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

项目摘要 斯温德尔博士是NIDDK导师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，有很强的培训和 经验。她拥有人类发展和家庭科学的理学硕士学位和博士学位 教育心理学学位。她在与肥胖相关的研究工作中担任领导职务已超过8年 多年来，已出版了18份与儿童健康和发展有关的出版物。目前，她正在攻读硕士学位 临床营养学专业，预计毕业日期为2016年12月。 斯温德尔博士之前的研究表明，他致力于通过研究为高危人群提供服务。 最近，她研究了早期托儿教育者的个人特征和信念，这可能是 影响他们在课堂上实施和维持最佳儿童营养做法的能力。她也有 作为美国农业部资助的WISE开发和评估工作的联合调查员(一起，我们激励Smart 以证据为基础的肥胖预防和儿童保育环境中的营养促进。这项研究将 合乎逻辑地建立在这项工作的基础上。 建议的研究计划有三个具体目标：(1)确定与保真度有关的因素 先前开发和测试的WISE基本实施策略；(2)制定增强的 实施战略，以支持利用利益相关者的意见进行明智的干预；以及(3)试点测试 使用形成法加强执行战略和儿童健康成果 评估。为了实现这些目标，我们将使用创新的方法，包括解释性混合 方法方法(目标1)，利益相关者驱动的循证质量改进(EBQI)过程(目标1 2)，以及使用形成性评估的混合类型3实施设计(目标3)。我们期待着 与利益攸关方共同制定的执行战略将导致执行忠诚度的提高。我们会 检验这样的假设，即提高WISE保真度与孩子的结果呈正相关(例如，孩子的水果和 蔬菜摄入量(BMI)。这项研究将提供有关投资价值的关键知识 对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方面补充拟议的研究目标 区域。斯温德尔博士将在(1)实施科学(2)儿童和社区方面提升她的专业知识和技能 营养，以及(3)社区参与。斯温德尔博士提出了一项全面的计划 研究、授课教育、跨学科协作和结构化的实地研究，以实现 在这些领域的能力。职业发展计划的活动将与她有效结合 研究策划并支持她的研究活动。 阿肯色州医学大学(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已经支持斯温德尔博士的 通过翻译研究所(TRI；UAMS)提供KL2奖项获得职业成功 CTSA)。TRI将继续为斯温德尔博士提供培训、设备、咨询和指导。 此外，由斯温德尔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性环境，并在实施方面提供有指导的研究经验 科学。斯温德尔博士也得到了她的部门(家庭和预防医学)的全力支持，该部门将 继续提供办公场所、保障时间、设备和职业发展资金。 这位候选人的主要导师杰弗里·柯伦博士是全国公认的实施专家 科学。共同导师苏珊·约翰逊博士以其在儿童营养和儿童喂养方面的专业知识而闻名， 尤其是在托儿环境中。此外，斯温德尔博士将在与她建立的指导关系的基础上再接再厉 Leanne Whiteside-Mansell博士在过去5年中对受影响的儿童进行基于社区的干预 贫穷。这些导师拥有指导斯温德尔博士走向独立所需的经验和知识。 研究战略、职业发展目标和指导计划将共同支持斯温德尔博士的 实现她作为肥胖预防研究人员的独立性的短期目标 在儿童保育方面的努力。这一奖项也将为她实现长期的职业目标奠定基础 成为推动或阻碍成功吸收和持续发展的因素研究的领先者 在现实世界环境中预防肥胖的努力。

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.