Abstract
Background: Understanding the contextual factors that influence the dissemination and implementation of evidence-based chronic disease prevention (EBCDP) interventions in public health settings across countries could inform strategies to support the dissemination and implementation of EBCDP interventions globally and more effectively prevent chronic diseases. A survey tool to use across diverse countries is lacking. This study describes the development and reliability testing of a survey tool to assess the stage of dissemination, multi-level contextual factors, and individual and agency characteristics that influence the dissemination and implementation of EBCDP interventions in Australia, Brazil, China, and the United States.Methods: Development of the 26-question survey included, a narrative literature review of extant measures in EBCDP; qualitative interviews with 50 chronic disease prevention practitioners in Australia, Brazil, China, and the United States; review by an expert panel of researchers in EBCDP; and test-retest reliability assessment.Results: A convenience sample of practitioners working in chronic disease prevention in each country completed the survey twice (N = 165). Overall, this tool produced good to moderately reliable responses. Generally, reliability of responses was higher among practitioners from Australia and the United States than China and Brazil.Conclusions: Reliability findings inform the adaptation and further development of this tool. Revisions to four questions are recommended before use in China and revisions to two questions before use in Brazil. This survey tool can contribute toward an improved understanding of the contextual factors that public health practitioners in Australia, Brazil, China, and the United States face in their daily chronic disease prevention work related to the dissemination and implementation of EBCDP interventions. This understanding is necessary for the creation of multi-level strategies and policies that promote evidence-based decision-making and effective prevention of chronic diseases on a more global scale.
Highlights
Chronic diseases are a threat to global health, in developed and developing countries alike, accounting for 60% of deaths worldwide [1]
Public Health Specialist was added as a primary employment position option post hoc, in order to capture a common “other” response provided by practitioners from Brazil
The mean survey completion time varied by country, with Brazil having the longest (33.2 min ± 27.8), followed by the United States (17.72 min ± 13.4), Australia (16.6 min ± 10.0), and China (13.8 min ± 10.5)
Summary
Chronic diseases are a threat to global health, in developed and developing countries alike, accounting for 60% of deaths worldwide [1]. Additional work has addressed some of the contextual barriers by training practitioners on the evidence-based decision-making process, clarifying the reasons for selecting EBCDP interventions and outlining how to find the interventions and resources to support effective implementation and quality improvement [3, 4, 7]. Understanding the contextual factors that influence the dissemination and implementation of evidence-based chronic disease prevention (EBCDP) interventions in public health settings across countries could inform strategies to support the dissemination and implementation of EBCDP interventions globally and more effectively prevent chronic diseases. This study describes the development and reliability testing of a survey tool to assess the stage of dissemination, multi-level contextual factors, and individual and agency characteristics that influence the dissemination and implementation of EBCDP interventions in Australia, Brazil, China, and the United States
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