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Table 1 A concise overview of the 5 sub-studies of CIAO

From: Design of CIAO, a research program to support the development of an integrated approach to prevent overweight and obesity in the Netherlands

Substudy nr. Theme ACCs Research phases
    Identification phase Development phase Testing phase Adaptation & finalization phase
1 Political-administrative support Limburg - Literature review on operational criteria of integrated public health policies - Develop a conceptual framework which describes the process of developing integrated public health policies. - Apply developed conceptual framework - Focus groups with actors at strategic and tactical levels within Dutch local governments to find solutions for previously identified barriers
    - Interviews with local governmental officials and key-informants, and theoretical reflections to gain insight in the process of developing integrated public health policies   - Interviews with local governmental officials to gain insight in hampering or facilitating factors for intersectoral collaboration - Refinement of the developed conceptual framework based on the outcomes of the previous studies
    - Interviews with key-informants within the policy process to explore existing 'interventions for the development of integrated public health policies’   - Comparison of cases to gain insight in the effects of implementation style on interventions aimed at local governmental officials - Refinement of the developed conceptual framework based on the outcomes of the previous studies
      Extra: - Developing a program or policy resource that might be able to stimulate or facilitate the development of integrated public health policies
- Test and evaluate the developed framework in Australia (NSW) - data-collection through interviews with General Managers, Directors of Community Services, Health officials and Environment and Recreation officials, and a document analysis.
2 Social marketing - CEPHIR/Eras mus/ GGD Rotterdam - Benchmarks - Monitoring case-studies - Evaluation of case-studies using developed monitoring format - Adapting monitoring tool for Dutch setting
    - Analyses of Determinants of healthy weight among children - Develop practical monitoring tool   - Overview of determinants of applying social marketing
    - Selecting case-studies (interventions to promote healthy weight in childhood based on Social Marketing approach)    
3 Implementation Noordelijk Zuid-Holland - Systematic Review of design and quality of implementation research regarding complex integrated programs targeting overweight - Construction of process evaluation plan & several instruments to evaluate the innovation process - Longitudinal case-studies (5x): Interviews, questionnaires, focus groups, observational research document analyses & semi-action research social network analysis - An overview of the level and determinants of the innovation process of the integrated approach
    - Consultation with experts and local project managers   - Parents versus teachers, the relation between task-orientation and implementation - Guidelines/ indicators for the innovation process
       - If needed, adaptation of framework Fleuren et al [37] (for innovation process of the integrated approach)
4 Strengthening parenting styles and practices in existing interventions AMPHI Nijmegen - Analyses existing data: attitudes professionals and parents on overweight - Development of a web-based parenting intervention (with the aim of strengthening existing overweight preventing interventions in children) - Testing the effectiveness of this web-based intervention in a two-armed cluster randomized controlled trial - Web-based parenting intervention to prevent overweight in children
    - Literature search of the role of parenting in interventions to prevent overweight in children - Development of an 'local pedagogical message regarding overweight and obesity’ applicable by all local professionals working with children and their parents - Focus groups with parents to improve the textual content of the ' local pedagogical message’ - local pedagogical message
    - Analyses of existing interventions for children and attached parental interventions   - Effect and process evaluation of implementation  
    - Focus groups to gain more insight and get specific examples of difficult daily life situations in which mothers experience problems in promoting healthy eating and physical activity among their children    
5 Monitoring & Evaluation VU University Amsterdam/Windesheim University Zwolle - Description of EPODE logic model - Development of evaluation handbook (1.0) and evaluation tools - Use of Evaluation Handbook (1.0) by JOGG municipalities - Adaptation and Finalization of: evaluation handbook (2.0), evaluation planning matrix, evaluation training
    - Evaluation literature - Development of evaluation training - Focus groups on evaluation handbook and evaluation training  
    - Interviews with Dutch experts - JOGG program goals and objectives - Feedback on evaluation tools and evaluation planning matrix  
    - Comprehensive analyses of evaluation frameworks - Development evaluation planning matrix - Data-collection from all CIAO sub-studies inserted in evaluation framework