Childcare is a critical target for promoting children’s physical activity (PA) and physical literacy (PL). With emerging evidence about the efficacy of policy and capacity-building strategies, more information about how to bring these strategies to scale is needed. This paper describes implementation at scale of Appetite to Play (ATP), a capacity-building intervention for childcare providers, and examines the implementation and impact on early years providers’ capacity to address PA. The ATP implementation evaluation was a natural experiment that utilized a mixed methods concurrent parallel design framed within the Reach, Effectiveness, Adoption, Implementation, Maintenance framework (RE-AIM). Workshop and website tracking assessed reach and adoption. Surveys and interviews with workshop participants and stakeholders assessed satisfaction, implementation, and maintenance. Training reached 60% of British Columbia municipalities and 2700 early years providers. Significant changes in participants’ knowledge and confidence to promote PA and PL were achieved (p > 0.01–0.001). Childcare level implementation facilitators as reported by early years providers included appropriate resources, planning, indoor space, and equipment, whereas weather and space were reported barriers. The stakeholder advisory group viewed the stakeholder network and Active Play policy as facilitators and adjustments to recent shifts in childcare funding and previous initiatives as barriers to implementation. ATP was scalable and impacted provider knowledge, confidence, and intentions. The impact on actual policies and practices, and children’s PA needs to be assessed along with sustainability.

Context: The Health System Impact (HSI) Fellowship, an innovative training program developed by the Canadian Institutes of Health Research' s Institute of Health Services and Policy Research, provides PhD-trained health researchers with an embedded, experiential learning opportunity within a health system organization. Methods/Design: An electronic Delphi (eDelphi) study was conducted to: (1) identify the criteria used to define success in the program and (2) elucidate the main contributions fellows made to their organizations. Through an iterative, two-round eDelphi process, perspectives were elicited from three stakeholder groups in the inaugural cohort of the HSI Fellowship: HSI fellows, host supervisors and academic supervisors. Discussion: A consensus was reached on many criteria of success for an embedded research fellowship and on several perceived contributions of the fellows to their host organization and academic institutions. This work begins to identify specific criteria for success in the fellowship that can be used to improve future iterations of the program. Résumé Contexte : Les bourses d' apprentissage en matière d'impact sur le système de santé (BAIS)-un programme de formation novateur mis au point par l'Institut des services et des politiques de santé des Instituts de recherche en santé du Canada-offrent aux chercheurs titulaires d' un Marc-André Blanchette et al.

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Background: Physical activity (PA) is critical to early child development, and child care is a key setting for promotion. The authors investigated differences in daily PA and sedentary behavior practices as well as physical environments between family child care (FCC) and group child care (GCC) settings for children aged 3–5 years in Canada. Methods: Group child care (n = 581) and FCC (n = 357) managers completed surveys assessing the implementation of PA promoting practices and description of their environments. Crosstabulation and chi-square tests of association were used to examine differences between GCC and FCC. Results: The prevalence of facilities implementing 120 minutes of active play (odds ratio [OR] 2.23; 95% confidence interval [CI], 1.58–3.15), <30 minutes on screens (OR 1.35; 95% CI, 1.02–1.80), and 60-minute outdoors daily (OR 1.99; 95% CI, 1.4–2.9) was more likely in FCC compared with GCC. However, implementation of fundamental movement skill activities (OR 1.40; 95% CI, 1.01–1.92), breaking up prolonged sitting (OR 1.86; 95% CI, 1.36–2.5), and outdoor space for large group running games (OR 1.74; 95% CI, 1.07–2.83) were more likely in GCC. Conclusions: Child care setting was associated with daily PA and sedentary practices and outdoor space for PA. Interventions to support PA in child care should be tailored to different settings and the facilitators explored.