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There is one clinical trial.
This study will compare the effectiveness and cost of Basic and Enhanced delivery models for Go NAPSACC on child care centers' use of evidence-based nutrition and physical activity practices. Technical assistance (TA) coaches from Child Care Aware of Kentucky will lead delivery. Half of the TA coaches will deliver Go NAPSACC using the Basic model and the other half will deliver the program using the Enhanced model. It is hypothesized that the Enhanced model will result in greater use of evidence-based nutrition and physical activity practices and will also be more cost effective.
Description: Each center's nutrition and physical activity environment will be assessed using the Environment and Policy Assessment and Observation- Self Report (EPAO-SR), a self-report measure filled out through online surveys by child care center directors and preschool classroom lead teachers. When directors upload a month of menus and policy handbooks, a trained staff member will fill out relevant items. If not, the directors will fill out those items. An overall nutrition and physical activity environment score will be derived with scores ranging from 0-57, where higher scores indicate better (more supportive) nutrition and physical activity environments.
Measure: Change in nutrition and physical activity environment score from baseline to 12 months Time: Measures collected 3-12 weeks prior to start of intervention and 1-8 weeks post-12-month interventionDescription: The number of participating centers will be captured by the Go NAPSACC website and extracted using the Go NAPSACC Registration Report. This Registration Report documents all child care centers that have completed registration and created a Go NAPSACC account. Creation of an account will be used to define participation/adoption.
Measure: Number of participating centers Time: Measures collected 3-12 weeks prior to start of interventionDescription: Percent of Go NAPSACC core program components completed will be captured by the Go NAPSACC website and extracted using the Detailed Activity Report. These data will serve as indicators of fidelity. The Detailed Activity report captures centers' completion of key steps in the improvement process (completion of a self-assessment, selection of goals, creation of action plans, etc.). For this study, centers will be expected to complete 2 cycles of the improvement process, including all key steps. These data will be used to calculate the percentage of steps completed.
Measure: Percent of Go NAPSACC core program components completed by centers Time: Measures collected during the 1 year intervention period.Description: Percent of Go NAPSACC core program components completed will be captured by the Go NAPSACC website and extracted using the TA Activity Report. These data will serve as indicators of fidelity. The TA Activity Report all coaches to document their implementation activities. Based on their prescribed implementation model (basic or enhanced), these data will be used to calculate the percentage of prescribed implementation activities completed.
Measure: Percent of Go NAPSACC core program components completed by TAs Time: Measures collected during the 1 year intervention period.Description: Child nutrition self-assessment scores are captured on the Go NAPSACC website each time child care centers complete a self-assessment for that module. Each self-assessment item is scored 1-4 points, where higher points indicate closer compliance with best practices. Responses are then used to calculate a total score (total points/total possible points x 100). As an indicator of maintenance, self-assessment data will be extracted using the Go NAPSACC Child Nutrition Self-Assessment Report pulled immediately post-intervention, as well as 6, 12, and 18 months post to calculate changes in scores over time. No change and/or positive change would indicate that the intervention effect was maintained.
Measure: Changes in child nutrition self-assessment scores at 6 and 12, and 18 months post-intervention Time: Measures will be collected at 6, 12, and 18 months post-interventionDescription: Physical activity self-assessment scores are captured on the Go NAPSACC website each time child care centers complete a self-assessment for that module. Each self-assessment items is scored 1-4 points, where higher points indicate closer compliance with best practices. Responses are then used to calculate a total score (total points/total possible points x 100). As an indicator of maintenance, self-assessment data will be extracted using the Go NAPSACC Physical Activity Self-Assessment Report pulled immediately post-intervention, as well as 6, 12, and 18 months post to calculate changes in scores over time. No change and/or positive change would indicate that the intervention effect was maintained.
Measure: Changes in physical activity self-assessment scores at 6, 12, and 18 months post-intervention Time: Measures will be collected at 6, 12, and 18 months post-interventionDescription: Contextual factors will be assessed using surveys completed by directors, teachers, and TA coaches. Specifically, Fernandez's CFIR Inner Setting measure will be used to assess Culture, Culture Stress, Culture Effort, Implementation Climate, Leadership Engagement, and Available Resources. Items are scored 1-5. Items within subscales will be averaged to determine the scale score. Higher scores indicate better contextual factors. These scores will be used to examine how context predicts changes in nutrition and physical activity environment scores.
Measure: Contextual factors scores- Culture, implementation climate, leadership engagement, and available resources Time: Measures collected 3-12 weeks prior to the start of interventionDescription: Contextual factors will be assessed using surveys completed by directors, teachers, and TA coaches. TCU's Organizational Readiness for Change Survey will be used to assess Networks and Communications and Access to Knowledge and Information. Items are scored 1-5 and items within subscales will be averaged to determine the scale score. Higher scores indicate better contextual scores. These scores will be used to examine how context predicts changes in nutrition and physical activity environment scores.
Measure: Contextual factors scores- Networks and communications and access to knowledge and information Time: Measures collected 3-12 weeks prior to the start of interventionDescription: Contextual factors will be assessed using surveys completed by directors, teachers, and TA coaches. Seward's Theoretical Domains Framework Questionnaire will be used to assess Knowledge, Beliefs and Consequences, and Self-Efficacy. Items are scored 1-7. Items within subscales will be averaged to determine the scale score. Higher scores indicate better contextual scores. These scores will be used to examine how context predicts changes in nutrition and physical activity environment scores.
Measure: Contextual factors scores- Knowledge, beliefs, and consequences and self-efficacy Time: Measures collected 3-12 weeks prior to the start of interventionDescription: Costs of implementation include TA coaches time and any resources required to train and support centers for 12 months. Cost tracking will use the TA Activity Log to capture TA coaches' time and TA coaches will be asked to fill out a supplemental log of additional costs (e.g., mileage, printing). These data will be combined to calculate the total cost per center for implementing Go NAPSACC. Average cost per center for basic and enhanced implementation models will also be calculated. To explore the cost-effectiveness of basic and enhanced implementation models, these data will be combined with data on the change in nutrition and physical activity environment scores to calculate the incremental cost-effectiveness ratio (average incremental cost of delivering Enhanced Go NAPSACC relative to Basic Go NAPSACC divided by the average incremental change in effectiveness from delivering Enhanced Go NAPSACC relative to Basic Go NAPSACC).
Measure: Cost of basic and enhanced implementation models Time: Measures collected throughout the 1 year intervention periodDescription: Center-level dietary intake of food served to preschool children will be assessed via the foods and beverages provided section of the EPAO-SR as filled out online by the director on 2 different days of the week. Center-level served dietary intake data will be used to calculate Healthy Eating Index 2015 (HEI2015) scores to produce a center-level estimate of children's diet quality. Scores will range from 0-100, where scores closer to 100 will indicate higher diet quality.
Measure: Change in children's diet quality served at child care from baseline to 12 months (exploratory) Time: Measures collected 3-12 weeks prior to start of intervention and 1-8 weeks post-12-month interventionDescription: A center-level score for time provided for active play for preschool children will be assessed via the daily activities section of the of the EPAO-SR as filled out online by 2 classroom teachers on 2 different days of the week. Active play time blocks will be summed each day and then averaged across the 2 days to calculate a center-level estimate, where higher scores indicate more active play time provided.
Measure: Change in time provided for physical activity for preschool children at child care from baseline to 12 months (exploratory) Time: Measures collected 3-12 weeks prior to start of intervention and 1-8 weeks post-12-month interventionAlphabetical listing of all HPO terms. Navigate: Correlations Clinical Trials
Data processed on September 26, 2020.
An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.
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