De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies

oleh: Taren Swindle, Julie M. Rutledge, Dong Zhang, Janna Martin, Susan L. Johnson, James P. Selig, Amy M. Yates, Daphne T. Gaulden, Geoffrey M. Curran

Format: Article
Diterbitkan: MDPI AG 2022-07-01

Deskripsi

This pilot evaluated strategies to decrease detrimental feeding practices in early care and education, which are hypothesized to compete with evidence-based feeding and obesity prevention practices. This study made two key comparisons: (1) a between-site comparison of sites receiving (a) no implementation or de-implementation strategies (i.e., Basic Support; B), (b) implementation strategies only (i.e., Enhanced Support; E), and (c) implementation and de-implementation strategies (i.e., De-implementation + Enhanced Support; D + E) and (2) a within-site pre-post comparison among sites with D + E. At nutrition lessons, the D + E group had more Positive Comments (Hedege’s <i>g</i> = 0.60) and higher Role Model fidelity (Hedege’s <i>g</i> = 1.34) compared to the E group. At meals, assistant teachers in the D + E group had higher Positive Comments than in the B group (<i>g</i> = 0.72). For within-group comparisons, the D + E group decreased Negative Comments (<i>t</i>(19) = 2.842, <i>p</i> = 0.01), increased Positive Comments (<i>t</i>(20) = 2.314, <i>p</i> = 0.031), and improved use of the program mascot at nutrition lessons (<i>t</i>(21) = 3.899, <i>p</i> = 0.001). At meals, lead teachers’ Negative Comments decreased (<i>t</i>(22) = 2.73, <i>p</i> = 0.01). Qualitative data identified strengths and opportunities for iteration. Despite a COVID interruption, mid-point comparisons and qualitative feedback suggest promise of the de-implementation strategy package.