How long does it take to scale-up obesity prevention interventions?

Area of Science:

• Public Health
• Health Services Research
• Obesity Prevention

Background:

• High rates of obesity necessitate the scale-up of evidence-based interventions.
• The timely scale-up of interventions is crucial but often delayed.
• Previous estimates suggest 14-17 years for research translation, but scale-up timelines for prevention interventions are largely unknown.

Purpose of the Study:

• To examine the time taken to scale-up obesity prevention interventions.
• To analyze scale-up timelines across four distinct scale-up pathways.

Main Methods:

• A systematic search identified obesity prevention interventions scaled to at least city-wide implementation.
• Interventions were mapped to four scale-up pathways.
• Timeframes for each stage of the scale-up pathway were recorded to determine total scale-up duration.

Main Results:

• Ninety interventions were analyzed; less than half reported a comprehensive research pathway to scale-up.
• A third of interventions lacked reported efficacy or effectiveness data before scale-up.
• Scale-up times ranged from 0 to 5 years, with comprehensive pathways taking approximately 5 years, and single-evidence-step pathways taking 1-1.5 years.

Conclusions:

• Obesity prevention interventions can be scaled up more rapidly than the estimated 14-17 years for research translation.
• Intervention scale-up occurs via diverse pathways.
• Scale-up frequently happens without prior evidence of effectiveness.