Effective Training Models for Implementing Health-Promoting Practices Afterschool

项目摘要。在过去的二十年里，过量的饮食摄入和低体力活动 导致了美国儿童肥胖症患病率的增加， 影响到三分之一的儿童，对少数群体和经济造成不成比例的影响 弱势儿童。鉴于肥胖是影响晚年健康状况的一个风险因素， 包括癌症在内，早期预防肥胖症的努力对人口健康至关重要。校外 时间(OST)计划是解决儿童肥胖症的重要环境，因为10.2 数以百万计的美国儿童参加课外活动。校外营养与体能 活动(OSNAP)组-随机试验显示儿童的活力有所改善 体力活动，供应和消费的食物和饮料的健康程度，以及健康- 推广计划政策。现在OSNAP的干预已经经过了严格的测试和 有效性已经确立，迫切需要评估培训模式，以 传播这一干预措施，以扩大人口覆盖面并产生影响。我们的长期目标是 调查#年循证预防干预措施的实施和传播情况 Ost设置。这项提议的总体目标是确定两个方面的有效性 扩大OSNAP干预的现有培训模式，并了解 关于有效执行的背景。在与基督教青年会的合作下，我们将进行三臂 小组随机试验，比较两种提供协作学习的方法和 对照组。本应用程序针对以下具体目标： 1.比较两种协作学习的效果和实施成本 OSNAP干预的培训模式。我们假设两种培训模式都会 在OST营养和体力活动实践中产生健康的变化，通过 与对照组比较，进行有效的观察性评估。的次要结果 具体的健康做法，如提供体育活动和水，以及过程 结果，如成本和可接受性，将因培训模式而异。 2.使用混合方法来确定实施环境中的可操作因素 影响OSNAP干预有效性的两个学习 协作式培训模式。我们假设有更多支持的项目 实施环境将比具有更少资源的计划更有效地实施OSNAP 支持性背景。定性数据将有助于解释实施的各个方面 背景会更深入地影响每个培训模式的有效实施。

Project Summary. Over the past two decades, excess dietary intake and low physical activity have contributed to an increase in the prevalence of childhood obesity in the United States, affecting a third of children and disproportionately impacting minority and economically disadvantaged children. Given that obesity is a risk factor for health outcomes later in life, including cancer, early obesity prevention efforts are critical for population health. Out-of-school time (OST) programs are an important setting for addressing childhood obesity given that 10.2 million U.S. children are enrolled in afterschool. The Out-of-school Nutrition and Physical Activity (OSNAP) group-randomized trial demonstrated improvements in children’s vigorous physical activity, the healthfulness of foods and beverages served and consumed, and health- promoting program policies. Now that the OSNAP intervention has been rigorously tested and effectiveness has been established, there is a critical need to evaluate training models to disseminate this intervention for broad population reach and impact. Our long-term goal is to investigate the implementation and dissemination of evidence-based prevention interventions in OST settings. The overall objective of this proposal is to establish the effectiveness of two existing training models for scaling up the OSNAP intervention and understand the influence of context on effective implementation. In collaboration with the YMCA, we will conduct a 3-arm group randomized trial to compare two methods of delivering the learning collaborative with a control group. This application addresses the following specific aims: 1. Compare the effectiveness and implementation cost of two learning collaborative training models for the OSNAP intervention. We hypothesize that both training models will produce healthy changes in OST nutrition and physical activity practices as measured by a validated observational assessment, compared to the control group. Secondary outcomes of specific healthy practices, such as offerings of physical activity and water, and process outcomes, such as cost and acceptability, will vary by training model. 2. Use mixed methods to identify actionable factors within the implementation context that influence the effectiveness of the OSNAP intervention delivered by two learning collaborative training models. We hypothesize that programs with more supportive implementation contexts will more effectively implement OSNAP than programs with less supportive contexts. Qualitative data will help explain how aspects of the implementation context influence effective implementation of each training model in greater depth.