Laurence Moore | University of Glasgow (original) (raw)

Papers by Laurence Moore

Research paper thumbnail of Framework for the development and evaluation of complex interventions: gap analysis, workshop and consultation-informed update

Health Technology Assessment, 2021

BackgroundThe Medical Research Council published the second edition of its framework in 2006 on d... more BackgroundThe Medical Research Council published the second edition of its framework in 2006 on developing and evaluating complex interventions. Since then, there have been considerable developments in the field of complex intervention research. The objective of this project was to update the framework in the light of these developments. The framework aims to help research teams prioritise research questions and design, and conduct research with an appropriate choice of methods, rather than to provide detailed guidance on the use of specific methods.MethodsThere were four stages to the update: (1) gap analysis to identify developments in the methods and practice since the previous framework was published; (2) an expert workshop of 36 participants to discuss the topics identified in the gap analysis; (3) an open consultation process to seek comments on a first draft of the new framework; and (4) findings from the previous stages were used to redraft the framework, and final expert re...

Research paper thumbnail of Fidelity of implementation of the Strengthening Families Programme 10-14 UK in Wales UK: a mixed-method process evaluation within a randomised controlled trial

European Journal of Public Health, 2014

Research paper thumbnail of Implementation of a Cooking Bus intervention to support cooking in schools in Wales, UK

Health Education, 2017

Purpose The teaching of cooking is an important aspect of school-based efforts to promote healthy... more Purpose The teaching of cooking is an important aspect of school-based efforts to promote healthy diets among children, and is frequently done by external agencies. Within a limited evidence base relating to cooking interventions in schools, there are important questions about how interventions are integrated within school settings. The purpose of this paper is to examine how a mobile classroom (Cooking Bus) sought to strengthen connections between schools and cooking, and drawing on the concept of the sociotechnical network, theorise the interactions between the Bus and school contexts. Design/methodology/approach Methods comprised a postal questionnaire to 76 schools which had received a Bus visit, and case studies of the Bus’ work in five schools, including a range of school sizes and urban/rural locations. Case studies comprised observation of Cooking Bus sessions, and interviews with school staff. Findings The Cooking Bus forged connections with schools through aligning interve...

Research paper thumbnail of The need for a complex systems model of evidence for public health

Lancet (London, England), Jan 13, 2017

Research paper thumbnail of Strengthening Families Programme (10-14UK) substance misuse prevention programme: findings from NPRI randomised trial of a proportionate universalism adaptation of an intervention for families with children aged 10-14

Research paper thumbnail of Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis

Public Health Research, 2013

BackgroundIn contrast to curriculum-based health education interventions in schools, the school e... more BackgroundIn contrast to curriculum-based health education interventions in schools, the school environment approach promotes health by modifying schools' physical/social environment. This systematic review reports on the health effects of the school environment and processes by which these might occur. It includes theories, intervention outcome and process evaluations, quantitative studies and qualitative studies.Research questionsResearch question (RQ)1: What theories are used to inform school environment interventions or explain school-level health influences? What testable hypotheses are suggested? RQ2: What are the effects on student health/inequalities of school environment interventions addressing organisation/management; teaching/pastoral care/discipline; and the physical environment? What are the costs? RQ3: How feasible/acceptable and context dependent are such interventions? RQ4: What are the effects on student health/inequalities of school-level measures of organisat...

Research paper thumbnail of Programme Fidelity in a Large Pragmatic Trial: Findings from a Process Evaluation of the Strengthening Families Programme 10-14 UK (SFP10-14UK)

Background: Fidelity evaluation is particularly important in pragmatic studies, which afford grea... more Background: Fidelity evaluation is particularly important in pragmatic studies, which afford greater potential for variation than explanatory trials. The Project SFP Cymru process evaluation has examined adherence, exposure, quality of delivery, participant engagement and programme differentiation during a randomised controlled trial of the Strengthening Families Programme (SFP10-14UK) involving more than 700 families. SFP10-14UK was delivered by local voluntary and statutory bodies in seven areas of Wales. Training, funding and programme manuals were provided as they would be in a non-research context and there were no special measures to control programme delivery. Methods: Data collection comprised: thirty-three interviews with and self-report data from programme staff; observation of programme sessions; and routine data from each area. Descriptive analyses of quantitative data were conducted with appropriate tests of significance and reliability. A thematic framework was develop...

Research paper thumbnail of A cross-sectional observational study of the nutritional intake of UK primary school children from deprived and non-deprived backgrounds: implications for school breakfast schemes

The international journal of behavioral nutrition and physical activity, Jan 25, 2015

This study examined the nutritional intake of 9-11 year old children in Wales, UK, to assess the ... more This study examined the nutritional intake of 9-11 year old children in Wales, UK, to assess the rationale for, and potential of, school breakfast initiatives. It also examined the possible unintended consequence of over consumption. The study employed a cross-sectional observational design within a randomized controlled trial of a free school breakfast programme. A total of 111 primary schools were randomly assigned to an intervention condition (in which a free school breakfast programme was implemented) or a control condition (in which implementation of the scheme was delayed). Sub-samples of children completed multiple-pass 24-hr dietary recall interviews at baseline (n = 581), and 12 months later (n = 582). Deprivation was assessed for each child in terms of whether or not they were entitled to free school meals. Prior to the introduction of the programme, rates of breakfast skipping were low and there was little evidence of widespread nutritional deficiency. However, there was ...

Research paper thumbnail of Exploring child dental service use among migrant families in metropolitan Melbourne, Australia

Australian Dental Journal, 2015

Background: This study describes and explores factors related to dental service use among migrant... more Background: This study describes and explores factors related to dental service use among migrant children. Methods: A cross-sectional analysis of baseline data from Teeth Tales, an exploratory trial implementing a community based child oral health promotion intervention. The sample size and target population was 600 families with 1-4 year old children from Iraqi, Lebanese and Pakistani backgrounds residing in metropolitan Melbourne. Participants were recruited into the study using purposive and snowball sampling techniques. Results: Most (88%; 550/625) children had never visited the dentist (mean (SD) age 3.06 years (1.11)). In the fully adjusted model the variable most significantly associated with child dental visiting was parent reported 'no reason for child to visit the dentist' (OR = 0.07, p < 0.001). Of those children whose parents reported their child had no reason to visit the dentist, 22% (37/165) experienced dental caries with 8% (13/165) at the level of cavitation. Conclusions: Dental service use by migrant preschool children was very low. The relationship between perceived dental need and dental service use is currently not aligned. One in 10 children of select migrant background had visited a dentist, which is in the context of 1 in 3 with dental caries. To improve utilization, health services should consider organizational cultural competence, outreach and increased engagement with the migrant community.

Research paper thumbnail of An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales

Research paper thumbnail of Evaluation of community-based obesity interventions

Evidence Policy and Practice, 2010

This chapter contains sections titled: Summary and recommendations for research Introduction Eval... more This chapter contains sections titled: Summary and recommendations for research Introduction Evaluation: purpose and resources Complexity: moving beyond “what works?” Evaluating complex interventions — research stages and research questions Formative evaluation Summative evaluation Evaluation funding Conclusion Acknowledgements References

Research paper thumbnail of Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting

Implementation science : IS, Jan 14, 2014

BackgroundThe value placed on types of evidence within decision-making contexts is highly depende... more BackgroundThe value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.MethodsThe study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate i...

Research paper thumbnail of Pragmatic trials of non-NHS interventions: experiences from a Randomised Controlled Trial of the Strengthening Families 10-14 UK Programme (SFP10-14 UK)

Research paper thumbnail of Free healthy breakfasts in primary schools: a cluster randomised controlled trial of a policy intervention in Wales, UK

Public Health Nutrition, 2010

ObjectiveThe present study evaluated the impact of a national school programme of universal free ... more ObjectiveThe present study evaluated the impact of a national school programme of universal free healthy breakfast provision in Wales, UK.DesignA cluster randomised controlled trial with repeated cross-sectional design and a 12-month follow-up. Primary outcomes were breakfast skipping, breakfast diet and episodic memory. Secondary outcomes were frequency of eating breakfast at home and at school, breakfast attitudes, rest-of-day diet and class behaviour.SettingPrimary schools in nine local education authority areas.SubjectsA total of 4350 students (aged 9–11 years) at baseline and 4472 at follow-up in 111 schools.ResultsStudents in intervention schools reported significantly higher numbers of healthy food items consumed at breakfast and more positive attitudes towards breakfast eating at 12 months. Parents in intervention schools reported significantly higher rates of consumption of breakfast at school and correspondingly lower rates of breakfast consumption at home. No other signif...

Research paper thumbnail of The effects on student health of interventions modifying the school environment: systematic review

Journal of Epidemiology and Community Health, 2013

Background Owing to the limited effectiveness of traditional health education curricula in school... more Background Owing to the limited effectiveness of traditional health education curricula in schools, there is increasing interest in interventions aiming to promote young people's health by modifying the school environment. Existing systematic reviews cannot determine whether environmental intervention is effective because they examine interventions combining environmental modifications and traditional health education. This gap is significant because schoolenvironment interventions are complex to implement and may be sidelined in underfunded and attainment-focused school systems without evidence to support such an approach. This systematic review examined the effectiveness of school-environment interventions without health-education components on student health and inequalities. Methods This was a systematic review of experimental/ quasi-experimental studies of school-environment interventions. Sixteen databases were searched, eliciting 62 329 references which were screened, with included studies quality assessed, data extracted and narratively synthesised. Results Sixteen reports of 10 studies were included, all from the USA and the UK. Five evaluations of interventions aiming to develop a stronger sense of community and/or improve relationships between staff and students suggested potential benefits particularly regarding violence and aggression. Two trials of interventions enabling students to advocate for changes in school catering and physical activity reported benefits for physical activity but not diet. Three evaluations of improvements to school playgrounds offered weak evidence of effects on physical activity. Conclusions School environment interventions show the potential to improve young people's health particularly regarding violence, aggression and physical activity. Further trials are required to provide a stronger and more generalisable evidence base.

Research paper thumbnail of Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia

BMJ open, Jan 11, 2015

The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally d... more The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. Significant differences in the Debris Inde...

Research paper thumbnail of The effects of the school environment on student health: A systematic review of multi-level studies

Health & Place, 2013

Health outcomes vary between schools and it is theorised that this may be partly attributable to ... more Health outcomes vary between schools and it is theorised that this may be partly attributable to variation in the school environment. Existing systematic reviews have not drawn authoritative conclusions because of methodological limitations in the review or studies available. We identified 42 multi-level studies, ten of which were judged of sufficient quality to narratively synthesize. There was consistent evidence that schools with higher attainment and attendance than would be expected from student intake had lower rates of substance use. Findings on the influence of smoking/alcohol policies were mixed. Three studies examined the health effects variously associated with school campus area and observability, year structure, school size and pupil-to-teacher ratio with mixed findings. The studies reviewed support the potential influence of the school environment on student health.

Research paper thumbnail of Cultural adaptation and intervention integrity: a response to Skarstrand, Sundell and Andreasson

The European Journal of Public Health, 2014

Research paper thumbnail of An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study)

BMC Public Health, 2011

Background Childhood overweight and obesity is the most prevalent and, arguably, politically comp... more Background Childhood overweight and obesity is the most prevalent and, arguably, politically complex child health problem internationally. Governments, communities and industry have important roles to play, and are increasingly expected to deliver an evidence-informed system-wide prevention program. However, efforts are impeded by a lack of organisational access to and use of research evidence. This study aims to identify feasible, acceptable and ideally, effective knowledge translation (KT) strategies to increase evidence-informed decision-making in local governments, within the context of childhood obesity prevention as a national policy priority. Methods/Design This paper describes the methods for KT4LG, a cluster randomised controlled trial which is exploratory in nature, given the limited evidence base and methodological advances. KT4LG aims to examine a program of KT strategies to increase the use of research evidence in informing public health decisions in local governments. ...

Research paper thumbnail of The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial

BMC Public Health, 2010

Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related ha... more Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. Objective: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. Design: A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. Results: The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. Conclusion: The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level. Trial registration: UKCRN 7090; ISRCTN: 80875696.

Research paper thumbnail of Framework for the development and evaluation of complex interventions: gap analysis, workshop and consultation-informed update

Health Technology Assessment, 2021

BackgroundThe Medical Research Council published the second edition of its framework in 2006 on d... more BackgroundThe Medical Research Council published the second edition of its framework in 2006 on developing and evaluating complex interventions. Since then, there have been considerable developments in the field of complex intervention research. The objective of this project was to update the framework in the light of these developments. The framework aims to help research teams prioritise research questions and design, and conduct research with an appropriate choice of methods, rather than to provide detailed guidance on the use of specific methods.MethodsThere were four stages to the update: (1) gap analysis to identify developments in the methods and practice since the previous framework was published; (2) an expert workshop of 36 participants to discuss the topics identified in the gap analysis; (3) an open consultation process to seek comments on a first draft of the new framework; and (4) findings from the previous stages were used to redraft the framework, and final expert re...

Research paper thumbnail of Fidelity of implementation of the Strengthening Families Programme 10-14 UK in Wales UK: a mixed-method process evaluation within a randomised controlled trial

European Journal of Public Health, 2014

Research paper thumbnail of Implementation of a Cooking Bus intervention to support cooking in schools in Wales, UK

Health Education, 2017

Purpose The teaching of cooking is an important aspect of school-based efforts to promote healthy... more Purpose The teaching of cooking is an important aspect of school-based efforts to promote healthy diets among children, and is frequently done by external agencies. Within a limited evidence base relating to cooking interventions in schools, there are important questions about how interventions are integrated within school settings. The purpose of this paper is to examine how a mobile classroom (Cooking Bus) sought to strengthen connections between schools and cooking, and drawing on the concept of the sociotechnical network, theorise the interactions between the Bus and school contexts. Design/methodology/approach Methods comprised a postal questionnaire to 76 schools which had received a Bus visit, and case studies of the Bus’ work in five schools, including a range of school sizes and urban/rural locations. Case studies comprised observation of Cooking Bus sessions, and interviews with school staff. Findings The Cooking Bus forged connections with schools through aligning interve...

Research paper thumbnail of The need for a complex systems model of evidence for public health

Lancet (London, England), Jan 13, 2017

Research paper thumbnail of Strengthening Families Programme (10-14UK) substance misuse prevention programme: findings from NPRI randomised trial of a proportionate universalism adaptation of an intervention for families with children aged 10-14

Research paper thumbnail of Systematic review of the effects of schools and school environment interventions on health: evidence mapping and synthesis

Public Health Research, 2013

BackgroundIn contrast to curriculum-based health education interventions in schools, the school e... more BackgroundIn contrast to curriculum-based health education interventions in schools, the school environment approach promotes health by modifying schools' physical/social environment. This systematic review reports on the health effects of the school environment and processes by which these might occur. It includes theories, intervention outcome and process evaluations, quantitative studies and qualitative studies.Research questionsResearch question (RQ)1: What theories are used to inform school environment interventions or explain school-level health influences? What testable hypotheses are suggested? RQ2: What are the effects on student health/inequalities of school environment interventions addressing organisation/management; teaching/pastoral care/discipline; and the physical environment? What are the costs? RQ3: How feasible/acceptable and context dependent are such interventions? RQ4: What are the effects on student health/inequalities of school-level measures of organisat...

Research paper thumbnail of Programme Fidelity in a Large Pragmatic Trial: Findings from a Process Evaluation of the Strengthening Families Programme 10-14 UK (SFP10-14UK)

Background: Fidelity evaluation is particularly important in pragmatic studies, which afford grea... more Background: Fidelity evaluation is particularly important in pragmatic studies, which afford greater potential for variation than explanatory trials. The Project SFP Cymru process evaluation has examined adherence, exposure, quality of delivery, participant engagement and programme differentiation during a randomised controlled trial of the Strengthening Families Programme (SFP10-14UK) involving more than 700 families. SFP10-14UK was delivered by local voluntary and statutory bodies in seven areas of Wales. Training, funding and programme manuals were provided as they would be in a non-research context and there were no special measures to control programme delivery. Methods: Data collection comprised: thirty-three interviews with and self-report data from programme staff; observation of programme sessions; and routine data from each area. Descriptive analyses of quantitative data were conducted with appropriate tests of significance and reliability. A thematic framework was develop...

Research paper thumbnail of A cross-sectional observational study of the nutritional intake of UK primary school children from deprived and non-deprived backgrounds: implications for school breakfast schemes

The international journal of behavioral nutrition and physical activity, Jan 25, 2015

This study examined the nutritional intake of 9-11 year old children in Wales, UK, to assess the ... more This study examined the nutritional intake of 9-11 year old children in Wales, UK, to assess the rationale for, and potential of, school breakfast initiatives. It also examined the possible unintended consequence of over consumption. The study employed a cross-sectional observational design within a randomized controlled trial of a free school breakfast programme. A total of 111 primary schools were randomly assigned to an intervention condition (in which a free school breakfast programme was implemented) or a control condition (in which implementation of the scheme was delayed). Sub-samples of children completed multiple-pass 24-hr dietary recall interviews at baseline (n = 581), and 12 months later (n = 582). Deprivation was assessed for each child in terms of whether or not they were entitled to free school meals. Prior to the introduction of the programme, rates of breakfast skipping were low and there was little evidence of widespread nutritional deficiency. However, there was ...

Research paper thumbnail of Exploring child dental service use among migrant families in metropolitan Melbourne, Australia

Australian Dental Journal, 2015

Background: This study describes and explores factors related to dental service use among migrant... more Background: This study describes and explores factors related to dental service use among migrant children. Methods: A cross-sectional analysis of baseline data from Teeth Tales, an exploratory trial implementing a community based child oral health promotion intervention. The sample size and target population was 600 families with 1-4 year old children from Iraqi, Lebanese and Pakistani backgrounds residing in metropolitan Melbourne. Participants were recruited into the study using purposive and snowball sampling techniques. Results: Most (88%; 550/625) children had never visited the dentist (mean (SD) age 3.06 years (1.11)). In the fully adjusted model the variable most significantly associated with child dental visiting was parent reported 'no reason for child to visit the dentist' (OR = 0.07, p < 0.001). Of those children whose parents reported their child had no reason to visit the dentist, 22% (37/165) experienced dental caries with 8% (13/165) at the level of cavitation. Conclusions: Dental service use by migrant preschool children was very low. The relationship between perceived dental need and dental service use is currently not aligned. One in 10 children of select migrant background had visited a dentist, which is in the context of 1 in 3 with dental caries. To improve utilization, health services should consider organizational cultural competence, outreach and increased engagement with the migrant community.

Research paper thumbnail of An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales

Research paper thumbnail of Evaluation of community-based obesity interventions

Evidence Policy and Practice, 2010

This chapter contains sections titled: Summary and recommendations for research Introduction Eval... more This chapter contains sections titled: Summary and recommendations for research Introduction Evaluation: purpose and resources Complexity: moving beyond “what works?” Evaluating complex interventions — research stages and research questions Formative evaluation Summative evaluation Evaluation funding Conclusion Acknowledgements References

Research paper thumbnail of Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting

Implementation science : IS, Jan 14, 2014

BackgroundThe value placed on types of evidence within decision-making contexts is highly depende... more BackgroundThe value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.MethodsThe study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate i...

Research paper thumbnail of Pragmatic trials of non-NHS interventions: experiences from a Randomised Controlled Trial of the Strengthening Families 10-14 UK Programme (SFP10-14 UK)

Research paper thumbnail of Free healthy breakfasts in primary schools: a cluster randomised controlled trial of a policy intervention in Wales, UK

Public Health Nutrition, 2010

ObjectiveThe present study evaluated the impact of a national school programme of universal free ... more ObjectiveThe present study evaluated the impact of a national school programme of universal free healthy breakfast provision in Wales, UK.DesignA cluster randomised controlled trial with repeated cross-sectional design and a 12-month follow-up. Primary outcomes were breakfast skipping, breakfast diet and episodic memory. Secondary outcomes were frequency of eating breakfast at home and at school, breakfast attitudes, rest-of-day diet and class behaviour.SettingPrimary schools in nine local education authority areas.SubjectsA total of 4350 students (aged 9–11 years) at baseline and 4472 at follow-up in 111 schools.ResultsStudents in intervention schools reported significantly higher numbers of healthy food items consumed at breakfast and more positive attitudes towards breakfast eating at 12 months. Parents in intervention schools reported significantly higher rates of consumption of breakfast at school and correspondingly lower rates of breakfast consumption at home. No other signif...

Research paper thumbnail of The effects on student health of interventions modifying the school environment: systematic review

Journal of Epidemiology and Community Health, 2013

Background Owing to the limited effectiveness of traditional health education curricula in school... more Background Owing to the limited effectiveness of traditional health education curricula in schools, there is increasing interest in interventions aiming to promote young people's health by modifying the school environment. Existing systematic reviews cannot determine whether environmental intervention is effective because they examine interventions combining environmental modifications and traditional health education. This gap is significant because schoolenvironment interventions are complex to implement and may be sidelined in underfunded and attainment-focused school systems without evidence to support such an approach. This systematic review examined the effectiveness of school-environment interventions without health-education components on student health and inequalities. Methods This was a systematic review of experimental/ quasi-experimental studies of school-environment interventions. Sixteen databases were searched, eliciting 62 329 references which were screened, with included studies quality assessed, data extracted and narratively synthesised. Results Sixteen reports of 10 studies were included, all from the USA and the UK. Five evaluations of interventions aiming to develop a stronger sense of community and/or improve relationships between staff and students suggested potential benefits particularly regarding violence and aggression. Two trials of interventions enabling students to advocate for changes in school catering and physical activity reported benefits for physical activity but not diet. Three evaluations of improvements to school playgrounds offered weak evidence of effects on physical activity. Conclusions School environment interventions show the potential to improve young people's health particularly regarding violence, aggression and physical activity. Further trials are required to provide a stronger and more generalisable evidence base.

Research paper thumbnail of Teeth Tales: a community-based child oral health promotion trial with migrant families in Australia

BMJ open, Jan 11, 2015

The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally d... more The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. Significant differences in the Debris Inde...

Research paper thumbnail of The effects of the school environment on student health: A systematic review of multi-level studies

Health & Place, 2013

Health outcomes vary between schools and it is theorised that this may be partly attributable to ... more Health outcomes vary between schools and it is theorised that this may be partly attributable to variation in the school environment. Existing systematic reviews have not drawn authoritative conclusions because of methodological limitations in the review or studies available. We identified 42 multi-level studies, ten of which were judged of sufficient quality to narratively synthesize. There was consistent evidence that schools with higher attainment and attendance than would be expected from student intake had lower rates of substance use. Findings on the influence of smoking/alcohol policies were mixed. Three studies examined the health effects variously associated with school campus area and observability, year structure, school size and pupil-to-teacher ratio with mixed findings. The studies reviewed support the potential influence of the school environment on student health.

Research paper thumbnail of Cultural adaptation and intervention integrity: a response to Skarstrand, Sundell and Andreasson

The European Journal of Public Health, 2014

Research paper thumbnail of An exploratory cluster randomised controlled trial of knowledge translation strategies to support evidence-informed decision-making in local governments (The KT4LG study)

BMC Public Health, 2011

Background Childhood overweight and obesity is the most prevalent and, arguably, politically comp... more Background Childhood overweight and obesity is the most prevalent and, arguably, politically complex child health problem internationally. Governments, communities and industry have important roles to play, and are increasingly expected to deliver an evidence-informed system-wide prevention program. However, efforts are impeded by a lack of organisational access to and use of research evidence. This study aims to identify feasible, acceptable and ideally, effective knowledge translation (KT) strategies to increase evidence-informed decision-making in local governments, within the context of childhood obesity prevention as a national policy priority. Methods/Design This paper describes the methods for KT4LG, a cluster randomised controlled trial which is exploratory in nature, given the limited evidence base and methodological advances. KT4LG aims to examine a program of KT strategies to increase the use of research evidence in informing public health decisions in local governments. ...

Research paper thumbnail of The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial

BMC Public Health, 2010

Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related ha... more Background: Licensed premises offer a valuable point of intervention to reduce alcohol-related harm. Objective: To describe the research design for an exploratory trial examining the feasibility and acceptability of a premises-level intervention designed to reduce severe intoxication and related disorder. The study also aims to assess the feasibility of a potential future large scale effectiveness trial and provide information on key trial design parameters including inclusion criteria, premises recruitment methods, strategies to implement the intervention and trial design, outcome measures, data collection methods and intra-cluster correlations. Design: A randomised controlled trial in licensed premises that had experienced at least one assault in the year preceding the intervention, documented in police or hospital Emergency Department (ED) records. Premises were recruited from four study areas by piloting four recruitment strategies of varying intensity. Thirty two licensed premises were grouped into matched pairs to reduce potential bias and randomly allocated to the control or intervention condition. The study included a nested process evaluation to provide information on intervention acceptability and implementation. Outcome measures included police-recorded violent incidents, assault-related attendances at each premises' local ED and patron Breath Alcohol Concentration assessed on exiting and entering study premises. Results: The most successful recruitment method involved local police licensing officers and yielded a 100% success rate. Police-records of violence provided the most appropriate source of data about disorder at the premises level. Conclusion: The methodology of an exploratory trial is presented and despite challenges presented by the study environment it is argued an exploratory trial is warranted. Initial investigations in recruitment methods suggest that study premises should be recruited with the assistance of police officers. Police data were of sufficient quality to identify disorder and street surveys are a feasible method for measuring intoxication at the individual level. Trial registration: UKCRN 7090; ISRCTN: 80875696.