Grant Number:	4R37CA252113-06 Interpret this number
Primary Investigator:	Swindle, Taren
Organization:	Univ Of Arkansas For Med Scis
Project Title:	Testing an Adaptive Implementation Strategy to Optimize Delivery of Obesity Prevention Practices in Early Care and Education Settings
Fiscal Year:	2026

Project Summary “Together, We Inspire Smart Eating” (WISE) is an intervention that improves children’s diets in Early Care and Education (ECE) settings. WISE includes 4 key evidence-based practices (EBPs): (1) multiple sensory based, hands-on exposures to fruits and vegetables (FV) support food acceptance; (2) role modeling by educators allows children to observe a trusted adult eating FV; (3) positive feeding practices support children’s self-regulation; and (4) mascot use associates a familiar character with FV. The ongoing, parent R37 grant will determine the effectiveness and cost-effectiveness of an adaptive implementation strategy to improve initial adoption of WISE after 8 months of implementation support (i.e., the acute period of implementation). This MERIT Extension proposal will answer new scientific questions about how best to provide support for sustainment (i.e., months 24 to 60), with the aim of sustaining WISE for the greatest number of ECEs. The Cooperative Extension System (CES) of the United States Department of Agriculture (USDA) embeds trained community members in every county of AR and parish of LA. This MERIT Extension will explore the adequacy of a low-intensity sustainment strategy and partnering with CES for WISE sustainment. Specific Aim 1. Evaluate our expanded adaptive implementation strategy to address sustainment. We will evaluate and refine our expanded strategy through assessing sustainment of delivery and fidelity for up to 60 months and by collecting qualitative feedback. Together, with results from the parent grant, we will have an adaptive implementation strategy package to address adoption through sustainment. Specific Aim 2. Assess the feasibility, acceptability, and determinants of sustaining WISE with CES. We will enlist CES agents to pilot support of sustainment efforts at parent grant sites. These CES agents will undergo training to be external facilitators for WISE. We will evaluate CES agents' perceptions of feasibility and acceptability in supporting WISE implementation via external facilitation, along with the resources they require (e.g., time, supplies). We will assess barriers and facilitators through field observations and in-depth interviews with CES agents and ECE partners. As a secondary objective, we will gather input on the potential for WISE scale-up (both implementation and sustainment) through CES. The expected outcome of this MERIT Extension is a fully specified adaptive implementation strategy packages for CES to sustain and scale WISE in ECE. Ultimately, sustaining and scaling EBPs in ECE that promote healthy diet and weight for children will advance the NCI’s priority of cancer prevention.




Implementation Strategies Applied in Communities Matching Process (ISAC Match): Expanded Guidance and Case Study.
Authors: Balis L.E. , Massey-Swindle T. , Palmer S. , Shaw E. , Jones-Dozier S. , Grocke-Dewey M. .
Source: Implementation Science : Is, 2025-10-17 00:00:00.0; 20(1), p. 43.
EPub date: 2025-10-17 00:00:00.0.
PMID: 41107971
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Evidence-Based Quality Improvement (EBQI) in the pre-implementation phase: key steps and activities.
Authors: Swindle T. , Baloh J. , Landes S.J. , Lovelady N.N. , Vincenzo J.L. , Hamilton A.B. , Zielinski M.J. , Teeter B.S. , Gorvine M.M. , Curran G.M. .
Source: Frontiers In Health Services, 2023; 3, p. 1155693.
EPub date: 2023-05-24 00:00:00.0.
PMID: 37292120
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De-Implementation of Detrimental Feeding Practices in Childcare: Mixed Methods Evaluation of Community Partner Selected Strategies.
Authors: Swindle T. , Rutledge J.M. , Zhang D. , Martin J. , Johnson S.L. , Selig J.P. , Yates A.M. , Gaulden D.T. , Curran G.M. .
Source: Nutrients, 2022-07-12 00:00:00.0; 14(14), .
EPub date: 2022-07-12 00:00:00.0.
PMID: 35889818
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Implementation fidelity, attitudes, and influence: a novel approach to classifying implementer behavior.
Authors: Swindle T. , Rutledge J.M. , Martin J. , Curran G.M. .
Source: Implementation Science Communications, 2022-06-06 00:00:00.0; 3(1), p. 60.
EPub date: 2022-06-06 00:00:00.0.
PMID: 35668517
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Obesity prevention practices in early care and education settings: an adaptive implementation trial.
Authors: Swindle T. , Rutledge J.M. , Selig J.P. , Painter J. , Zhang D. , Martin J. , Johnson S.L. , Whiteside-Mansell L. , Almirall D. , Barnett-McElwee T. , et al. .
Source: Implementation Science : Is, 2022-03-18 00:00:00.0; 17(1), p. 25.
EPub date: 2022-03-18 00:00:00.0.
PMID: 35303894
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A Cross-Sectional Study of Early Childhood Educators' Childhood and Current Food Insecurity and Dietary Intake.
Authors: Swindle T.M. , Ward W.L. , Bokony P. , Whiteside-Mansell L. .
Source: Journal Of Hunger & Environmental Nutrition, 2018; 13(1), p. 40-54.
EPub date: 2016-12-12 00:00:00.0.
PMID: 29606990
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Context Matters: The Importance of Investigating Random Effects in Hierarchical Models for Early Childhood Education Researchers.
Authors: Corkins C.M. , Harrist A.W. , Washburn I.J. , Hubbs-Tait L. , Topham G.L. , Swindle T. .
Source: Early Childhood Research Quarterly, 2025 1st Quarter; 70, p. 178-186.
EPub date: 2024-10-17 00:00:00.0.
PMID: 39494354
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