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[Reflections on implementing population-based measures for the prevention of non-communicable diseases]
Lisa M Pfadenhauer1,2, Kerstin Sell3,4, Stephan Voss3,4
1Lehrstuhl für Public Health und Versorgungsforschung, Institut für Medizinische Informationsverarbeitung Biometrie und Epidemiologie - IBE, Medizinische Fakultät, Ludwig-Maximilians-Universität München, Elisabeth-Winterhalter-Weg 6, 81377, München, Deutschland. pfadenhauer@ibe.med.uni-muenchen.de.
Background:
In view of the global burden of non-communicable diseases (NCDs), the focus is shifting increasingly towards structural prevention measures. Effective implementation of these measures is crucial. Using the Context and Implementation of Complex Interventions (CICI) Framework, this article reflects on the implementation of two ratio prevention measures and discusses challenges in the application of implementation science approaches.
Methods:
Case 1 (Collaboration for Evidence-Based Healthcare and Public Health in Africa-CEBHA+) examined measures for the prevention of NCDs and road traffic accidents in sub-Saharan Africa. Case 2 ("Präventionskette Freiham") evaluated a community network in Germany that aims to enable children and adolescents from socially disadvantaged families to grow up well and healthy. Data published in project-related publications served as the basis for the analysis, supplemented by a questionnaire-based reflection by the researchers involved. For both data sources, the data collected were coded inductively and assigned to the deductive categories of the CICI Framework.
Results:
In both cases, contextual and structural conditions, implementation agents, and strategies were assessed on multiple levels, with an emphasis on implementation agents. While Präventionskette Freiham pursued a systematic process evaluation with explicit use of implementation science approaches, this was only implicitly considered in CEBHA+, which makes comparability, classification in the literature, and overarching consideration more difficult.
Discussion:
Implementation science approaches should be given a stronger focus in the field of relationship prevention in order to fully exploit their potential.
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