Perceived impacts of COVID-19 and bushfires on the implementation of an obesity prevention trial in Northeast Victoria, Australia

Jillian Whelan; Monique Hillenaar; Penny Fraser; Steven Allender; Michelle Jackson; Claudia Strugnell; Colin Bell

doi:10.1371/journal.pone.0287468

Perceived impacts of COVID-19 and bushfires on the implementation of an obesity prevention trial in Northeast Victoria, Australia

PLoS One. 2023 Jun 20;18(6):e0287468. doi: 10.1371/journal.pone.0287468. eCollection 2023.

Authors

Jillian Whelan^{1

2}, Monique Hillenaar¹, Penny Fraser¹, Steven Allender¹, Michelle Jackson¹, Claudia Strugnell^{1

3}, Colin Bell^{1

2}

Affiliations

¹ Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
² School of Medicine, Deakin University, Geelong, Victoria, Australia.
³ Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia.

Abstract

Background: Calls for the adoption of a systems approach to chronic disease prevention date back at least ten years because of the potential to empower communities to identify and address the complex causes of overnutrition, undernutrition and climate change. Australia, like many countries, has high levels of obesity and extreme climate events. The Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND) trial aims to prevent unhealthy weight gain in children in 10 intervention and two pilot communities in north-east Victoria, Australia using community-based participatory approaches informed by systems science. Intervention activities co-designed in 2019 were disrupted by COVID-19 and bushfires. This paper explores the impacts of these 'shocks' on the local prevention workforce to implement actions within communities.

Methods: A case study design involving one-hour online focus groups and an on-line survey (November 2021-February 2022). Purposive sampling was used to achieve diverse representation from RESPOND stakeholders including local council, health services, primary care partnerships and department of health. The focus group interview schedule and survey questions were based on Durlak and DuPre's implementation factors.

Results: Twenty-nine participants from seven different communities participated in at least one of nine focus groups to discuss the impacts of COVID-19 and bushfires on localised implementation. Twenty-eight participants (97% of focus group sample) also completed the on-line survey. Implementation of RESPOND stalled or stopped in most communities due to bushfires and/or COVID-19. These shocks resulted in organisational priorities changing, loss of momentum for implementation, redeployment of human resources, culminating in fatigue and exhaustion. Participants reported adaptation of RESPOND, but implementation was slowed due to limited resources.

Conclusion: Further research is needed to advance risk management strategies and protect resources within health promotion. System shocks such as bushfires and COVID-19 are inevitable, and despite multiple adaptation opportunities, this intervention approach was not 'shock proof'.

Copyright: © 2023 Whelan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
COVID-19* / prevention & control
Child
Health Promotion / methods
Humans
Obesity / epidemiology
Obesity / prevention & control
Surveys and Questionnaires
Victoria / epidemiology

Grants and funding

RESPOND is funded by Australia’s National Health and Medical Research Council’s (NHMRC’s) Partnership Projects Research Grants scheme, (GNT1151572) with further funding and in-kind contributions from 12 partner organisations who were signatories to the grant. Partners to the RESPOND grant were Deakin University (lead agency), the Victorian Government Departments of Education and Training and of Health and Human Services, Beechworth Health Service, Yarrawonga Health, Gateway Health, Numurkah District Health, Lower Hume Primary Care Partnership, Central Hume Primary Care Partnership, Upper Hume Primary Care Partnership, Goulburn Valley Primary Care Partnership, and VicHealth. Additional organisations who have joined the partnership since establishment include Greater Shepparton City Council, Murrindindi Shire Council, and Nexus Primary Health. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.