NAP SACC UK: protocol for a feasibility cluster randomised controlled trial in nurseries and at home to increase physical activity and healthy eating in children aged 2–4 years

Abstract

IntroductionSystematic reviews have identified the lack of intervention studies with young children to prevent obesity. This feasibility study examines the feasibility and acceptability of adapting the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) intervention in the UK to inform a full-scale trial.Methods and analysisA feasibility cluster randomised controlled trial in 12 nurseries in England, with 6 randomly assigned to the adapted NAP SACC UK intervention: nursery staff will receive training and support from an NAP SACC UK Partner to review the nursery environment (nutrition, physical activity, sedentary behaviours and oral health) and set goals for making changes. Parents will be invited to participate in a digital media-based home component to set goals for making changes in the home. As this is a feasibility study, the sample size was not based on a power calculation but will indicate the likely response rates and intracluster correlations. Measures will be assessed at baseline and 8–10 months later. We will estimate the recruitment rate of nurseries and children and adherence to the intervention and data. Nursery measurements will include the Environmental Policy Assessment and Observation score and the nursery staff's review of the nursery environment. Child measurements will include height and weight to calculate z-score body mass index (zBMI), accelerometer-determined minutes of moderate-to-vigorous physical activity per day and sedentary time, and diet using the Child and Diet Evaluation Tool. Questionnaires with nursery staff and parents will measure mediators. A process evaluation will assess fidelity of intervention delivery and views of participants.Ethics and disseminationEthical approval for this study was given by Wales 3 NHS Research Ethics Committee. Findings will be made available through publication in peer-reviewed journals, at conferences and to participants via the University of Bristol website. Data will be available from the University of Bristol Research Data Repository.Trial registration numberISRCTN16287377.

Adapting the ToyBox obesity prevention intervention for use in Scottish preschools: protocol for a feasibility cluster randomised controlled trial

“…Adapting successful interventions for use in other settings is becoming an increasingly common practice in child health research. 72 However, for success to translate from one setting to the other, adequate context-specific adaptations must be made to ensure the intervention can function as intended and still meets its desired aims. 73 The study outlined in this protocol aims to test whether the ToyBox-Scotland obesity prevention intervention is feasible and acceptable in the Scottish preschool and home setting, and to determine whether progression to a full-scale cluster RCT is recommended.…”

Latino parents’ perceptions of the eating and physical activity experiences of their pre-school children at home and at family child-care homes: a qualitative study

“…The current study was part of a multicomponent qualitative research project exploring factors influencing eating, PA and sedentary behaviours among Latino children of pre-school age attending FCCH in Massachusetts, USA (20) .…”

“…Many Latino families prefer FCCH to other EEC settings due to cultural preferences for family-like care, flexible hours and lower costs, thus making FCCH an ideal setting for obesity prevention targeting Latino families and children (16) . Research indicates that healthful eating and PA practices implemented in child-care settings can positively affect children's healthful behaviours in this setting (17)(18)(19)(20) . Moreover, this effect on healthful behaviours may possibly transfer to the home environment (21,22) .…”

“…While more research is needed to examine whether behaviours learned in FCCH transfer to the home and family, the potential for transferability is especially important given that Latino children's home environment is often characterized by obesogenic parenting practices (23) . Although a growing number of studies have focused on FCCH as a setting for promoting early healthful eating and PA (17)(18)(19)(20)(24)(25)(26) , to our knowledge no study has examined Latino parents' perceptions of their children's eating and PA experiences in FCCH run by Latino providers. Therefore, the purpose of the current qualitative study was to examine Latino parents' perceptions of their children's eating and PA experiences while at home and at FCCH.…”

Preschool staff and parents’ perceptions of preschool children’s physical activity and fundamental movement skills from an area of high deprivation: a qualitative study

“…All staff did comment that they would like more training as this would ensure that they are all more competent at delivering PA and developing FMS, and this would help the preschools financially, as they would not need to hire in external companies. This is possible as childcare settings provide opportunities to improve time engaged in PA and allow staff to promote healthy behaviours (Kipping et al 2016).…”