The University of Southampton
University of Southampton Institutional Repository

Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care

Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care
Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care

Background: Early Childhood Education and Care (ECEC) centers play an important role in fostering healthy dietary habits. The Nutrition Now project focusing on improving dietary habits during the first 1000 days of life. Central to the project is the implementation of an e-learning resource aimed at promoting feeding practices among staff and healthy dietary behaviours for children aged 0–3 years in ECEC. Implementing new interventions often presents challenges. This study explores ECEC staff views and experiences with selected strategies for implementing an e-learning resource in ECEC centers in a municipality in Southern Norway. 

Methods: the study is a part of the Nutrition Now study, a hybrid type 1 non-randomized controlled trial. The implementation process followed the Dynamic Integrated Evaluation Model (DIEM). Implementation strategies were selected from the Expert Recommendations for Implementing Change (ERIC) project and included identify and prepare champions, conduct educational meetings, distribute educational materials, create a learning collaborative, and remind clinicians. ECEC teachers from participating ECEC centers in the intervention municipality were recruited as champions. Brief (5–7 min minutes), semi-structured phone interviews, covering key points, were conducted with the champions 8 times, evenly distributed over six months. The interviews were analysed using qualitative thematic analysis. 

Results: in total, 29 of the invited ECEC centers (53%) participated, and 260 brief interviews (88%) were conducted with champions (n = 37). An evaluation of the feedback from the champions suggests that the five selected implementation strategies were acceptable. Five main themes were developed by qualitative analysis: 1) Being a champion resembles what I already do. 2) Educational meetings are fine but take time. I prefer when peers share experiences. 3) Newsletters were helpful and reminded me, but I do not always have enough time to read. 4) Evaluations have increased my awareness, and we do them informally and formally. 5) The regular phone calls reminded me I could receive support and express my opinion. 

Conclusion: this study’s findings suggest that several implementation strategies are acceptable for stakeholders in an ECEC e-learning healthy eating intervention. However, time constraints among champions may hinder deep engagement. These results provide valuable insights into how the selected implementation strategies may function in practice and how they are perceived and experienced by the ECECs staff. Trial registration: Trial registration on June 6, 2022: ISRCTN10694967.

Champion, Dynamic integrated evaluation model, Early childhood education and care, Expert recommendations for implementing change, Implementation strategies, Newsletters, Nutrition Now
Lian, Henrik
9bef4bf5-bde0-4fd7-b3ce-4957baf8265a
Øverby, Nina Cecilie
4e7dbd40-aa5b-4a47-87f3-cb5f73f27a89
Vik, Frøydis Nordgård
eb2b8d15-866b-4406-b2da-d0cb7df0cedd
Medin, Anine Christine
1e653cac-45e5-45cf-ab7a-b3ac12c42053
Osorio, Natalie Garzon
4aab0858-32b4-4895-81de-17cb111cd5e8
Helle, Christine
768500a8-355c-47c3-a71f-29e6aab22d22
Bjørkkjær, Tormod
9c5014cf-dc06-4948-b3dc-8feb45c7132c
Love, Penelope
57ed4862-bfdd-40f8-b2fb-54352d6ae71d
Rutter, Harry
afa16426-2dad-4db8-87a1-87ff4ad4d03b
Barker, Mary Elizabeth
374310ad-d308-44af-b6da-515bf5d2d6d2
Hillesund, Elisabet Rudjord
4a8a2b64-b65f-407b-8a86-668d34ca9a6e
Helland, Sissel Heidi
c89e3010-e9d7-4528-8232-f527e337e387
Lian, Henrik
9bef4bf5-bde0-4fd7-b3ce-4957baf8265a
Øverby, Nina Cecilie
4e7dbd40-aa5b-4a47-87f3-cb5f73f27a89
Vik, Frøydis Nordgård
eb2b8d15-866b-4406-b2da-d0cb7df0cedd
Medin, Anine Christine
1e653cac-45e5-45cf-ab7a-b3ac12c42053
Osorio, Natalie Garzon
4aab0858-32b4-4895-81de-17cb111cd5e8
Helle, Christine
768500a8-355c-47c3-a71f-29e6aab22d22
Bjørkkjær, Tormod
9c5014cf-dc06-4948-b3dc-8feb45c7132c
Love, Penelope
57ed4862-bfdd-40f8-b2fb-54352d6ae71d
Rutter, Harry
afa16426-2dad-4db8-87a1-87ff4ad4d03b
Barker, Mary Elizabeth
374310ad-d308-44af-b6da-515bf5d2d6d2
Hillesund, Elisabet Rudjord
4a8a2b64-b65f-407b-8a86-668d34ca9a6e
Helland, Sissel Heidi
c89e3010-e9d7-4528-8232-f527e337e387

Lian, Henrik, Øverby, Nina Cecilie, Vik, Frøydis Nordgård, Medin, Anine Christine, Osorio, Natalie Garzon, Helle, Christine, Bjørkkjær, Tormod, Love, Penelope, Rutter, Harry, Barker, Mary Elizabeth, Hillesund, Elisabet Rudjord and Helland, Sissel Heidi (2025) Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care. BMC Nutrition, 11 (1), [7]. (doi:10.1186/s40795-024-00990-3).

Record type: Article

Abstract

Background: Early Childhood Education and Care (ECEC) centers play an important role in fostering healthy dietary habits. The Nutrition Now project focusing on improving dietary habits during the first 1000 days of life. Central to the project is the implementation of an e-learning resource aimed at promoting feeding practices among staff and healthy dietary behaviours for children aged 0–3 years in ECEC. Implementing new interventions often presents challenges. This study explores ECEC staff views and experiences with selected strategies for implementing an e-learning resource in ECEC centers in a municipality in Southern Norway. 

Methods: the study is a part of the Nutrition Now study, a hybrid type 1 non-randomized controlled trial. The implementation process followed the Dynamic Integrated Evaluation Model (DIEM). Implementation strategies were selected from the Expert Recommendations for Implementing Change (ERIC) project and included identify and prepare champions, conduct educational meetings, distribute educational materials, create a learning collaborative, and remind clinicians. ECEC teachers from participating ECEC centers in the intervention municipality were recruited as champions. Brief (5–7 min minutes), semi-structured phone interviews, covering key points, were conducted with the champions 8 times, evenly distributed over six months. The interviews were analysed using qualitative thematic analysis. 

Results: in total, 29 of the invited ECEC centers (53%) participated, and 260 brief interviews (88%) were conducted with champions (n = 37). An evaluation of the feedback from the champions suggests that the five selected implementation strategies were acceptable. Five main themes were developed by qualitative analysis: 1) Being a champion resembles what I already do. 2) Educational meetings are fine but take time. I prefer when peers share experiences. 3) Newsletters were helpful and reminded me, but I do not always have enough time to read. 4) Evaluations have increased my awareness, and we do them informally and formally. 5) The regular phone calls reminded me I could receive support and express my opinion. 

Conclusion: this study’s findings suggest that several implementation strategies are acceptable for stakeholders in an ECEC e-learning healthy eating intervention. However, time constraints among champions may hinder deep engagement. These results provide valuable insights into how the selected implementation strategies may function in practice and how they are perceived and experienced by the ECECs staff. Trial registration: Trial registration on June 6, 2022: ISRCTN10694967.

Text
Nutrition_Now_Paper_1_2024_12_19_ second revision - Accepted Manuscript
Available under License Creative Commons Attribution.
Download (265kB)
Text
s40795-024-00990-3 - Version of Record
Available under License Creative Commons Attribution.
Download (1MB)

More information

Accepted/In Press date: 30 December 2024
Published date: 13 January 2025
Keywords: Champion, Dynamic integrated evaluation model, Early childhood education and care, Expert recommendations for implementing change, Implementation strategies, Newsletters, Nutrition Now

Identifiers

Local EPrints ID: 499472
URI: http://eprints.soton.ac.uk/id/eprint/499472
PURE UUID: 397158a1-cb38-4881-acba-6aad6a6ebff2
ORCID for Mary Elizabeth Barker: ORCID iD orcid.org/0000-0003-2976-0217

Catalogue record

Date deposited: 20 Mar 2025 18:18
Last modified: 22 Aug 2025 01:39

Export record

Altmetrics

Contributors

Author: Henrik Lian
Author: Nina Cecilie Øverby
Author: Frøydis Nordgård Vik
Author: Anine Christine Medin
Author: Natalie Garzon Osorio
Author: Christine Helle
Author: Tormod Bjørkkjær
Author: Penelope Love
Author: Harry Rutter
Author: Elisabet Rudjord Hillesund
Author: Sissel Heidi Helland

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×