Obesity prevention practices in early care and education settings: an adaptive implementation trial

Swindle, T (通讯作者),Univ Arkansas Med Sci, Dept Family & Prevent Med, 4301 W Markham St,530, Little Rock, AR 72205 USA.
2022-3-18
Background: Despite the potential for Early Care and Education (ECE) settings to promote healthy habits, a gap exists between current practices and evidence-based practices (EBPs) for obesity prevention in childhood. Methods: We will use an enhanced non-responder trial design to determine the effectiveness and incremental cost-effectiveness of an adaptive implementation strategy for Together, We Inspire Smart Eating (WISE), while examining moderators and mediators of the strategy effect. WISE is a curriculum that aims to increase children's intake of carotenoid-rich fruits and vegetables through four evidence-based practices in the early care and education setting. In this trial, we will randomize sites that do not respond to low-intensity strategies to either (a) continue receiving low-intensity strategies or (b) receive high-intensity strategies. This design will determine the effect of an adaptive implementation strategy that adds high-intensity versus one that continues with low-intensity among non-responder sites. We will also apply explanatory, sequential mixed methods to provide a nuanced understanding of implementation mechanisms, contextual factors, and characteristics of sites that respond to differing intensities of implementation strategies. Finally, we will conduct a cost effectiveness analysis to estimate the incremental effect of augmenting implementation with high-intensity strategies compared to continuing low-intensity strategies on costs, fidelity, and child health outcomes. Discussion: We expect our study to contribute to an evidence base for structuring implementation support in real-world ECE contexts, ultimately providing a guide for applying the adaptive implementation strategy in ECE for WISE scale-up. Our work will also provide data to guide implementation decisions of other interventions in ECE. Finally, we will provide the first estimate of relative value for different implementation strategies in this setting.
IMPLEMENTATION SCIENCE
卷号:17|期号:1
ISSN:1748-5908|收录类别:SCIE
语种
英语
来源机构
University of Arkansas System; University of Arkansas Medical Sciences; University of Louisiana System; Louisiana Technical University; University of Arkansas System; University of Arkansas Medical Sciences; University of Arkansas System; University of Arkansas Medical Sciences; University of Colorado System; University of Colorado Anschutz Medical Campus; University of Michigan System; University of Michigan; University of Arkansas System; University of Arkansas Little Rock; University of Arkansas System; University of Arkansas Medical Sciences
资助信息
Research reported in this publication was supported by the National Cancer Institute of the National Institutes for Health (NIH) under Award Number NIH NCI R37CA25113. Drs. Curran and Swindle are supported by the Translational Research Institute (TRI), UL1TR003107, through the National Center for Advancing Translational Sciences of the NIH. Drs. Swindle and Rutledge are supported by NIH R03 DK117197 and the Lincoln Health Foundation. Dr. Swindle is supported by NIH R21CA237985 and NIH P20GM109096. The content is solely the responsibility of the authors and does not necessarily represent the official views of funding agencies.
被引频次(WOS)
2
被引频次(其他)
2
180天使用计数
1
2013以来使用计数
9
出版年
2022-3-18
DOI
10.1186/s13012-021-01185-1
学科领域
循证公共卫生
关键词
Implementation science Early care and education Childcare Early intervention Obesity Child nutrition sciences
资助机构
National Cancer Institute of the National Institutes for Health (NIH) Translational Research Institute (TRI) through the National Center for Advancing Translational Sciences of the NIH NIH(United States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA) Lincoln Health Foundation
WOS学科分类
Health Care Sciences & Services Health Policy & Services