 Process to translate research into practice
1 Family & societal issues (Other family and healthrelated issues impacting on behaviours)
2 Existing resources, e.g. information leaflets
1 (Not) Pitching to the right level
1 Parental knowledge, education, skills
1 Mismatch between policy & practice
2 Obesity prevention prioritised in funding 2 Co-production of knowledge
1 Lack of resources to implement
2 Implementing in schools
1 Lack of shared realistic goals
2 Money, funding, incentivisation
1 Research which is (in)compatible with scalability
2 Education and training for healthcare professionals 2 Political will
Conclusions • Research priorities, and barriers and facilitators to knowledge translation, in childhood obesity prevention co-created • Key themes = importance of funding and resources, co-production of research with all stakeholders and a focus on both implementation research and social determinants within childhood obesity prevention • Wide range of barriers and facilitators to knowledge translation – differ somewhat to previous studies, diverse perspectives? • Engaging parents - identified in previous exercises, featured as barrier to knowledge translation • Parent/lay/male involvement
• Consensus on priorities? Broad themes -> actionable research questions • Findings will be of interest to researchers, funding bodies, policymakers and health service commissioners/managers, and may facilitate the development of research funding applications and stimulate multidisciplinary collaboration
Acknowledgements PhD funding: Health Research Board SPHeRE Programme POCKETS funding: Irish Research Council POCKETS co-hosts: ASOI and Dr Karen Matvienko-Sikar, UCC POCKETS participants & workshop facilitators (colleagues within the CHErIsH study team, HBCRG, ASOI) HSE: Sarah O’Brien and Dr Phil Jennings
More information
Advance online publication. doi: https://doi.org/10.1093/tbm/iby074
Setting the agenda in childhood obesity prevention: Co-production of research priorities and facilitators and barriers to knowledge translation Marita Hennessy1, Molly Byrne1, Rachel Laws2, Jenny Mc Sharry1, Grace O’Malley3,4, Caroline Heary5 1Health
Behaviour Change Research Group, School of Psychology, NUI Galway, Galway, Ireland; 2IPAN, Deakin University, Australia; 3Division of Population Health Sciences, Royal College of Surgeons of Ireland, Dublin, Ireland; 4Association for the Study of Obesity on the Island of Ireland5; School of Psychology, NUI Galway, Galway, Ireland
@MaritaHennessy @hbcrg ICBM 2018, xx November 2018 [Session title]
