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Published on: June 20, 2020
Cross-Site Process Evaluation Results for the Early Childhood Education Center Setting: CORD Study
Tracey Ledoux1, Debbe Thompson2, Teresia O'Connor2
1Department of Health and Human Performance, University of Houston, Houston, TX, USA.
Insights
The Childhood Obesity Research Demonstration project successfully reached many children and teachers in early childhood education centers. However, maintaining intervention fidelity across sites presented a significant challenge.
Area of Science:
- Public Health
- Childhood Obesity Prevention
- Intervention Science
Background:
- Childhood obesity is a major public health concern requiring effective prevention strategies.
- Evidence-based interventions are crucial for addressing obesity in at-risk families.
- Early childhood education centers (ECECs) are key settings for delivering prevention programs.
Purpose of the Study:
- To evaluate the process of delivering obesity prevention interventions in ECECs.
- To assess reach, dose delivered, and fidelity of interventions across demonstration sites.
- To identify challenges in implementing interventions in real-world settings.
Main Methods:
- Cross-site process evaluation of the Childhood Obesity Research Demonstration project.
- Assessment of reach, dose delivered, and fidelity at researcher-to-provider and provider-to-family levels.
- Data collection using standardized forms by research teams with evaluation center support.
Main Results:
- The project reached 5174 children and 390 teachers across 58 ECECs.
- Interventions included teacher training, material distribution, and technical support.
- Fidelity at the researcher-to-provider level was 49.5% for teacher training completion; significant site variations were observed.
Conclusions:
- The Childhood Obesity Research Demonstration project demonstrated the capacity to reach a large number of children and educators.
- Significant variations in reach, dose, and fidelity across sites highlight implementation challenges.
- Balancing broad reach with consistent intervention fidelity is critical for successful obesity prevention programs.
Abstract:
The Childhood Obesity Research Demonstration project aimed to deliver evidence-based obesity prevention interventions to at-risk families at three demonstration sites. The interventions were delivered in multiple settings, including early childhood education centers (ECECs), public schools, and primary care clinics. An evaluation center conducted cross-site process, impact, and sustainability evaluations. Results of the cross-site process evaluation for the ECECs will be described. Reach (proportion of the target population who participated), dose delivered (materials and interventions that were distributed), and fidelity (proportion of planned intervention components delivered) were assessed at two levels (researcher-to-provider and provider-to-family levels). Standardized data forms were completed by research team members at each demonstration site with assistance from the evaluation center. The Childhood Obesity Research Demonstration project reached 5174 children and 390 teachers in 58 ECECs. The centers delivered an average of 3.9 hours of training to teachers. A total of 1382 different types of materials were distributed to providers, and from 1.3 to 4.3 hours of technical support were delivered to centers monthly. For fidelity at the researcher-to-provider level, 49.5% (n = 370) of eligible teachers completed all training sessions. Considerable variations across demonstration sites in reach, dose delivered, and fidelity across were observed. The Childhood Obesity Research Demonstration project reached large numbers of children, families, teachers, and ECECs. Maintaining intervention fidelity while reaching large numbers of at-risk individuals proved to be a challenge.
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