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Table 1 Results of the analysis of recommendations. Analysis of essential elements within the recommendations using the Implementation framework

From: Analysis of the UK recommendations on obesity based on a proposed implementation framework

Implementation framework elements Number out of 21 set of recommendations Details
Target population 21 out of 21
14 = Both adults and children;[1216, 19, 23, 2529, 31, 32]
4 = Children and young adults (up to 18 years) only;[17, 18, 24, 30]
3 = Obese adults [2022]
Children and adults, obese adults, children of obese parents and with a family history, people with diabetes and coronary heart disease, low income groups, pregnant women, smokers, disabled people and ethnic groups
Responsible agency 20 out of 21[1226, 2832] Government, Department of Health for overall development and implementation of strategies
NHS for management within NHS and training of GPs and nurses
GPs for implementation of clinical guidelines and maintaining the audit for compliance Local authorities for local implementation of recommendations (i.e safe routes)
Food Standard Agency for Nutrition
Department of Sports, Sports England and Sports Scotland for Physical activity
Monitoring and Evaluation 16 out of 21[1216, 1923, 25, 26, 28, 3032] One third of the articles did not report on how the implementation progress would be monitored or evaluated.
The Government, Department of Health, cabinet task force, NHS and physicians were implied for the monitoring of implementation.
Achieving the set milestones, conducting regular audits and maintaining databases on progress were few of the tools suggested for monitoring progress of implementation.
Time-frame for the implementation 4 out of 21[13, 14, 23, 31] Very few set out specific time-frame for implementation.
Two studies[12, 24] stressed implementation was urgent and some studies anticipated problems in implementing the recommendations
Prioritisation 21 out of 21
4 had treatment as priority [2023]
2 had treatment and prevention[27, 32]
15 had prevention only as priority [1219, 2426, 2831]
Although the recommendations was separated out broadly into 'Treatment' and 'Prevention', in many there was a long list of recommendations without any priority for specific components
Cost and resources 7 out of 21[14, 2023, 28, 32] Seven studies estimated the costs to the NHS for implementation of their recommendations. 11 did not mention cost or funding and the rest only recognised cost as an issue for successful implementation