Improving the Physical Activity and Outdoor Play Environment of Family Child Care Homes in Nebraska Through Go Nutrition and Physical Activity Self-Assessment for Child Care

Dinkel, Danae; Dev, Dipti A.; Guo, Yage; Hulse, Emily; Sedani, Ami; Coyle, Brian

doi:10.1123/jpah.2017-0411

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…This study will compare the effects of two implementation approaches, Basic and Enhanced Go NAPSACC, both of which use multifaceted strategies to support centers’ participation in Go NAPSACC. While the traditional approach in Basic Go NAPSACC it has been effective, several contextual barriers to widespread use have also been noted [18, 19, 22, 23, 25]. The integration of QIF [30] and CFIR [33] into the enhanced approach offers a systematic method for identifying contextual barriers and then tailoring key implementation strategies.…”

Section: Discussionmentioning

confidence: 99%

“…As recommended by the CFIR framework [33], the most salient constructs were identified based on barriers identified in previous NAPSACC studies [18, 19, 22, 23, 25] and our extensive and ongoing work implementing Go NAPSACC. Prioritized constructs were operationalized for the child care setting and a nutrition and physical activity intervention.…”

Section: Methodsmentioning

confidence: 99%

“…While effective, several implementation challenges have been identified, including variation in experience and implementation across NAPSACC Consultants [18, 25]; difficulty converting child care programs into active users [18]; child care programs’ noncompliance with the improvement process [25]; variable director motivation [19]; low staff engagement [23]; turnover in management [19]; insufficient peer learning opportunities to support changes [23]; and lack of funding [22]. The field of implementation science offers several frameworks [26] and strategies [27] that can help systematically identify and address these contextual challenges.…”

Section: Introductionmentioning

confidence: 99%

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The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

et al. 2019

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BackgroundTo prevent childhood obesity and promote healthy development, health authorities recommend that child care programs use the evidence-based practices that foster healthy eating and physical habits in children. Go NAPSACC is an intervention shown to improve use of these recommended practices, but it is known to encounter barriers that limit its impact and widespread use.MethodsThis study will use a type 3 hybrid effectiveness-implementation cluster-randomized trial to compare effectiveness and implementation outcomes achieved from Go NAPSACC delivered with a basic or enhanced implementation approach. Participants will include approximately 25 coaches from Child Care Aware of Kentucky (serving four geographic regions), 97 child care centers with a director and teacher from each and two cross-sectional samples of 485 3–4-year-old children (one recruitment at baseline, another at follow-up). Coaches will be randomly assigned to deliver Go NAPSACC using either the basic or enhanced implementation approach. “Basic Go NAPSACC” represents the traditional way of delivering Go NAPSACC. “Enhanced Go NAPSACC” incorporates preparatory and support activities before and during their Go NAPSACC work, which are guided by the Quality Implementation Framework and the Consolidated Framework for Implementation Research. Data will be collected primarily at baseline and post-intervention, with select measures continuing through 6, 12, and 24 months post-intervention. Guided largely by RE-AIM, outcomes will assess change in centers’ use of evidence-based nutrition and physical activity practices (primary, measured via observation); centers’ adoption, implementation, and maintenance of the Go NAPSACC program (assessed via website use); center directors’, teachers’, and coaches’ perceptions of contextual factors (assessed via self-report surveys); children’s eating and physical activity behaviors at child care (measured via observation and accelerometers); and cost-effectiveness (assessed via logs and expense tracking). The hypotheses anticipate that “Enhanced Go NAPSACC” will have greater effects than “Basic Go NAPSACC.”DiscussionThis study incorporates many lessons gleaned from the growing implementation science field, but also offers opportunities to address the field’s research priorities, including applying a systematic method to tailor implementation strategies, examining the processes and mechanisms through which implementation strategies produce their effects, and conducting an economic evaluation of implementation strategies.Trial RegistrationClinicalTrials.gov, NCT03938103, Registered April 8, 2019

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

et al. 2019

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“…Although studies may have examined interventions to improve family day care environments, not having a parallel control group resulted in their exclusion. Online Appendix B provides an overview of such types of previous interventions undertaken in this setting (29)(30)(31)(32)(33)(34)(35)(36) .…”

Section: Study Selectionmentioning

confidence: 99%

A systematic review of interventions to improve the dietary intake, physical activity and weight status of children attending family day care services

Yoong

Lum

Jones

et al. 2020

Public Health Nutr.

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Objective:To (i) identify and synthesise findings from interventions to improve the dietary intake, physical activity and weight status of children aged 0–6 years attending family day care services; and (ii) assess the impact of interventions on family day care environments, intervention cost and adverse outcomes.Design:Medline in Process, PsycINFO, ERIC, Embase, CINAHL, CENTRAL and Scopus databases were searched in March 2019. Studies were included if they (i) evaluated an intervention to improve the diet, physical activity and/or weight of children aged 0–6 years; (ii) were delivered in family day care services; (iii) targeted child diet, physical activity and/or weight; and (iv) used a parallel control group design. Screening was undertaken by two reviewers with disagreements resolved by a third reviewer.Setting:Family day care services, also known as family childcare homes.Participants:Children aged 0–6 years attending family day care services.Results:In total, 8977 titles were retrieved, and 199 full-texts reviewed. No studies met the inclusion criteria for the primary outcome; however, two studies reporting on the secondary outcome of family day care environments were included. The 4-year community-wide obesity prevention programme and the 12-month train-the-trainer programme both reported statistically significant improvements in the healthy eating and physical activity environments of family day care, compared to cross-sectional state-average control groups.Conclusions:Findings highlight few existing interventions in family day care services and a need for high-quality controlled trials to identify effective interventions to improve children’s diet, activity and weight in this setting.

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“…A 2020 systematic review conducted by Yoong et al identified and assessed the effectiveness of interventions to improve the diet intake, PA and weight status of children aged 0–6 years attending FCCH [ 50 ]. They found only two intervention studies with quasi-experimental designs [ 58 – 62 ] that examined changes in FCCH food and/or PA environments, but no randomized trials nor studies that examined child-level outcomes. These findings clearly indicate a need for controlled trials to identify effective obesity prevention interventions in FCCH.…”

Section: Introductionmentioning

confidence: 99%

A multi-component tailored intervention in family childcare homes improves diet quality and sedentary behavior of preschool children compared to an attention control: results from the Healthy Start-Comienzos Sanos cluster randomized trial

Gans

Tovar

Kang

et al. 2022

Int J Behav Nutr Phys Act

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Background Childcare settings are important environments for influencing child eating and physical activity (PA). Family childcare homes (FCCH) care for many children of low-income and diverse racial/ethnic backgrounds who are at greater risk for poor diet quality, low PA, and obesity, but few interventions have targeted this setting. The aim of this study was to assess the efficacy of a multicomponent intervention conducted in FCCH on the diet quality and PA of 2–5 year old children in their care. Trial design Cluster randomized trial. Methods The cluster-randomized trial, Healthy Start/Comienzos Sanos (2015–2019) evaluated an 8-month nutrition and PA intervention that included four components: (1) monthly telephone calls from a support coach using brief motivational interviewing, (2) tailored reports, newsletters and videos, (3) group support meetings, and (4) active play toys. After completing baseline measurement, FCCH were randomized into intervention or comparison groups in matched pairs. Both groups received the same intervention components but on different topics (intervention: nutrition/PA vs. comparison: reading readiness/literacy). Evaluation staff were blinded to group assignment. Child primary outcome measures collected at baseline and 8-months included: 1) Healthy Eating Index (HEI-2015) scores calculated from diet observation, and 2) accelerometer measurement of PA. Process measures were collected from field data and provider surveys. Generalized Estimating Equation Models assessed changes in HEI-2015 scores and PA over time by experimental condition. Results Ethnically diverse FCCH providers (n = 119) and 2-to-5-year-old children in their care (n = 377) were included in the final analysis. Process evaluation showed high participation in all intervention components except for group meetings. Compared to children in comparison group FCCH, children in intervention FCCH increased total HEI-2015 scores by 7.2 points (p < .001) including improvement in component scores for vegetables (0.84 points, p = .025) and added sugar (0.94 points, p = .025). For PA, compared to children in the comparison group, children in intervention FCCH decreased sedentary time by 5.7% (p = .021). Conclusions The multicomponent Healthy Start intervention was effective in improving diet quality and sedentary behavior of children in FCCH, which demonstrates the promise of obesity prevention interventions in this setting. Future research could include enhancing the Healthy Start intervention to strengthen the PA component, considering virtual peer support, and determining how to best translate and disseminate the intervention into FCCH nationally. Trial registration National Institutes of Health, NCT02452645. Registered 5 May 2015.

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Improving the Physical Activity and Outdoor Play Environment of Family Child Care Homes in Nebraska Through Go Nutrition and Physical Activity Self-Assessment for Child Care

Cited by 11 publications

References 17 publications

The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

The impact of basic vs. enhanced Go NAPSACC on child care centers’ healthy eating and physical activity practices: protocol for a type 3 hybrid effectiveness-implementation cluster-randomized trial

A systematic review of interventions to improve the dietary intake, physical activity and weight status of children attending family day care services

A multi-component tailored intervention in family childcare homes improves diet quality and sedentary behavior of preschool children compared to an attention control: results from the Healthy Start-Comienzos Sanos cluster randomized trial

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