Obesity is a significant global public health issue. In Australia, a recent national health survey found 25% of children aged 5-17 years have been classified as overweight or obese. Childhood obesity has been linked to a range of social and physical health problems in later life including type 2 diabetes . As a result, data suggests that the financial cost of obesity in 2008 was $8.283 Billion AUD . Such forecasts are fuelling political imperatives to implement obesity prevention strategies, particularly for primary-school aged children. Developing strategies that incorporate new knowledge into policy development is essential.
Local governments in Australia have responsibility for a range of local infrastructure and activities including maternal and child health programs, child care, kindergartens, recreation facilities, parks, planning and building, traffic management and food regulations. Due to this diverse portfolio, local government has the potential to make a significant contribution to obesity prevention in Australia [3, 4]. To be most effective however, strategies undertaken by local government need to be informed by the best available research evidence. Research evidence can be broadly defined as including descriptive evidence of prevalence and risk, evidence of intervention or program effectiveness and evidence about implementation of these interventions (for whom interventions work or not, in what circumstances and why) [5–7]. The crucial role of evidence has been formally acknowledged in this arena in Victoria with the Victorian Health and Wellbeing Act 2008, stipulating that local governments use evidence to inform their Municipal Public Health Plans . The use of research evidence is important not only in terms of identifying the combinations of strategies that impact on obesity, but also how well they work, for which sub-groups, the potential for harm, the mechanisms needed to support strategies, and associated cost . The use of research evidence to inform decision-making, and the development of strategies to support this process is therefore crucial.
Evidence-informed decision-making (EIDM) involves integrating the best available research evidence with contextual factors including community preferences, local health issues, political preferences and public health resources[10
]. The benefits of EIDM include:
▪ adoption of effective and cost-efficient interventions,
▪ prudent use of scarce resources,
▪ improved client satisfaction, and
▪ better health outcomes for individuals and communities .
In order for evidence-informed decision-making to occur efficiently and effectively, a series of mechanisms are required. Researchers and decision-makers need to work in partnership to fund and conduct research that addresses key policy questions; research needs to be conceptualised, conducted and communicated in a way that is meaningful to decision-makers; and research evidence needs to be accessed, assessed and appropriately  applied by decision-makers within a complex political system. (Appropriate use of research evidence to inform decision-making refers to an unbiased assessment of the evidence-base rather than using research evidence to support a position or decision that been made in the absence of evidence)
While decision-makers are under increasing pressure to use research evidence to inform their decisions, significant barriers have been identified. These include absence of personal contact between researchers and policy-makers and practitioners, lack of time and resources, organisational structures and processes, timeliness of research, poor quality or limited availability of research, and political influence [11–14]. To address these barriers, a range of strategies, often conceptualised as knowledge translation (KT) have been described and in some cases implemented. KT strategies range from researcher focused interventions (often designed to support the dissemination of research findings), decision-maker focused interventions (often designed to change practices and behaviours related to the integration of research evidence into decision-making processes) and interventions designed to create partnerships between researchers and decision-makers (where questions of mutual interest are identified, research is conducted in partnership and the research is used to inform policy-level decisions) . These have also been categorised as interventions that encourage push, pull and exchange of evidence . This study focuses on the application of decision-maker focused interventions, that is, those that facilitate decision-makers to access and use research evidence to inform their decisions.
Despite the fervour around KT in public health, very few rigorous studies have been or are being conducted . As a result, it is likely that strategies have been either modified from those conducted in clinical environments or informed by the plethora of studies (of varying quality) that outline barriers and facilitators to KT in public health environments . Much of the work to date has occurred in Canada where the government has actively invested in exploring and facilitating KT . This exploratory trial will assess the potential effectiveness, as well as feasibility and acceptability, of a multi-component KT intervention in increasing the use of research evidence to support decision making in local governments. The trial is informed by a series of preliminary projects including a state-wide survey, a systematic review and key informant interviews, which will be published elsewhere. This paper describes the methods of the trial in detail.