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Publication - Dr Ruth Kipping

    Child-care self-assessment to improve physical activity, oral health and nutrition for 2- to 4-year-olds

    a feasibility cluster RCT


    Kipping, R, Langford, B, Brockman, R, Wells, S, Metcalfe, C, Papadaki, A, Hollingworth, W, Moore, L, Ward, DS, Campbell, R, Kadir, BOA, Tinner, L, Er, V, Dias, K, Busse, H, Collingwood, J, Jago, R & Nicholson, A, 2019, ‘Child-care self-assessment to improve physical activity, oral health and nutrition for 2- to 4-year-olds: a feasibility cluster RCT’. Public Health Research, vol 7.


    Background: The nutrition and physical activity self-assessment for childcare (NAP SACC) intervention has shown evidence of effectiveness in the USA but not been adapted or assessed for effectiveness in the UK.

    Objectives: To evaluate the feasibility and acceptability of implementing NAP SACC in the UK.

    Design: Adaptation and development of NAP SACC and feasibility cluster randomised controlled trial (RCT) including process and economic evaluations. Sub-studies assessed mediator questionnaire test-retest reliability and feasibility of food photography methods.

    Setting: Nurseries, staff and parents: North Somerset, Cardiff, Gloucestershire, Bristol.

    Participants: Development: 15 early years/public health staff and Health Visitors, 12 nursery managers; 31 parents. RCT: 12 nurseries and 31 staff; four Partners and 168 children/parents.

    Mediator sub-study: 82 parents; 69 nursery staff. Food photography sub-study: four nurseries; 18 staff; 51 children.

    Intervention: NAP SACC UK Partners supported nurseries to review policies and practices and set goals to improve nutrition, oral health and physical activity (PA) over five months. Two workshops were delivered to nursery staff by local experts. A home component (website, SMS and emails) supported parents. Control group continued with usual practice.

    Main outcome measures: Feasibility and acceptability of the intervention and methods according to pre-specified criteria.

    Data sources: Qualitative data to adapt the intervention. Measurements with children, parents and staff at baseline and post-intervention (8-10 months after baseline). Interviews with nursery managers, staff, parents and NAP SACC UK Partners; observations of training, workshops and meetings. Nursery environment observation; nursery Review and Reflect score; resource log. Child height and weight, accelerometer determined PA and sedentary time, screen time and dietary outcomes using the Child and Diet Evaluation Tool. Staff and parent questionnaires of knowledge, motivation and self-efficacy. Child quality-of-life and nursery, family and healthcare costs. Food photography of everything consumed by individual children and staff questionnaire to assess acceptability.

    Full details in the University publications repository