Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, Priority Research Centre Lifecourse Nutrition, University of Agder, Kristiansand, Norway.
Department of Community Medicine and Global Health , Institute of Health and Society, University of Oslo, Oslo, Norway.
Front Endocrinol (Lausanne). 2023 Jan 10;13:1071489. doi: 10.3389/fendo.2022.1071489. eCollection 2022.
UNLABELLED: Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0-2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n800), while a matched non-equivalent control municipality (n800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic diverse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice.
CLINICAL TRIAL REGISTRATION: https://www.isrctn.com/, identified ISRCTN10694967.
未标注:令人失望的是,成功扩大规模并在实际环境中实施的有效卫生干预措施很少。这代表了证据与实践之间的差距,错失了改善实践的机会。我们旨在改善生命最初 1000 天的营养状况,将四种有效的饮食干预措施结合到一个单一的适应数字资源(Nutrition Now)中,以便在挪威社区环境中实施。Nutrition Now 针对孕妇和 0-2 岁儿童的父母,传递注重健康饮食行为的信息。幼儿教育和保育(ECEC)工作人员获得了关于健康食品接触和儿童食物接受度的教学工具。目标:a)评估提供 Nutrition Now 资源对儿童饮食和饮食相关结果的有效性,特别关注社会经济地位的影响,b)收集有关实施过程有效性的信息,为即将进行的扩大规模提供信息,c)进行试验和基于模型的经济评估。这是一项混合类型 1 实施研究,重点是评估有效性。将使用准实验设计,进行前后测试,一个市获得资源(n800),而一个匹配的非等效对照市(n800)则没有。有效性将通过检查例如饮食结果、发育结果和喂养实践来评估。该资源将在 ECEC 环境中实施,并通过挪威母婴保健(MCH)系统向孕妇和父母提供。实施过程包括根据与利益相关者的对话,从实施框架专家建议实施变革(ERIC)中进行迭代调整和实施策略。通过父母、ECEC 和 MCH 工作人员的问卷和访谈评估实施结果(例如,可接受性和采用率),特别关注少数民族群体。将进行试验内和基于模型的经济评估。Nutrition Now 将通过对市政规模扩大的严格科学有效性评估来弥合现有的证据与实践之间的差距,并为随后的县规模扩大提供信息。该研究首次使用技术实施有效的早期生命营养干预措施,以提高父母和 MCH 饮食指导以及 ECEC 实践的覆盖面和影响力,从而改善健康。
临床试验注册:https://www.isrctn.com/,识别号 ISRCTN8301234。
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