Table 2 NAPSACC UK TIDieR framework outlining the intervention details

Name

Nutrition and Physical Activity Self-Assessment for Child Care UK (NAP SACC UK)

Why

NAP SACC UK is an intervention delivered in childcare settings with the aim of improving the nutrition and physical activity environment, through a process of self-assessment and targeted assistance. NAP SACC UK is a theory-based programme that employs components of social cognitive theory (SCT) and the socio-ecological framework. The objectives of the programme are to improve the nutritional quality, variety and quantity of food served, amount and quality of physical activity, staff-child interactions and staff behaviours around nutrition and physical activity and childcare provider policies.

What: materials

The NAP SACC UK intervention is based around a self-assessment tool (the ‘Review & Reflect’) completed by nursery managers with advice and support from a NAP SACC UK Partner. This is a 100-item multiple choice questionnaire, completed by the nursery manager, covering areas in nutrition, physical activity and play, outdoor play and learning, and screen time. Following completion of the ‘Review & Reflect’, the nursery manager along with the NAP SACC UK Partner agree on eight goals: three nutrition, three physical activity and a further two of the nursery’s choice.

What: procedures

The NAP SACC UK intervention is a five-stage process:

1. Self-Assessment.

2. Workshop delivery: Specialised staff deliver workshops to all nursery staff on: i) Nutrition; ii) Physical Activity.

3. Goal setting and Action Planning: The NAP SACC UK Partner works with the nursery manager to develop an action plan, listing eight goals for improvement.

4. Tailored technical assistance: NAP SACC UK Partner continues regular contact with nursery to provide support and advice toward them meeting their goals.

5. Evaluate, revise, repeat. The ‘Review & Reflect’ self-assessment is repeated by the nursery manager after 6 months and reviewed with the NAP SACC UK Partner to see where improvements have been made or not, and to explore ways to overcome barriers; action plans are revised to set eight new goals for the next 6 months.

Who provided

Within each local authority, NAP SACC UK Partners who deliver the nursery workshops will be chosen from a range of health or health improvement staff with appropriate skills. All staff will be provided with 1 day of training led by specialists in nutrition and physical activity who provided the training in the feasibility study.

How

The main part of the intervention will be delivered face to face; this includes NAP SACC UK Partners going through the ‘Review & Reflect’, action planning and delivering the workshops. Other parts of the intervention, such as on-going support and advice from the NAP SACC UK Partner can be provided over the phone, by email or face to face. All parts of the intervention will be delivered to participating nurseries individually. Some parts may be delivered on a one-to-one basis (e.g. nursery manager and NAP SACC UK Partner setting goals), while other parts such as the workshops will be delivered to a group of staff from one nursery. NAP SACC UK Partners will have 4 days contact with each nursery over the 12 months.

Where

The NAP SACC UK intervention is delivered in the nursery itself. The NAP SACC UK Partner offers visits to the nursery and the workshops take place at the nursery.

When and how much

The NAP SACC UK intervention takes place over 12 months. The length of the workshops are a total of 6 h, followed by a 2 h workshop after 6 months. The nurseries receive ongoing regular support over the 12 months.

Tailoring

The technical assistance offered by the NAP SACC UK Partner will depend on the goals.

Modifications

In the feasibility study the intervention was 5 months; in the full trial it will be 12 months. NAP SACC was designed in the US to be for a year and this longer period enables a mid-intervention review of progress against goals and further goals to be sets. In the feasibility study the NAP SACC UK Partners were Health Visitors; in the full trial Local Authorities will chose appropriate health staff.