NUTRITION AND PHYSICAL ACTIVITY SELF-ASSESSMENT FOR CHILD CARE
(NAP SACC)
OVERVIEW
The Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) is a provider-based program that is implemented in child care centers. This program is designed to promote healthy weight development in preschool children by improving the nutritional quality of food served, amount and quality of physical activity, staff-child interactions, facility nutrition and physical activity policies and practices, and related environmental characteristics. NAP SACC includes a 5-step intervention to help facilitate gradual change and promote continuous quality improvement.
A randomized controlled study using a sample of child care health consultants and child care centers yielded non-significant results.
DESCRIPTION OF PROGRAM
Target
population: Preschool Children (ages 2 - 5 years) attending
NAP SACC is a provider-based program designed to promote healthy weight development in preschool children. The NAP SACC intervention consists of five steps: (1) self assessment, (2) action planning, (3) continuing education workshops, (4) technical assistance, and (5) re-assessment. This intervention is facilitated by trained child care health consultants. The consultants are required to complete three in-person training sessions that are three hours in length or web-based training which is approximately 124 minutes in length. During the self-assessment period, an assessment of the child care facility's strengths and limitations with regard to 14 areas of nutrition and physical activity policy is conducted.
The program costs are low. It includes the cost of hiring one health professional to work as a health consultant .0375 FTE (approximately 1 hour and 20 minutes per week) for 6 months. Each toolkit costs about $38 to create. Finally, funding must be allocated to: a) printing and copying costs; b) incentives for child care facilities such as gift cards for classroom supplies, books, balls, etc.; and (c) mileage reimbursement for travel to child care facilities.
EVALUATION(S) OF PROGRAM
Ward, Dianne
S., Benjamin, Sara E., Ammerman, Alice S., Ball,
Sarah C., Neelon, Brian H, Bangdiwala,
Evaluated population: The sample consisted of 84 child care centers.
Approach: The child care health consultants were randomized into intervention (n= 19) and control (n=10) groups. Approximately three child care centers were recruited from consultants' existing caseloads, yielding 84 eligible childcare centers (58 intervention, 26 control). During the intervention, two centers assigned to the intervention closed and were excluded from the study centers. In order to be eligible for the study the child care centers must have between 20-150 children enrolled at the time of the study, not be restricted to a special population, and have no open cases of abuse or neglect. The intervention centers had a slightly higher percentage of nonwhite children (40%) that the control centers (35%). Other than child race/ethnicity no other significant differences between intervention and control centers were present.
The Environment and Policy Assessment and Observation (EPAO) instrument was used to measure the primary outcome for this study (nutrition and physical activity scores). This instrument consists of a one day observation and review of center documents. From this instrument, 75 items were selected to evaluate. The item responses were converted to a three point scale (0, 1, and 2) and averaged within a subscale to represent nutrition and physical activity scores. Following this assessment, a child care health consultant worked with center staff to set goals and develop plans for follow-up actions to improve practice. The EPAO was administered by trained field observers before and immediately after implementation of the NAP SACC intervention (in the Fall of 2005 and the Spring of 2006).
Note: The evaluation study did not account for the fact that children were nested within child care centers. Thus, the findings should be interpreted with caution.
Results: Intervention centers demonstrated an 11% increase in average physical activity scores from pretest to posttest; however, this change was only marginally significant. No significant differences in children's nutrition was observed. Although the study did not yield significant results, positive change was noted for the intervention group compared with a negative change for the intervention group. In addition, the inclusion of non-participating centers in the intervention group (resulting from the ITT evaluation approach) may have diluted program impacts.
SOURCES FOR MORE INFORMATION
Link to program curriculum:
http://www.center-trt.org/index.cfm?fa=opinterventions.intervention&intervention=napsacc&page=intent
PDF describing various costs of NAP SACC: http://www.center-trt.org/downloads/obesity_prevention/interventions/napsacc/NAPSACC_Template.pdf
References:
Ammerman, Alice S., Ward, Dianne S., Benjamin, Sara E., Ball, Sarah C., Sommers, Janice K., Molloy, Meg, and Dodds, Janice M. (2007). An Intervention to Promote Healthy Weight: Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) Theory and Design. Preventing Chronic Disease, 4(3), 1-12.
Benjamin, Sara E., Neelon, Brian, Ball, Sarah C., Bangdiwala, Shrikant I., Ammerman, Alice S., and Ward, Dianne S. (2007). Reliability and Validity of a Nutrition and Physical Activity Environmental Self-Assessment for Child Care. International Journal of Behavioral Nutrition and Physical Activity, 4(29), PAGE NUMBERS?.
(2008). Nutrition and Physical Activity Self-Assessment for Child
Care (NAP SACC).
Ward, Dianne S.,
Benjamin, Sara E., Ammerman, Alice S., Ball, Sarah
C., Neelon, Brian H, Bangdiwala,
Program categorized in this guide according to the following:
Evaluated participant ages: n/a
Program age ranges in the guide: 2-5
Program components: Child Care, Provider-Based or Miscellaneous
Measured outcomes: Physical Health
KEYWORDS: Physical Health, Nutrition, Early Childhood (0-5), Child Care, Provider-Based or Miscellaneous.
Program information last updated on November 24, 2008.
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