Efficacy of an enhanced implementation strategy to increase parent engagement with a health promotion program in childcare

Courtney T. Luecking; Cody D. Neshteruk; Stephanie Mazzucca; Dianne S. Ward

doi:10.3390/ijerph19010106

Efficacy of an enhanced implementation strategy to increase parent engagement with a health promotion program in childcare

Courtney T. Luecking
, Cody D. Neshteruk
, Stephanie Mazzucca
, Dianne S. Ward

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Previous efforts to involve parents in implementation of childcare-based health promotion interventions have yielded limited success, suggesting a need for different implementation strategies. This study evaluated the efficacy of an enhanced implementation strategy to increase parent engagement with Healthy Me, Healthy We. This quasi-experimental study included childcare centers from the second of two waves of a cluster-randomized trial. The standard approach (giving parents intervention materials, prompting participation at home, inviting participation with classroom events) was delivered in 2016–2017 (29 centers, 116 providers, and 199 parents). The enhanced approach (standard plus seeking feedback, identifying and addressing barriers to parent participation) was delivered in 2017–2018 (13 centers, 57 providers, and 114 parents). Parent engagement was evaluated at two levels. For the center-level, structured interview questions with providers throughout the intervention were systematically scored. For the parent-level, parents completed surveys following the intervention. Differences in parent engagement were evaluated using linear regression (center-level) and mixed effects (parent-level) models. Statistical significance was set at p < 0.025 for two primary outcomes. There was no difference in parent engagement between approaches at the center-level, β = −1.45 (95% confidence interval, −4.76 to 1.87), p = 0.38l. However, the enhanced approach had higher parent-level scores, β = 3.60, (95% confidence interval, 1.49 to 5.75), p < 0.001. In the enhanced approach group, providers consistently reported greater satisfaction with the intervention than parents (p < 0.001), yet their fidelity of implementing the enhanced approach was low (less than 20%). Results show promise that parent engagement with childcare-based health promotion innovations can positively respond to appropriately designed and executed implementation strategies, but strategies need to be feasible and acceptable for all stakeholders.

Original language	English
Article number	106
Journal	International Journal of Environmental Research and Public Health
Volume	19
Issue number	1
DOIs	https://doi.org/10.3390/ijerph19010106
State	Published - Jan 1 2022

Bibliographical note

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.

Funding

Funding: This research was supported by funding from the National Heart, Lung, and Blood Institute of the National Institutes of Health R01HL120969 and conducted at the UNC Center for Health Promotion and Disease Prevention, a member of the Prevention Research Centers Program of the Centers for Disease Control and Prevention U48-DP000059. This work was also supported in part by the National Cancer Institute P50CA244431, the National Institute of Diabetes and Digestive and Kidney Diseases P30DK092950, and Cooperative Agreement number U48DP006395 from the Centers for Disease Control and Prevention.

Funders	Funder number
National Institutes of Health (NIH)	R01HL120969
National Institutes of Health (NIH)
Centers for Disease Control and Prevention	U48-DP000059
Centers for Disease Control and Prevention
National Heart, Lung, and Blood Institute (NHLBI)
National Childhood Cancer Registry – National Cancer Institute	P50CA244431
National Childhood Cancer Registry – National Cancer Institute
National Institute of Diabetes and Digestive and Kidney Diseases	U48DP006395, P30DK092950
National Institute of Diabetes and Digestive and Kidney Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Early care and education
Family
Implementation
Nutrition
Physical activity

ASJC Scopus subject areas

Pollution
Public Health, Environmental and Occupational Health
Health, Toxicology and Mutagenesis

Access to Document

10.3390/ijerph19010106

Cite this

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title = "Efficacy of an enhanced implementation strategy to increase parent engagement with a health promotion program in childcare",

abstract = "Previous efforts to involve parents in implementation of childcare-based health promotion interventions have yielded limited success, suggesting a need for different implementation strategies. This study evaluated the efficacy of an enhanced implementation strategy to increase parent engagement with Healthy Me, Healthy We. This quasi-experimental study included childcare centers from the second of two waves of a cluster-randomized trial. The standard approach (giving parents intervention materials, prompting participation at home, inviting participation with classroom events) was delivered in 2016–2017 (29 centers, 116 providers, and 199 parents). The enhanced approach (standard plus seeking feedback, identifying and addressing barriers to parent participation) was delivered in 2017–2018 (13 centers, 57 providers, and 114 parents). Parent engagement was evaluated at two levels. For the center-level, structured interview questions with providers throughout the intervention were systematically scored. For the parent-level, parents completed surveys following the intervention. Differences in parent engagement were evaluated using linear regression (center-level) and mixed effects (parent-level) models. Statistical significance was set at p < 0.025 for two primary outcomes. There was no difference in parent engagement between approaches at the center-level, β = −1.45 (95\% confidence interval, −4.76 to 1.87), p = 0.38l. However, the enhanced approach had higher parent-level scores, β = 3.60, (95\% confidence interval, 1.49 to 5.75), p < 0.001. In the enhanced approach group, providers consistently reported greater satisfaction with the intervention than parents (p < 0.001), yet their fidelity of implementing the enhanced approach was low (less than 20\%). Results show promise that parent engagement with childcare-based health promotion innovations can positively respond to appropriately designed and executed implementation strategies, but strategies need to be feasible and acceptable for all stakeholders.",

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author = "Luecking, \{Courtney T.\} and Neshteruk, \{Cody D.\} and Stephanie Mazzucca and Ward, \{Dianne S.\}",

note = "Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

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AU - Mazzucca, Stephanie

AU - Ward, Dianne S.

PY - 2022/1/1

Y1 - 2022/1/1

N2 - Previous efforts to involve parents in implementation of childcare-based health promotion interventions have yielded limited success, suggesting a need for different implementation strategies. This study evaluated the efficacy of an enhanced implementation strategy to increase parent engagement with Healthy Me, Healthy We. This quasi-experimental study included childcare centers from the second of two waves of a cluster-randomized trial. The standard approach (giving parents intervention materials, prompting participation at home, inviting participation with classroom events) was delivered in 2016–2017 (29 centers, 116 providers, and 199 parents). The enhanced approach (standard plus seeking feedback, identifying and addressing barriers to parent participation) was delivered in 2017–2018 (13 centers, 57 providers, and 114 parents). Parent engagement was evaluated at two levels. For the center-level, structured interview questions with providers throughout the intervention were systematically scored. For the parent-level, parents completed surveys following the intervention. Differences in parent engagement were evaluated using linear regression (center-level) and mixed effects (parent-level) models. Statistical significance was set at p < 0.025 for two primary outcomes. There was no difference in parent engagement between approaches at the center-level, β = −1.45 (95% confidence interval, −4.76 to 1.87), p = 0.38l. However, the enhanced approach had higher parent-level scores, β = 3.60, (95% confidence interval, 1.49 to 5.75), p < 0.001. In the enhanced approach group, providers consistently reported greater satisfaction with the intervention than parents (p < 0.001), yet their fidelity of implementing the enhanced approach was low (less than 20%). Results show promise that parent engagement with childcare-based health promotion innovations can positively respond to appropriately designed and executed implementation strategies, but strategies need to be feasible and acceptable for all stakeholders.

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KW - Nutrition

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JO - International Journal of Environmental Research and Public Health

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M1 - 106

ER -

Efficacy of an enhanced implementation strategy to increase parent engagement with a health promotion program in childcare

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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Cite this