Sustainability of Nutrition and Physical Activity Interventions in Childcare

项目摘要 吃健康的饮食，参加体力活动，保持健康的体重 显著预防癌症和癌症相关死亡。鉴于早期的生命模式追踪到 成年后，需要进行14，15次早期干预，以降低晚年患癌症的风险。 在儿童保育方面的干预措施有望促进健康的约会、PA和肥胖预防。 执行科学在很大程度上侧重于增加最初采用方案的战略。19 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。在……里面 事实上，可能需要采取不同的方法来促进循证证据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，我们没有充分了解哪些因素 预测可持续性，18，20，而这一知识差距构成了我们目前工作的前提。 该项目的总体目标是确定以下各项的保真度和可持续性的预测因素 针对儿童保育环境的两个营养/PA计划，以确定成功的可持续性战略 从那些自力更生、吸取经验教训发展可持续发展的项目中 基于利益相关者意见的战略。两个节目-美食之友21-24和我们一起，激励 聪明饮食(WISE)25-28-是由美国农业部资助的营养教育和PA项目。美食之友最多有20个 WISE的使用年限长达6年，但使用量正在增加。和其他节目一样， 两个团队都没有研究为什么一些设置在最初采用后继续使用程序，而其他设置则是这样做的 不。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。 我们将使用说明性的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)进行现场访问，以执行关键 线人面谈并验证关于可持续性的自我报告；确定环境贡献者 可持续性；并记录计划的适应情况。我们还将与外部利益攸关方进行面谈。 了解影响对营养/PA计划支持的决策。 具体目标2：制定有利益攸关方参与的多方面可持续发展战略。 我们将使用基于证据的质量改进(EBQI)会议30-32来吸引利益相关者参与 制定多组成部分的可持续发展战略。目标1关于可持续性和可持续发展预测因素的数据 来自高可持续性网站的创新将被用来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发展和生产的因素的基础理解 在更广泛的范围内推动可持续性研究的基本信息。

Project Summary Consuming a healthy diet, engaging in physical activity (PA), and maintaining a healthy weight9,12,13 provide significant protection against cancer and cancer-related mortality. Given that early life patterns track into adulthood,14,15 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.19 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,18,20 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 21–24 and Together, We Inspire Smart Eating (WISE)25–28—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) sessions30–32 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.