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. 2018 Sep 21;8(9):e019151.
doi: 10.1136/bmjopen-2017-019151.

Strategies to improve the implementation of policies, practices or programmes in sporting organisations targeting poor diet, physical inactivity, obesity, risky alcohol use or tobacco use: a systematic review

Tameka McFadyen  1   2 , Li Kheng Chai  3 , Rebecca Wyse  1 , Melanie Kingsland  1 , Sze Lin Yoong  1 , Tara Clinton-McHarg  1 , Adrian Bauman  4 , John Wiggers  1   2 , Chris Rissel  4 , Christopher Michael Williams  1 , Luke Wolfenden  1   2
Affiliations

Strategies to improve the implementation of policies, practices or programmes in sporting organisations targeting poor diet, physical inactivity, obesity, risky alcohol use or tobacco use: a systematic review

Tameka McFadyen et al. BMJ Open. .

Abstract

Objectives: The primary aim for this review is to determine the effectiveness of strategies to improve the implementation of policies, practices or programmes in sporting organisations. The secondary aims are to describe the cost or cost-effectiveness and adverse effects of such strategies and to examine the effects of those implementation strategies on individual's diet, physical activity, obesity, alcohol use or tobacco use.

Methods: We conducted searches of academic databases (eg, MEDLINE, EMBASE and CENTRAL), trial registers and hand searches of selected journals. Studies were included if they were conducted at a sporting venue; described a strategy to improve implementation of policies, practices or programmes focusing on one or more health risks (diet, physical inactivity, obesity, alcohol or tobacco use), and included a parallel control group. Two authors independently screened citations and extracted data. The results of included studies were synthesised narratively.

Results: Of the 5926 citations screened three studies met the inclusion criteria. Two studies were randomised controlled trials. Two studies sought to improve the implementation of nutrition-related policy and practices and one study sought to improve implementation of alcohol-related policy and practices. Each study reported improvement in at least one measure of policy or practice implementation. Two studies reported individual-level outcomes and found a reduction in excessive alcohol consumption and an increase in purchase of fruits and vegetables at the sports club ground. Two studies assessed club revenue as a potential adverse effect, neither reported significant between-group differences on these measures.

Conclusion: There is a sparse evidence base regarding the effectiveness of strategies to improve the implementation of policies, practices or programmes targeting chronic disease risk factors in sporting clubs. While all studies reported some improvements in implementation, for some multistrategic implementation strategies it is difficult to determine the extent to which such effects are generalisable.

Prospero registration number: CRD42016039490.

Keywords: health risk behaviours; implementation science; sports clubs; systematic review.

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Conflict of interest statement

Competing interests: MK, LW and JW authored two of the studies included in this review. For these studies, data were extracted and risk of bias was conducted by review authors who were not directly involved in these studies. The authors have not received any benefit, in cash or in kind, any hospitality or any subsidy or any other source perceived to have an interest in the outcome of this review.

Figures

Figure 1
Figure 1
Risk of bias graph, reviewing authors’ judgements about each risk of bias item across all included studies, classifying as low risk, unclear risk or high risk.
Figure 2
Figure 2
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram, depicting the process undertaken for the review with the inclusion of the number of studies that were screened and assessed for eligibility.
See this image and copyright information in PMC

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