Related Experiment Video
Updated: May 21, 2026
Measuring the Functional Abilities of Children Aged 3-6 Years Old with Observational Methods and Computer Tools
Published on: June 20, 2020
A RE-AIM Analysis of Better Together: A Multi-Level Program to Improve Nutrition and Physical Activity in Early Care
Caliste B Hope1, Roshelle Payes1, Falon T Smith2
1Nemours Children's Health, Washington, DC, USA.
Background:
Systemic barriers contribute to challenges in implementing sustainable improvements in early care and education (ECE) health promotion practices, including fragmented state systems, limited organizational capacity, and a lack of accessible, high-quality professional development. Guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, this study evaluated the Better Together approach-a multi-level quasi-experimental program aimed at enhancing health promotion practices in ECE programs.
Methods:
Better Together, developed by Nemours Children's Health and University of North Carolina Chapel Hill Community Health & Wellness Resource Team, used organizational- and systems-level approaches to improve ECE health promotion practices. Learning collaboratives (organizational level) addressing ECE health practices were delivered by trained consultants. State partners coordinated efforts to impact state systems change using the CDC's Spectrum of Opportunities 2.0 Framework (systems-level). Surveys and program data were collected to assess reach, effectiveness, adoption, and implementation. Descriptive statistics were used to evaluate RE-AIM outcomes.
Results:
Four states implemented Better Together learning collaboratives, reaching 1,078 staff from 533 ECE programs. Across states, ECE program completion of initiative components ranged from 58.0 to 94.7% (adoption). Consultants implemented planned sessions (n = 26; implementation). On average, ECE programs experienced a 15.1% increase in health-promoting practices (range 11.8-17.5%; effectiveness). Partner groups generated 10 state system-level action plans to promote ECE health practices in perpetuity (maintenance).
Conclusions:
The RE-AIM evaluation of the Better Together program showed positive results. It reached a significant number of ECE programs, leading to increased health-promoting practices, policies, and environments, as well as initiated state-level ECE systems change to sustain support.
Related Concept Videos
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:26Levels of Health Promotion and Illness Prevention
In primary prevention, actions taken before disease onset prevent the disease from...
01:18Models of Health Promotion and Illness Prevention II
The agent-host-environment model states that disease results from...
01:25Models of Health Promotion and Illness Prevention I
The health belief model (HBM) attempts to predict health-related behavior in specific belief patterns. According to the HBM, a person's...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
01:29Aims Of Nursing