Abstract
Purpose and ObjectivesThe National Early Care and Education Learning Collaboratives Project (ECELC) aims to improve best practices in early care and education (ECE) programs in topic areas of the Nutrition and Physical Activity Self-Assessment in Child Care (NAP SACC). Technical assistance is a component of the ECELC, yet its effect on outcomes is unclear. Beyond dose and duration of technical assistance, limited research exists on characteristics of technical assistance that contribute to outcomes. The objective of this study was to identify and describe technical assistance characteristics and explore associations with NAP SACC outcomes.Intervention ApproachWe collected data from 10 collaboratives comprising 84 ECE programs in 2 states in 2015–2016. The objective of technical assistance was to support programs in improving best practices. Technical assistance was provided to programs via on-site, telephone, or email and was tailored to program needs.Evaluation MethodsWe used a mixed-methods design to examine associations between technical assistance and NAP SACC outcomes. We used multiple regression analysis to assess quantitative data and qualitative comparative analysis to determine necessary and sufficient technical assistance conditions supporting NAP SACC outcomes. We also conducted a document review to describe technical assistance that referred conditions identified by the qualitative comparative analysis.ResultsRegression analyses detected an inverse relationship between changes in NAP SACC scores and hours of technical assistance. No clear pattern emerged in the qualitative comparative analysis, leaving no necessary and sufficient conditions. However, the qualitative comparative analysis identified feedback as a potentially important component of technical assistance, whereas resource sharing and frequent email were characteristics that seemed to reduce the likelihood of improved outcomes. Email and resource sharing were considered primarily general information rather than tailored technical assistance.Implications for Public HealthTechnical assistance may be used in programs and made adaptable to program needs. The inclusion and evaluation of technical assistance, especially tailored approaches, is warranted for environmental interventions, including ECE settings.
Highlights
The prevalence of obesity is 9% among preschool-aged children in the United States [1]
The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions
NAP SACC outcomes at the program level vary; this variation may be attributed to dosage of components of the Education Learning Collaboratives Project (ECELC) received by early care and education (ECE) programs and the ability of ECE programs to select their own goals within the intervention [9]
Summary
The prevalence of obesity is 9% among preschool-aged children in the United States [1]. Given that almost 7 million children in the United States under the age of 5 spend an average 25 hours or more per week in child care centers or Head Start, early care and education (ECE) programs are a critical setting for obesity prevention efforts [4,5]. The physical and social environment of ECE programs help shape children’s physical activity and dietary behaviors; fostering effective strategies to help child care providers establish healthy environments is key [5,6,7]. The National Early Care and Education Learning Collaboratives Project (ECELC), funded by the Centers for Disease Control and Prevention and implemented by Nemours Children’s Health System, is using a train-the-trainer model to reduce childhood obesity by promoting healthy environments in ECE programs [8]. NAP SACC outcomes at the program level vary; this variation may be attributed to dosage of components of the ECELC received by ECE programs and the ability of ECE programs to select their own goals within the intervention [9]
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