What strategies best promote healthy
eating in pubs and clubs?
Reflections on a rapid review
Peter Bragge
Breanna Wright
Acknowledgements
This project was commissioned by Ernst and Young as part of a
project funded by The National Heart Foundation of Australia
The researchers declare no conflicts of interest
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National Heart Foundation
27.5% of Australian adults are obese
A further 35% are overweight
Healthy Dining Victoria Program
BWA commissioned to review
literature informing this
http://heartfoundation.org.au/programs/plating-up-healthier-choices-in-pubs-and-clubs Accessed March 1, 2016
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Identify and synthesise research
evidence to inform strategies promoting
healthy dining choices in Victorian pubs
and clubs
... in 7 days
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“Policymakers, decision makers,
stakeholders and other knowledge
users require access to
contextualized resources that
succinctly and methodically
address scientific evidence
quickly”
Khangura et al. Systematic Reviews. 2012;1:doi:10.1186/2046-4053-1-10.
http://rosetta.jpl.nasa.gov/instruments Accessed November 18, 2014
Rapid Evidence Reviews
Serve as an informative brief that prepares
stakeholders for discussion on a policy
issue
Support the direction and evidencebase for various health policy
initiatives
Support the development of clinical
interventions and/or health services
programs
Khangura et al. Systematic Reviews 2012; 1: doi:10.1186/2046-4053-1-10
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Rapid Evidence Review
Timeframe 2 – 6 weeks
Question
Specified a priori; broad
Sources and Explicit comprehensive search
searches
strategy; multiple databases;
limits applied (e.g. last 3 – 5
years)
Selection
Criterion-based, focus on
reviews / systematic reviews
Appraisal
Rigorous critical appraisal (SRs)
Synthesis
Descriptive / thematic
Inferences Limited to main themes
Traditional Systematic Review
6 months – 2 years
Specified a priori; narrow
Explicit comprehensive search
strategy; multiple databases; less
or no limits
Criterion-based, primary studies
Rigorous critical appraisal
Descriptive + / - meta-analysis
More robust and detailed
Adapted from Khangura et al. Systematic Reviews. 2012;1:doi:10.1186/2046-4053-1-10.
Rapid Evidence Review
Traditional Systematic Review
Timeframe
2 – 6 weeks
6 months – 2 years
Selection
Criterion-based, focus on
reviews / systematic reviews
Criterion-based, primary studies
“Caution needs to be applied interpreting
rapid review findings, as more
comprehensive review approaches may
elucidate further information and insights,
which would influence review
interpretation and conclusions.
Therefore, systematic reviews remain the
definitive method of literature review, and
we recommend systematic reviews be
undertaken whenever possible.”
Khangura et al. Systematic Reviews. 2012;1:doi:10.1186/2046-4053-1-10.
Searching the literature
JUNK
Small studies
Larger studies
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Systematic reviews
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Data extraction
Date of most recent search
Population
Setting
Number of studies
Number of participants
Intervention
Outcomes measured
Authors’ conclusions
Quality assessment
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Who cares about quality?
Egger et al. Systematic reviews in health care. London: BMJ books, 2001.
Results
Social Norms
Manipulation of
portion / dishware
/ cutlery size
Provision of health
information
3 systematic reviews
4 systematic reviews
3 systematic reviews
61 primary studies
45 primary studies
26 primary studies
And
Social Modelling
13th October 2012
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Implications for Strategy and Practice
Target
audience
• Overweight
and obese
• Child vs Adult
Setting
• 85%
Laboratory
In the
real
world
In the real world
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Review impact
“Reinforced to government that a combination of
interventions are likely to provide the best outcome”
“Provided a counterpoint to the long-held ‘conventional
wisdom’ … around the effectiveness of crockery and
cutlery size”
“We have used this challenge of conventional wisdom in
subsequent campaign bids”
“The evidence provided around establishing new social
models / norms is one of the interventions we would be
keen to try”
Roni Beauchamp | Healthy Living Manager, Heart Foundation (Victoria)
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Reflections on the rapid review process
Time limited (under 3-6 months)
Review evidence is available OR industry reports have
reviewed literature
Important to refine question with stakeholders
Interested in the key findings of an area, does not
provide detail
No directional hypotheses
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Any questions?
Thank you for your time today
What would a systematic
review have revealed?
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AMSTAR Quality Checklist
A priori design
Duplicate study selection and
data extraction
Characteristics of included studies
Scientific quality assessed and
documented
Scientific quality used appropriately
to formulate conclusions
Comprehensive literature search
Appropriate methods to combine
findings of studies
Status of publication (grey
literature) included
List of included and excluded
studies
Publication bias
Conflict of interest
What’s in and what’s out?
Systematic Reviews
Healthy populations
Behavioural focus
Healthy eating interventions
Outcomes
• Food choice
• Food consumption
• Food purchase
English language
Peer-reviewed publications
2010 onwards
Analysis of nutritional qualities
Dietary trends
Diets and disease
Animal studies
Food labelling
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