A Hybrid Effectiveness-Implementation Trial of Go NAPSACC: A Childcare Obesity Prevention Program

Childcare settings play a significant role in shaping the eating and physical activity habits of many young children. These programs can foster healthy behaviors by serving healthy foods and limiting access to unhealthy foods, integrating time for active play, limiting screen time, providing healthy role models, and teaching children the knowledge and skills needed to make healthy lifestyle choices. National efforts to address childhood obesity increasingly call upon childcare programs to implement these evidence-based practices; however, compliance remains low. Dissemination and implementation studies represent a critical next step in helping to advance childcare-based health promotion and obesity prevention efforts. The proposed study (submitted in response to Dissemination and Implementation Research in Health, PAR-16-238), will address these gaps using a stepped wedge cluster randomized controlled trial and hybrid effectiveness- implementation design to evaluate the impact of Go NAPSACC on centers’ implementation of evidence-based practices and assess the reach, adoption, implementation, and maintenance that can be achieved with an Enhanced implementation model. We will target childcare centers in Kentucky, the state with the sixth highest rate of child obesity in the U.S. We will work with The Kentucky Department of Health and eight of their existing regional technical assistance (TA) providers to recruit 97 childcare centers (10-15 centers per region).We will partner with the University of Kentucky as a sub-contract with Alison Gustafson, PhD as Principal Investigator of the Kentucky site leading all key efforts. Regional TA Providers delivering enhanced Go NAPSACC will integrate steps from the Quality Implementation Framework to support general and intervention-specific capacity building by childcare centers, which are hypothesized to improve the implementation of evidence- based best practices. Outcomes, guided by RE-AIM and Consolidated Framework for Implementation Research, will assess centers’ environmental changes, markers of dissemination and implementation, actors, and costs. Also, a sub-study will assess impact on children’s diet quality and physical activity at childcare.