Scaling up community-based obesity prevention in Australia : background and evaluation design of the health promoting communities : being active eating well initiative

Background : There is only limited evidence available on how best to prevent childhood obesity and community-based interventions hold promise, as several successful interventions have now been published. The Victorian Government has recently funded six disadvantaged communities across Victoria, Australia for three years to promote healthy eating and physical activity for children, families, and adults in a community-based participatory manner. Five of these intervention communities are situated in Primary Care Partnerships and are the subject of this paper. The interventions will comprise a mixture of capacity-building, environmental, and whole-of-community approaches with targeted and population-level interventions. The specific intervention activities will be determined locally within each community through stakeholder and community consultation. Implementation of the interventions will occur through funded positions in primary care and local government. This paper describes the design of the evaluation of the five primary care partnership-based initiatives in the 'Go for your life' Health Promoting Communities: Being Active Eating Well (HPC:BAEW) initiative.

Methods/Design : A mixed method and multi-level evaluation of the HPC:BAEW initiative will capture process, impact and outcome data and involve both local and state-wide evaluators. There will be a combined analysis across the five community intervention projects with outcomes compared to a comparison group using a cross-sectional, quasi-experimental design. The evaluation will capture process, weight status, socio-demographic, obesity-related behavioral and environmental data in intervention and comparison areas. This will be achieved using document analysis, paper-based questionnaires, interviews and direct measures of weight, height and waist circumference from participants (children, adolescents and adults).

Discussion : This study will add significant evidence on how to prevent obesity at a population level in disadvantaged and ethnically diverse communities. The outcomes will have direct influence on policy and practice and guide the development and implementation of future obesity prevention efforts in Australia and internationally.

Process evaluation design and tools used in a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study

Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.

Evaluation of the childhood obesity prevention program kids - go for your life

Background
Kids - 'Go for your life' (K-GFYL) is an award-based health promotion program being implemented across Victoria, Australia. The program aims to reduce the risk of childhood obesity by improving the socio-cultural, policy and physical environments in children's care and educational settings. Membership of the K-GFYL program is open to all primary and pre-schools and early childhood services across the State. Once in the program, member schools and services are centrally supported to undertake the health promotion (intervention) activities. Once the K-GFYL program 'criteria' are reached the school/service is assessed and 'awarded'. This paper describes the design of the evaluation of the statewide K-GFYL intervention program.

Methods/Design
The evaluation is mixed method and cross sectional and aims to:
1) Determine if K-GFYL award status is associated with more health promoting environments in schools/services compared to those who are members only;
2) Determine if children attending K-GFYL award schools/services have higher levels of healthy eating and physical activity-related behaviors compared to those who are members only;
3) Examine the barriers to implementing and achieving the K-GFYL award; and
4) Determine the economic cost of implementing K-GFYL in primary schools
Parent surveys will capture information about the home environment and child dietary and physical activity-related behaviors. Environmental questionnaires in early childhood settings and schools will capture information on the physical activity and nutrition environment and current health promotion activities. Lunchbox surveys and a set of open-ended questions for kindergarten parents will provide additional data. Resource use associated with the intervention activities will be collected from primary schools for cost analysis.

Discussion
The K-GFYL award program is a community-wide intervention that requires a comprehensive, multi-level evaluation. The evaluation design is constrained by the lack of a non-K-GFYL control group, short time frames and delayed funding of this large scale evaluation across all intervention settings. However, despite this, the evaluation will generate valuable evidence about the utility of a community-wide environmental approach to preventing childhood obesity which will inform future public health policies and health promotion programs internationally.

Trial Registration
ACTRN12609001075279

Evaluating impact of clinical guidelines using a realist evaluation framework

RATIONALE, AIMS AND OBJECTIVES: The Remote Primary Health Care Manuals (RPHCM) project team manages the development and publication of clinical protocols and procedures for primary care clinicians practicing in remote Australia. The Central Australian Rural Practitioners Association Standard Treatment Manual, the flagship manual of the RPHCM suite, has been evaluated for accessibility and acceptability in remote clinics three times in its 20-year history. These evaluations did not consider a theory-based framework or a programme theory, resulting in some limitations with the evaluation findings. With the RPHCM having an aim of enabling evidence-based practice in remote clinics and anecdotally reported to do so, testing this empirically for the full suite is vital for both stakeholders and future editions of the RPHCM. METHODS: The project team utilized a realist evaluation framework to assess how, why and for what the RPHCM were being used by remote practitioners. A theory regarding the circumstances in which the manuals have and have not enabled evidence-based practice in the remote clinical context was tested. The project assessed this theory for all the manuals in the RPHCM suite, across government and aboriginal community-controlled clinics, in three regions of Australia. CONCLUSION: Implementing a realist evaluation framework to generate robust findings in this context has required innovation in the evaluation design and adaptation by researchers. This article captures the RPHCM team's experience in designing this evaluation.

Preliminary investigations into triazole derived androgen receptor antagonists

A range of 1,4-substituted-1,2,3-N-phenyltriazoles were synthesized and evaluated as non-steroidal androgen receptor (AR) antagonists. The motivation for this study was to replace the N-phenyl amide portion of small molecule antiandrogens with a 1,2,3-triazole and determine effects, if any, on biological activity. The synthetic methodology presented herein is robust, high yielding and extremely rapid. Using this methodology a series of 17 N-aryl triazoles were synthesized from commercially available starting materials in less than 3h. After preliminary biological screening at 20 and 40 μM, the most promising three compounds were found to display IC50 values of 40-50 μM against androgen dependent (LNCaP) cells and serve as a starting point for further structure-activity investigations. All compounds in this work were the focus of an in silico study to dock the compounds into the human androgen receptor ligand binding domain (hARLBD) and compare their predicted binding affinity with known antiandrogens. A comparison of receptor-ligand interactions for the wild type and T877A mutant AR revealed two novel polar interactions. One with Q738 of the wild type site and the second with the mutated A877 residue.

Enhancing quality in online learning : scaffolding planning and design through proactive evaluation

A major issue confronting educators is the extent to which they wish to conform to so-called paradigm shifts in teaching and learning. In the contemporary world of tertiary education these shifts embrace both pedagogy (from instructivist to constructivist) and technology (from classroom to online). As teachers and learners are faced with the potential of these new learning environments, the extent to which learning outcomes are achieved remains a high priority and subject to a wide range of evaluation strategies. Conventionally, evaluation has been positioned at the end of the instructional development cycle, to assess first whether or not the creative effort achieved the original product goals and second whether or not the desired learning outcomes were realized. In the context of online teaching and learning environments, however, the level of understanding teachers, learners and developers have of the medium can impact the ultimate effectiveness of the product. This paper articulates an additional dimension to post-development evaluation processes in proposing proactive evaluation, a framework that identifies critical online learning factors and influences that will better inform the planning, design and development of learning resources. This notion of proactive evaluation advocates resource development being undertaken where all planning activities are assessed against the evaluation criteria that would normally be applied during formative assessment. By performing these evaluation checks proactively, online learning resources will, in principle, work first time as all relevant factors and issues will have been considered and resolved. More importantly, for those participants who are new to online environments, proactive evaluation will perform a scaffolding and professional development role by enhancing online teaching or learning competencies.

Evaluation of the implementation of a state government community design policy aimed at increasing local walking : design issues and baseline results from RESIDE, Perth Western Australia

Objectives.
To describe the design and baseline results of an evaluation of the Western Australian government's pedestrian-friendly subdivision design code (Liveable Neighborhood (LN) Guidelines).
Methods.

Baseline results (2003–2005) from a longitudinal study of people (n = 1813) moving into new housing developments: 18 Liveable, 11 Hybrid and 45 Conventional (i.e., LDs, HDs and CDs respectively) are presented including usual recreational and transport-related walking undertaken within and outside the neighborhood, and 7-day pedometer steps.
Results.

At baseline, more participants walked for recreation and transport within the neighborhood (52.6%; 36.1% respectively), than outside the neighborhood (17.7%; 13.2% respectively). Notably, only 20% of average total duration of walking (128.4 min/week (SD159.8)) was transport related and within the neighborhood. There were few differences between the groups' demographic, psychosocial and perceived neighborhood environmental characteristics, pedometer steps, or the type, amount and location of self-reported walking (p > 0.05). However, asked what factors influenced their choice of housing development, more participants moving into LDs reported aspects of their new neighborhood's walkability as important (p < 0.05).
Conclusions.

The baseline results underscore the desirability of incorporating behavior and context-specific measures and value of longitudinal designs to enable changes in behavior, attitudes, and urban form to be monitored, while adjusting for baseline residential location preferences.

Critical evaluation of cashmere nutrition experiments and suggestions for the design and conduct of successful experiments

Cashmere fibre production is an order of magnitude less than fibre production of Merino sheep or Angora goats and is more difficult to measure. Based on a comparison between cashmere experiments reporting responses to nutrition and those reporting no response, 13 design and management characteristics were identified that are related to the ability of experiments to discriminate among treatments. Methods must be adopted to reduce the variance in cashmere production within treatments, by using sufficient. animals per treatment, having enough replication to provide plenty of degrees of freedom to reduce error terms in analysis, and using pre-experimental cashmere production attributes as co-variants in analysis. It is preferable to use more productive and older goats, and goats that are used to handling, and to the conditions and feed to be used. Nutrition treatments need to produce different live weight growth curves and an appropriate control is needed such as live weight maintenance. As the raw cashmere fleece is composed primarily of hair and other contaminants, careful attention is required to measure, sample and test cashmere. Cashmere growth experiments should start by midsummer and last for at least four and preferably six months. These requirements make it more difficult for many university students to plan, undertake and complete long-term cashmere nutrition experiments without considerable management support.

Evaluation of an environmental rating tool for commercial building design

This research examined the inclusion of environmental rating tools in the design of commercial buildings. Environmental issues are becoming increasingly important for designers and the results of the study suggest that rating tools can be an asset to design teams, provided they are integrated and reinforced throughout the design process.

The design and evaluation of two types of chemical sensor

During the course of this investigation it was discovered that functionalised Ruthenium tris(bipyridyl) complexes exhibit different chemical, spectroscopic and electrochemical properties to those of the parent compound. Furthermore, it was possible to develop 1,8-naphthalimide-based compounds that furnished strong 1:1 host:guest complexes with larger anions such as hydrogen pyrophosphate. This dissertation presents in investigation into the systhesis and analytical evaluation of two types of chemical sensors: chemiluminescent and fluorescent.

Design, fabrication and evaluation of universal polymerase chain reaction devices

Novel and low cost PCR devices were developed to perform rapid polymerase chain reaction based diagnostics for infectious diseases. The main advantages of using these devices are that it can perform multi sample and also multiplexing of DNA samples woth low sample volume compared to the conventional PCR devices.

Design, synthesis and preliminary analytical evaluation of water soluble reagents for peroxyoxalate chemiluminescence

Describes the investigation into a number of facets of the peroxyoxalate chemiluminescence reaction, and the application of this chemistry to the detection of certain analytes under purely aqueous conditions.