Background: Victorian children with low socio-educational advantage are more likely to be living with overweight or obesity and the relationship is mediated by sedentary behaviour, soft-drink consumption, and Health-Related Quality of Life (HRQoL). This makes a compelling case for moving obesity prevention actions upstream but, as Geoffrey Rose notes in his classic paper, motivation for such population approaches to improving health is low. What if we keep the approach but replace the goal? More people are likely to get behind a school-based initiative to address climate change, for example, than to prevent obesity. The aim of this presentation is to contend that obesity prevention is not needed in schools.
Methods: STAIR is a hybrid type 1 cluster randomised controlled trial in primary school communities in Victoria, Australia.(1) Schools were randomised to receive STAIR (a community-based systems dynamics co-designed intervention and, implementation support guided by an active implementation framework) over 2 years (2025-2027) or usual support for promoting student wellbeing (control), which includes access to government resources. Schools choose their own intervention goal.
Results: This presentation will describe the conceptual model, systems thinking and active implementation framework used in STAIR to provide schools with intervention and implementation processes to help them achieve their goals but that also delivers a range of health benefits. It will describe baseline health behaviours for >1000 students and characteristics of 15 schools that promote student health and wellbeing.
Conclusions: If successful, STAIR will help schools move health and wellbeing actions upstream and provide them with dynamic implementation strategies to sustain them.