To evaluate a responsive feeding intervention ‘Ecological Approach to (EAT) Family Style’ through the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
Use of Theory or Research
EAT Family Style is guided by the self-determination theory and includes an evidence-informed implementation improvement system to enhance use of evidence-informed responsive feeding practices.
Center-based childcare directors (n = 8) and teachers (n = 17) caring for preschool (3-5 years) children and Cooperative Extension coaches (n = 9).
EAT Family Style is a 14-week intervention and utilizes an improvement system of 3 implementation strategies: (a) online professional development and goal setting with 7 lessons: role modeling, peer modeling, sensory exploration, self-regulation, children serve themselves, praise and rewards, and family engagement; (b) administrative support; and (c) ongoing monitoring, feedback, and follow-up support through Extension. The evidence-informed practices and implementation system was delivered through childcare directors and teachers completing 1 online lesson/week followed by a coaching session with an Extension coach.
Semi-structured interviews were conducted, transcribed verbatim, and coded deductively by 3 coders using RE-AIM dimensions as a priori codes and placed into sub-themes and themes using thematic analysis.
All participants perceived EAT Family Style improved children's nutritional and developmental outcomes and encouraged a positive mealtime environment (Effectiveness). Coaches and directors reported EAT Family Style aligned with their professional goals and beliefs. Coaches found incentives to PD important, whereas directors/teachers valued in-service hours followed by other incentives (Adoption). Teachers reported successful implementation of EAT Family Style practices in the classroom. Directors and coaches supported the teachers through administrative and coaching strategies (Implementation). All participants reported they intended to continue using the intervention. Directors and teachers discussed incorporating EAT Family Style practices into handbook/school policy (Maintenance).
EAT Family Style was viewed as feasible by participants. Its implementation strategy has the potential to improve the uptake of evidence-informed feeding practices in childcare centers.
Appendix. Supplementary data
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