Department of Health Promotion, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, PO Box 616, 6200, MD, Maastricht, The Netherlands.
Implement Sci. 2021 Dec 4;16(1):101. doi: 10.1186/s13012-021-01161-9.
The Early Care and Education (ECE) setting plays an important role in the promotion of a healthy lifestyle in young children. SuperFIT is a comprehensive, integrated intervention approach designed to promote healthy energy balance-related behaviours in preschoolers. Insight in the process of implementation and the context in which SuperFIT was implemented supports the understanding of how the intervention works in practice. This process evaluation examined factors that influenced the implementation and maintenance, as well as the (perceived) changes in the ECE setting.
A mixed-methods study was conducted. SuperFIT was implemented at twelve preschools in the south of the Netherlands. The process evaluation was performed among preschool teachers, managers of the preschool organisation, and implementers. Semi-structured in-depth (group) interviews, quantitative process questionnaires, the Child-care Food and Activity Practices Questionnaire (CFAPQ) and the Environmental and Policy Assessment and Observation (EPAO) were used to evaluate the implementation and maintenance of SuperFIT and the changes in the preschool setting. The interviews were analysed using a theoretical framework based on the Implementation Framework of Fleuren and Damschröder's Consolidated Framework for Implementation Research. Descriptive analyses were performed on the quantitative data.
Various intervention activities were implemented in the preschool setting. Although the intention to maintain SuperFIT was present, this was hindered by time constraints and lack of financial resources. Important factors that influenced implementation and maintenance were incongruence with current practice, limited perceived capabilities to integrate SuperFIT in daily practice, group composition at the preschools, and the perceived top-down implementation. Organizational vision and societal attention regarding healthy behaviour in general were perceived to be supportive for implementation and maintenance. Predominantly, favourable changes were seen in the nutrition- and physical activity-related practices of preschool teachers and other aspects of the social preschool environment such as the use of play materials. Limited changes were observed in the physical preschool environment.
Several factors influenced the implementation and maintenance of SuperFIT in the preschool setting. Some factors evolved over time from hindering to facilitating, emphasising the importance of allowing sufficient time for intervention implementation. SuperFIT changed mainly the social preschool environment.
Clinicaltrials.gov, NCT03021980 , date registered: January 16, 2017, prospectively registered.
早期儿童照护与教育（ECE）环境在促进幼儿健康生活方式方面发挥着重要作用。SuperFIT 是一种综合的、综合的干预方法，旨在促进学龄前儿童健康的能量平衡相关行为。深入了解实施过程和 SuperFIT 的实施背景有助于理解干预在实践中的作用方式。本过程评估研究了影响实施和维持的因素，以及 ECE 环境的（感知）变化。
采用混合方法研究。SuperFIT 在荷兰南部的 12 所幼儿园实施。过程评估在幼儿园教师、幼儿园组织管理人员和实施者中进行。采用半结构化深度（小组）访谈、定量过程问卷、儿童照护食品和活动实践问卷（CFAPQ）和环境与政策评估和观察（EPAO）来评估 SuperFIT 的实施和维持情况以及幼儿园环境的变化。访谈根据基于 Fleuren 和 Damschröder 的实施研究综合框架的理论框架进行分析。对定量数据进行描述性分析。
在幼儿园环境中实施了各种干预活动。尽管存在维持 SuperFIT 的意图，但由于时间限制和缺乏财政资源，这一意图受到了阻碍。影响实施和维持的重要因素包括与当前实践不一致、在日常实践中整合 SuperFIT 的能力有限、幼儿园的群体构成以及感知的自上而下的实施。对健康行为的组织愿景和社会关注被认为对实施和维持具有支持作用。幼儿园教师的营养和身体活动相关实践以及幼儿园社会环境的其他方面，如游戏材料的使用，主要发生了有利的变化。幼儿园物理环境的变化有限。
在幼儿园环境中，多种因素影响了 SuperFIT 的实施和维持。随着时间的推移，一些因素从阻碍因素演变为促进因素，这强调了为干预实施提供足够时间的重要性。SuperFIT 主要改变了幼儿园的社会环境。
Clinicaltrials.gov，NCT03021980，注册日期：2017 年 1 月 16 日，前瞻性注册。
