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

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101258411 Publication Model: Electronic Cited Medium: Internet ISSN: 1748-5908 (Electronic) Linking ISSN: 17485908 NLM ISO Abbreviation: Implement Sci Subsets: MEDLINE
    • Publication Information:
      Original Publication: [London] : BioMed Central, 2006-
    • Subject Terms:
      Health Promotion*/methods ; Obesity*/prevention & control; Child ; Evidence-Based Practice ; Humans
    • Abstract:
      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.
      Trial Registration: NCT05050539 ; 9/20/21.
      (© 2022. The Author(s).)
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    • Grant Information:
      P50 DA054039 United States DA NIDA NIH HHS; R01 DA039901 United States DA NIDA NIH HHS; R37 CA252113 United States CA NCI NIH HHS
    • Contributed Indexing:
      Keywords: Child nutrition sciences; Childcare; Early care and education; Early intervention; Implementation science; Obesity
    • Molecular Sequence:
      ClinicalTrials.gov NCT05050539
    • Publication Date:
      Date Created: 20220319 Date Completed: 20220502 Latest Revision: 20220716
    • Publication Date:
      20231215
    • Accession Number:
      PMC8932138
    • Accession Number:
      10.1186/s13012-021-01185-1
    • Accession Number:
      35303894