Sustainability of Nutrition and Physical Activity Interventions in Childcare

儿童保育中营养和身体活动干预措施的可持续性

• 批准号: 10112847
• 负责人: Laura Bellows
• 金额: $ 17.77万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-03-01 至 2024-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10112847
• 关键词: 5 year old; Address; Adherence; Adopted; Adoption; Adult; Affect; Age; Antioxidants; Cardiovascular Diseases; Child; Child Health; Child Nutrition; Consumption; Data; Diet; Early Intervention; Eating; Education; Evidence based program; Fiber; Focus Groups; Food; Foundations; Friends; Funding; Goals; Health; Health behavior; Incidence; Intervention; Interview; Knowledge; Life; Location; Malignant Neoplasms; Metabolic syndrome; Methods; Modeling; Multivariate Analysis; Obesity; Online Systems; Participant; Patient Self-Report; Pattern; Persons; Physical activity; Population; Predictive Factor; Prevention Guidelines; Prevention program; Process; Program Sustainability; Public Health; Risk; Schools; Series; Site; Site Visit; Surveys; Training; Variant; Weight; Weight Gain; Work; base; cancer prevention; community engagement; community setting; design; dietary guidelines; evidence base; exercise intervention; good diet; healthy weight; implementation science; informant; innovation; intervention program; mortality; multidisciplinary; nutrition; nutrition education; obesity prevention; overweight child; programs; teacher; uptake

Project Summary Consuming a healthy diet, engaging in physical activity (PA), and maintaining a healthy weight provide significant protection against cancer and cancer-related mortality. Given that early life patterns track into adulthood, early interventions are needed to decrease the risk of developing cancer later in life. Interventions in childcare are promising to promote healthy date, PA and obesity prevention. Implementation science has largely focused on strategies for increasing the initial adoption of programs. However, there is little evidence for strategies that may effectively promote the sustainability of programs. In fact, different approaches may be needed to promote the initial uptake and long-term use of evidence-based programs in community settings. A critical barrier to progress is that we do not fully understand what factors predict sustainability, and this gap in knowledge forms the premise of our current work. The overarching goals of this project are to identify predictors of fidelity and sustainability across two nutrition/PA programs for the childcare setting, to identify successful sustainability strategies from programs who have sustained on their own, and use lessons learned to develop sustainability strategies based with stakeholder input. The two programs—Food Friends and Together, We Inspire Smart Eating (WISE)—are USDA-funded nutrition education and PA programs. Food Friends has up to 20 years in the field, but use is declining; WISE has up to 6 years, and use is increasing. Like other programs, neither team has studied why some settings continue to use a program after initial adoption, while others do not. Toward our goals, we propose two specific aims: Specific Aim 1: Identify factors associated with sustaining nutrition/PA programs in childcare settings. We will use an explanatory, sequential mixed-methods design to (a) collect survey data and conduct multivariate analyses to understand predictors of sustainability and (b) conduct site visits to perform key informant interviews and validate self-reports on sustainability; identify environmental contributors to sustainability; and document program adaptations. We will also conduct interviews with external stakeholders to understand decisions affecting support for nutrition/PA programs. Specific Aim 2: Develop a multi-faceted sustainability strategy with stakeholder input. We will use evidence-based quality improvement (EBQI) sessions to engage stakeholders in developing a multi-component sustainability strategy. Data from Aim 1 on the predictors of sustainability and innovation from sites with high sustainment will be used to inform stakeholder-selected strategies. This work will provide a foundational understanding of factors that support sustainability and produce essential information to advance the study of sustainability more broadly.

项目概要 健康饮食、参加体力活动 (PA) 和保持健康体重可提供 鉴于早期的生活模式可以有效预防癌症和癌症相关的死亡。 在成年期，需要早期干预以降低晚年患癌症的风险。 儿童保育干预措施有望促进健康约会、PA 和肥胖预防。 实施科学主要关注提高项目最初采用率的策略。 然而，几乎没有证据表明可以有效促进项目可持续性的策略。 事实上，可能需要采取不同的方法来促进循证医学的初步采用和长期使用 社区环境中的计划取得进展的一个关键障碍是我们不完全了解哪些因素。 预测可持续性，这种知识差距构成了我们当前工作的前提。 该项目的总体目标是确定跨领域保真度和可持续性的预测因素 两项针对儿童保育环境的营养/公共活动计划，以确定成功的可持续发展战略 来自自行维持的计划，并利用吸取的经验教训来发展可持续性 基于利益相关者意见的战略——“食品之友”和“共同激励”这两个项目。 智能饮食 (WISE) — 是美国农业部资助的营养教育和 PA 项目，食品之友项目有多达 20 个。 WISE 已有长达 6 年的历史，但与其他程序一样，其使用量正在增加。 两个团队都没有研究为什么某些设置在初次采用后继续使用程序，而其他设置则这样做 为了实现我们的目标，我们提出了两个具体目标： 具体目标 1：确定与儿童保育环境中维持营养/PA 计划相关的因素。 我们将使用解释性、顺序混合方法设计来 (a) 收集调查数据并进行 多变量分析以了解可持续性的预测因素，并 (b) 进行实地考察以执行关键任务 知情者访谈并验证有关可持续发展的自我报告； 我们还将与外部利益相关者进行访谈。 了解影响营养/PA 计划支持的决策。 具体目标 2：根据利益相关者的意见制定多方面的可持续发展战略。 我们将使用基于证据的质量改进 (EBQI) 会议来吸引利益相关者参与 制定多成分可持续发展战略，目标 1 中有关可持续发展预测因素的数据 具有高度可持续性的地点的创新将用于为利益相关者选择的战略提供信息。 这项工作将提供对支持可持续性和生产的因素的基本了解 更广泛地推进可持续性研究的重要信息。