Deimplementation of Inappropriate Feeding Practices in Early Care and Education Settings

NCT07107321 | Enrolling By Invitation

• 2 other identifiers: 276116:R01DK138153
• Study Type: interventional
• Target: 2,640
• Locations: 1 country
• Sites: 1

Brief Summary

Arkansas and Louisiana have among the highest rates of adult obesity in the United States at 38.7% and 38.6%, respectively. Prevention and intervention efforts are needed to reduce the number of children who will become obese adults and suffer the host of negative health consequences that accompany it. This proposal will develop and test strategies to stop the use of detrimental feeding practices by early childhood educators which promote unhealthy weight trajectories, inappropriate eating behaviors and poor dietary outcomes for children.

Conditions

Obesity, Childhood

Outcome Measures

Primary Outcomes (1)

• Table Talk

  This observational instrument includes the ability to rate the use of eight inappropriate and six evidence-based feeding practices within a single mealtime (approximately 30 minutes). Trained and field-reliable staff blinded to the study condition will collect fidelity data consistent with published protocols. This tool is not affected by ceiling effects are other measures feeding practices. That is, each discrete use of the 14 target feeding practices is captured. Continuous composite scores for inappropriate and evidence-based feeding practices will be used.

  Five times: (1) baseline in the spring of the year prior to training, (2,3) during winter and spring in the implementation school year, and (4,5) during the fall of the following two school years.

Study Arms (2)

WISE Words

EXPERIMENTAL

Bundle of deimplementation strategies including training, peer learning collaborative, external facilitation, audit and feedback, environmental reminders, and educational materials

Behavioral: WISE Words

Standard educational practice

NO INTERVENTION

Usual practice in ECE does not require a standard approach to nutrition education, and implementation varies based on the discretion of the site and/or educator.

Interventions

WISE Words BEHAVIORAL

WISE Words is a co-designed, multicomponent deimplementation strategy package including 6 discrete strategies. Of these, three are delivered in a standard fashion: (1) dynamic training driven by improvisation methods, (2) a peer learning collaborative, and (3) external facilitation. The additional three are tailored to each educator's preferences and goals: (4) reminders, (5) educational materials, and (6) audit and feedback. Educators are supported to set and achieve goals for one feeding practice they want to stop and one they want to start.

WISE Words

Eligibility Criteria

• Age: 3 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Sites within a 100-mile radius of staff offices serving 12+ children ages 3 to 5 years
• Agreeing to participate in data collection
• Sites will serve meals.
• All classrooms at a site will receive the same deimplementation strategies and participate in data collection. We will select one classroom at random per site to participate in the collection of child outcomes (N= 264 classrooms, 15 children per classroom= 1320 children total).

You may not qualify if:

• We will exclude sites that have participated in intervention studies with our team in the last 3 years.

Sponsors & Collaborators

• Arkansas Children's Hospital Research Institute: lead
• National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): collaborator
• Louisiana Tech University: collaborator

Study Sites (1)

Arkansas Children's Nutrition Center

Little Rock, Arkansas, 72205, United States

Location

MeSH Terms

Conditions

Pediatric Obesity

Condition Hierarchy (Ancestors)

Obesity; Overweight; Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 30, 2025
• First Posted: August 6, 2025
• Study Start: August 12, 2025
• Primary Completion (Estimated): April 30, 2029
• Study Completion (Estimated): April 30, 2029
• Last Updated: October 2, 2025

Record last verified: 2025-09

Locations

US (1)