Developing and Testing Implementation Strategies for Evidence-Based Obesity Prevention in Childcare

项目概要 Swindle 博士是 NIDDK 指导研究科学家发展奖的杰出候选人。 她是家庭和预防医学的助理教授，拥有丰富的培训背景和 经验。她拥有人类发展和家庭科学理学硕士学位和博士学位 教育心理学学位。她在肥胖相关研究工作中担任领导职务超过 8 年 年，拥有 18 份与儿童健康和发展相关的出版物。目前，她正在攻读硕士学位 临床营养科学，预计毕业日期为 2016 年 12 月。 Swindle 博士之前的研究表明了通过研究为高危人群提供服务的承诺。 最近，她研究了幼儿教育工作者的个人特征和信仰，这些特征和信仰可能 影响他们在课堂上实施和维持最佳儿童营养实践的能力。她也有 是美国农业部资助的 WISE 开发和评估项目的联合研究员（共同激励智能 Eating），针对儿童保育环境的基于证据的肥胖预防和营养促进。这项研究将 逻辑地建立在该工作的基础上。 拟议的研究计划有三个具体目标：（1）确定与真实程度相关的因素 先前开发和测试的 WISE 基本实施策略； (2) 开发增强型 利用利益相关者的意见支持 WISE 干预措施的实施战略； (3) 中试 使用形成性方法强化实施和儿童健康成果的实施战略 评价。为了实现这些目标，我们将使用创新方法，包括解释性混合方法 方法方法（目标 1），利益相关者驱动的循证质量改进 (EBQI) 流程（目标 2），以及使用形成性评估的混合类型 3 实施设计（目标 3）。我们期望 与利益相关者共同制定的实施战略将提高实施的保真度。我们会 检验以下假设：提高 WISE 保真度与儿童结果呈正相关（例如，儿童水果和 蔬菜摄入量，体重指数）。这项研究将提供有关投资价值的关键知识 现有肥胖预防干预措施的实施支持策略 职业发展目标将在三个不同的方面补充拟议的研究目标 地区。 Swindle 博士将提高她在 (1) 实施科学 (2) 儿童和社区方面的专业知识和技能 营养，以及 (3) 社区参与。 Swindle 博士提出了一项全面的指导计划 研究、教学教育、跨学科合作和结构化实地研究，以实现 这些领域的能力。职业发展计划的活动将与她有效结合 研究计划并支持她的研究活动。 阿肯色医科大学 (UAMS) 将提供理想的环境来支持 拟议的职业发展和研究活动。 UAMS 已经支持 Swindle 博士的 通过转化研究所（TRI；UAMS）提供 KL2 奖项，实现职业成功 CTSA）。 TRI 将继续为 Swindle 博士提供培训、设备、咨询和指导。 此外，由 Swindle 博士的主要导师领导的 UAMS 实施研究中心 (CIR) 将 为她的职业发展提供支持环境，并在实施方面提供指导研究经验 科学。 Swindle 博士还得到了她所在部门（家庭和预防医学）的全力支持，该部门将 继续提供办公空间、受保护的时间、设备和专业发展资金。 候选人的主要导师 Geoffrey Curran 博士是全国公认的实施专家 科学。联合导师苏珊·约翰逊博士因其在儿童营养和儿童喂养方面的专业知识而闻名， 特别是在儿童保育环境中。此外，Swindle 博士将建立在她与 Leanne Whiteside-Mansell 博士在过去 5 年中致力于针对受该疾病影响的儿童进行社区干预 贫穷。这些导师拥有指导 Swindle 博士独立所需的经验和知识。 研究策略、职业发展目标和指导计划将共同支持 Swindle 博士的 实现了作为肥胖预防研究者的独立性的短期目标 儿童保育方面的努力。该奖项也将为她实现长期职业目标奠定基础 成为研究促进或阻碍成功吸收和可持续性因素的领导者 现实世界中预防肥胖的努力。

Project Summary Dr. Swindle is an outstanding candidate for a NIDDK Mentored Research Scientist Development Award. She is an Assistant Professor of Family and Preventive Medicine with a strong background of training and experience. She has a Master of Science degree in Human Development and Family Sciences and a Doctoral Degree in Educational Psychology. She has held leadership roles in obesity-related research efforts for over 8 years and has 18 publications related to child health and development. At present, she is pursuing a Master of Science in Clinical Nutrition with an anticipated graduation date of December 2016. Dr. Swindle's previous research illustrates a commitment to serving at-risk populations through research. Recently, she has studied the personal characteristics and beliefs of early childcare educators that may influence their ability to implement and sustain best child nutrition practices in their classrooms. She has also been a Co-Investigator on a USDA-funded effort to develop and evaluate WISE (Together, We Inspire Smart Eating), an evidence-based obesity prevention and nutrition promotion for childcare settings. This study will build logically upon that work. The proposed research plan has three specific aims: (1) Identify factors associated with degree of fidelity in a previously developed and tested basic implementation strategy of WISE; (2) Develop an enhanced implementation strategy to support uptake of the WISE intervention using stakeholder input; and (3) Pilot test the enhanced implementation strategy on implementation and child health outcomes using formative evaluation. To execute these aims, we will use innovative methodologies including an explanatory mixed methods approach (Aim 1), a stakeholder-driven Evidence-Based Quality Improvement (EBQI) process (Aim 2), and a Hybrid Type 3 implementation design using formative evaluation (Aim 3). We expect that implementation strategies developed with stakeholders will lead to improved implementation fidelity. We will test the hypothesis that improved WISE fidelity is positively related to child outcomes (e.g., child fruit and vegetable intake, BMI). This research will provide critical knowledge on the value of investments in implementation support strategies to existing obesity prevention interventions The career development objectives will complement the proposed research aims in three distinct areas. Dr. Swindle will advance her expertise and skills in (1) Implementation Science (2) Child and community nutrition, and (3) Community Engagement. Dr. Swindle has proposed a comprehensive plan of mentored research, didactic education, cross-disciplinary collaborations, and structured field studies to achieve competency in these areas. The activities of the career development plan will integrate effectively with her research plan and support her research activities. The University of Arkansas for Medical Sciences (UAMS) will provide the ideal environment to support the proposed career development and research activities. UAMS has already supported Dr. Swindle's career success through the provision of a KL2 award through the Translational Research Institute (TRI; UAMS CTSA). The TRI will continue to provide training, equipment, consultation, and mentoring to Dr. Swindle. Further, the Center for Implementation Research (CIR) at UAMS led by Dr. Swindle's primary mentor will provide a supportive context for her career development and mentored research experience in Implementation Science. Dr. Swindle also has the full backing of her department (Family and Preventive Medicine) which will continue to provide office space, protected time, equipment, and professional development funds. The candidate's primary mentor, Dr. Geoffrey Curran, is a nationally-recognized expert in Implementation Science. Co-mentor, Dr. Susan Johnson is well known for her expertise in child nutrition and child feeding, particularly in childcare settings. Further, Dr. Swindle will build on the mentoring relationship she has had with Dr. Leanne Whiteside-Mansell for the last 5 years in community-based intervention for children impacted by poverty. These mentors have the experience and knowledge needed to mentor Dr. Swindle to independence. Together, the research strategy, career development objectives, and mentoring plan will support Dr. Swindle's achievement of her short-term goal of establishing independence as an investigator in obesity prevention efforts in childcare. This award will also lay the foundation for the accomplishment of her long-term career goal of becoming a leader in the study of factors that promote or hinder successful uptake and sustainability of obesity prevention efforts in real world settings.