||5R21CA201567-02 Interpret this number
||Harvard School Of Public Health
||Effective Training Models for Implementing Health-Promoting Practices Afterschool
Project Summary. Over the past two decades, excess dietary intake and low physical activity
have contributed to an increase in the prevalence of childhood obesity in the United States,
affecting a third of children and disproportionately impacting minority and economically
disadvantaged children. Given that obesity is a risk factor for health outcomes later in life,
including cancer, early obesity prevention efforts are critical for population health. Out-of-school
time (OST) programs are an important setting for addressing childhood obesity given that 10.2
million U.S. children are enrolled in afterschool. The Out-of-school Nutrition and Physical
Activity (OSNAP) group-randomized trial demonstrated improvements in children?s vigorous
physical activity, the healthfulness of foods and beverages served and consumed, and health-
promoting program policies. Now that the OSNAP intervention has been rigorously tested and
effectiveness has been established, there is a critical need to evaluate training models to
disseminate this intervention for broad population reach and impact. Our long-term goal is to
investigate the implementation and dissemination of evidence-based prevention interventions in
OST settings. The overall objective of this proposal is to establish the effectiveness of two
existing training models for scaling up the OSNAP intervention and understand the influence of
context on effective implementation. In collaboration with the YMCA, we will conduct a 3-arm
group randomized trial to compare two methods of delivering the learning collaborative with a
control group. This application addresses the following specific aims:
1. Compare the effectiveness and implementation cost of two learning collaborative
training models for the OSNAP intervention. We hypothesize that both training models will
produce healthy changes in OST nutrition and physical activity practices as measured by a
validated observational assessment, compared to the control group. Secondary outcomes of
specific healthy practices, such as offerings of physical activity and water, and process
outcomes, such as cost and acceptability, will vary by training model.
2. Use mixed methods to identify actionable factors within the implementation context
that influence the effectiveness of the OSNAP intervention delivered by two learning
collaborative training models. We hypothesize that programs with more supportive
implementation contexts will more effectively implement OSNAP than programs with less
supportive contexts. Qualitative data will help explain how aspects of the implementation
context influence effective implementation of each training model in greater depth.
Nutrition Impact Symptoms Are Prognostic of Quality of Life and Mortality after Surgery for Oesophageal Cancer.
, Martin L.
, Djärv T.
, Johar A.
, Lagergren P.
Cancers, 2018-09-07 00:00:00.0; 10(9), .
Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children's Food, Beverage, and Calorie Consumption among Snacks Served.
, Giles C.M.
, Cradock A.L.
, Emmons K.M.
, Okechukwu C.
, Kenney E.L.
, Thayer J.
, Gortmaker S.L.
Journal Of The Academy Of Nutrition And Dietetics, 2018 Aug; 118(8), p. 1425-1437.
Obesity Prevention Interventions in US Public Schools: Are Schools Using Programs That Promote Weight Stigma?
, Wintner S.
, Lee R.M.
, Austin S.B.
Preventing Chronic Disease, 2017-12-28 00:00:00.0; 14, p. E142.