Development and testing of a novel survey to assess Stakeholder-driven Community Diffusion of childhood obesity prevention efforts

Abstract

BackgroundInvolving groups of community stakeholders (e.g., steering committees) to lead community-wide health interventions appears to support multiple outcomes ranging from policy and systems change to individual biology. While numerous tools are available to measure stakeholder characteristics, many lack detail on reliability and validity, are not context specific, and may not be sensitive enough to capture change over time. This study describes the development and reliability of a novel survey to measure Stakeholder-driven Community Diffusion via assessment of stakeholders’ social networks, knowledge, and engagement about childhood obesity prevention.MethodsThis study was completed in three phases. Phase 1 included conceptualization and online survey development through literature reviews and expert input. Phase 2 included a retrospective study with stakeholders from two completed whole-of-community interventions. Between May–October 2015, 21 stakeholders from the Shape Up Somerville and Romp & Chomp interventions recalled their social networks, knowledge, and engagement pre-post intervention. We also assessed one-week test-retest reliability of knowledge and engagement survey modules among Shape Up Somerville respondents. Phase 3 included survey modifications and a second prospective reliability assessment. Test-retest reliability was assessed in May 2016 among 13 stakeholders involved in ongoing interventions in Victoria, Australia.ResultsIn Phase 1, we developed a survey with 7, 20 and 50 items for the social networks, knowledge, and engagement survey modules, respectively. In the Phase 2 retrospective study, Shape Up Somerville and Romp & Chomp networks included 99 and 54 individuals. Pre-post Shape Up Somerville and Romp & Chomp mean knowledge scores increased by 3.5 points (95% CI: 0.35–6.72) and (− 0.42–7.42). Engagement scores did not change significantly (Shape Up Somerville: 1.1 points (− 0.55–2.73); Romp & Chomp: 0.7 points (− 0.43–1.73)). Intraclass correlation coefficients (ICCs) for knowledge and engagement were 0.88 (0.67–0.97) and 0.97 (0.89–0.99). In Phase 3, the modified knowledge and engagement survey modules included 18 and 25 items, respectively. Knowledge and engagement ICCs were 0.84 (0.62–0.95) and 0.58 (0.23–0.86).ConclusionsThe survey measures upstream stakeholder properties—social networks, knowledge, and engagement—with good test-retest reliability. Future research related to Stakeholder-driven Community Diffusion should focus on prospective change and survey validation for intervention effectiveness.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-5588-1) contains supplementary material, which is available to authorized users.

Engaging Coalitions in Community-Based Childhood Obesity Prevention Interventions: A Mixed Methods Assessment

“…8,10 New, sensitive, and valid measurement tools and mechanistic models are likely needed to gain new insights into this understudied area, with the aim to understand why interventions do or do not succeed and what approaches may curb childhood obesity rates. 50 Study strengths include rigorous search strategies in three electronic databases at two time points. To address the limited coalition information available in the published literature, review findings were complemented with original survey and interview data from intervention researchers.…”

Protocol for the measurement of changes in knowledge and engagement in the stepped wedge cluster randomised trial for childhood obesity prevention in Australia: (Reflexive Evidence and Systems interventions to Prevent Obesity and Non-communicable Disease (RESPOND))

“…Data will be collected using a modified version of the Stakeholder-driven Community Diffusion Survey (SDCD) developed by Korn et al [ 28 ]. This survey developed by Korn et al’s [ 28 ] was informed by extensive work with communities implementing interventions using a stakeholder-driven community diffusion model [ 12 ] and an in-depth review of the core elements of capacity building that are specific to community-based participatory childhood obesity prevention interventions [ 11 ]. This work identified strong community engagement as being associated with positive intervention outcomes, and the development of effective coalitions in turn built community capacity, particularly in the fields of leadership [ 28 ].…”

“…This survey developed by Korn et al’s [ 28 ] was informed by extensive work with communities implementing interventions using a stakeholder-driven community diffusion model [ 12 ] and an in-depth review of the core elements of capacity building that are specific to community-based participatory childhood obesity prevention interventions [ 11 ]. This work identified strong community engagement as being associated with positive intervention outcomes, and the development of effective coalitions in turn built community capacity, particularly in the fields of leadership [ 28 ]. This tool is designed to be simple to administer and capture the elements of community capacity that are directly relevant to the community and systems-based approach and childhood obesity focus of the RESPOND intervention.…”

“…Korn et al [ 28 ] developed a tool that includes the major concepts we aim to measure in systems change: knowledge, resources and leadership, and extended the relevance to systems change by looking at the specific characteristics that leaders require to catalyse change and diffuse innovation effectively throughout the community with a specific focus on the prevention of childhood obesity. The resulting Stakeholder-driven Community Diffusion (SDCD) Survey assesses several domains which quantifies the knowledge about the problem of obesity, knowledge about effective and sustainable interventions, available resources, mutual learnings, flexibility, leadership and trust (defined as belief and confidence in others).…”

Design and methods of Shape Up Under 5: Integration of systems science and community-engaged research to prevent early childhood obesity

“…: knowledge about and engagement with obesity prevention efforts) of those who design and implement whole-of-community interventions (i.e. : stakeholders) are important to an intervention’s success [13, 15, 21]. The diffusion science literature suggests that these salient persional attributes can change over time and subsequently be diffused throughout stakeholders’ social networks into the broader community, and create conditions that maximize policy and environmental change [22–24].…”