What strategies best promote healthy eating in pubs and clubs? Reflections on a rapid review. Peter Bragge Breanna Wright

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1 What strategies best promote healthy eating in pubs and clubs? Reflections on a rapid review Peter Bragge Breanna Wright

2 Acknowledgements This project was commissioned by Ernst and Young as part of a project funded by The National Heart Foundation of Australia The researchers declare no conflicts of interest 2

Dining Victoria Program BWA commissioned to review literature informing

3 National Heart Foundation 27.5% of Australian adults are obese A further 35% are overweight Healthy Dining Victoria Program BWA commissioned to review literature informing this Accessed March 1,

4 Identify and synthesise research evidence to inform strategies promoting healthy dining choices in Victorian pubs and clubs... in 7 days 4

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6 Policymakers, decision makers, stakeholders and other knowledge users require access to contextualized resources that succinctly and methodically address scientific evidence quickly Khangura et al. Systematic Reviews. 2012;1:doi: /

7 Accessed November 18, 2014

Rapid Evidence Reviews Serve as an informative brief that prepares stakeholders for discussion on a policy issue Support the direction and evidencebase for various health

9 Rapid Evidence Reviews Serve as an informative brief that prepares stakeholders for discussion on a policy issue Support the direction and evidencebase for various health policy initiatives Support the development of clinical interventions and/or health services programs Khangura et al. Systematic Reviews 2012; 1: doi: /

10 Rapid Evidence Review Traditional Systematic Review Timeframe 2 6 weeks 6 months 2 years Question Specified a priori; broad Specified a priori; narrow Sources and searches Selection Explicit comprehensive search strategy; multiple databases; limits applied (e.g. last 3 5 years) Criterion-based, focus on reviews / systematic reviews Explicit comprehensive search strategy; multiple databases; less or no limits Criterion-based, primary studies Appraisal Rigorous critical appraisal (SRs) Rigorous critical appraisal Synthesis Descriptive / thematic Descriptive + / - meta-analysis Inferences Limited to main themes More robust and detailed Adapted from Khangura et al. Systematic Reviews. 2012;1:doi: /

11 Rapid Evidence Review Traditional Systematic Review Timeframe 2 6 weeks 6 months 2 years Selection Criterion-based, focus on reviews / systematic reviews Criterion-based, primary studies

12 Caution needs to be applied interpreting rapid review findings, as more comprehensive review approaches may elucidate further information and insights, which would influence review interpretation and conclusions. Therefore, systematic reviews remain the definitive method of literature review, and we recommend systematic reviews be undertaken whenever possible. Khangura et al. Systematic Reviews. 2012;1:doi: /

13 Searching the literature JUNK Small studies Larger studies 9 Systematic reviews 13

14 Data extraction Date of most recent search Population Setting Number of studies Number of participants Intervention Outcomes measured Authors conclusions Quality assessment 14

15 Who cares about quality? Egger et al. Systematic reviews in health care. London: BMJ books, 2001.

16 Results Social Norms And Social Modelling Manipulation of portion / dishware / cutlery size Provision of health information 3 systematic reviews 61 primary studies 4 systematic reviews 45 primary studies 3 systematic reviews 26 primary studies 13 th October

17 Implications for Strategy and Practice Target audience Setting In the real world Overweight and obese Child vs Adult 85% Laboratory

18 In the real world 18

19 Review impact Reinforced to government that a combination of interventions are likely to provide the best outcome Provided a counterpoint to the long-held conventional wisdom around the effectiveness of crockery and cutlery size We have used this challenge of conventional wisdom in subsequent campaign bids The evidence provided around establishing new social models / norms is one of the interventions we would be keen to try Roni Beauchamp Healthy Living Manager, Heart Foundation (Victoria) 19

20 Reflections on the rapid review process Time limited (under 3-6 months) Review evidence is available OR industry reports have reviewed literature Important to refine question with stakeholders Interested in the key findings of an area, does not provide detail No directional hypotheses 20

21 Any questions? Thank you for your time today

22 What would a systematic review have revealed? 22

23 AMSTAR Quality Checklist A priori design Duplicate study selection and data extraction Comprehensive literature search Status of publication (grey literature) included List of included and excluded studies Characteristics of included studies Scientific quality assessed and documented Scientific quality used appropriately to formulate conclusions Appropriate methods to combine findings of studies Publication bias Conflict of interest

24 What s in and what s out? Systematic Reviews Healthy populations Behavioural focus Healthy eating interventions Outcomes Food choice Food consumption Food purchase English language Peer-reviewed publications 2010 onwards Analysis of nutritional qualities Dietary trends Diets and disease Animal studies Food labelling 24

The Research Process: Coming to Terms

The Research Process: Coming to Terms Describe the research process from formulating questions to seeking and finding solutions. Describe the difference between dependent and independent variables. Identify