NAP SACC UK: A feasibility cluster randomised controlled trial in child care settings to increase physical activity and healthy eating in 2-4 year olds

Lead investigator
Dr Ruth Kipping, University of Bristol

Nearly 10% of children aged 4 to 5 in England are obese and more than 13% are overweight. Obesity is more common in children from poorer backgrounds. However, we have little information about how to prevent young children becoming obese. It is recommended that pre-school children are physically active for at least 3 hours per day. Yet, only one third of 2 to 4 year olds are physically active for at least 60 minutes per day. Young children do not eat enough fruits and vegetables and most of their sugar intake is from soft drinks. It is important that care environments are healthy to reduce the risk of obesity. Over 3 million children attend some form of childcare in England. In England and Wales free childcare is available for children aged 3 to 4.

Aims & objectives
The Nutrition and Physical Activity Self Assessment for Child Care (NAP SACC) is an intervention delivered in childcare centres with the aim of improving policies, practices and the nutrition and physical activity environment, through a process of self-assessment and targeted assistance. We aim to answer the following research questions: • Can the NAP SACC childcare intervention from the US be adapted and developed for use in the UK? • Does the childcare intervention have the potential to increase healthy eating, increase physical activity and decrease sedentary time among 2-4 year old children in UK childcare provider settings? • Is it feasible to conduct a cluster RCT evaluation of NAP SACC in childcare providers in the UK and how should such a trial be designed?
Study design

This project has 2-phases.

Phase 1: Intervention adaptation and development.

We will adapt NAC SACC to the UK setting informed by focus groups with stakeholders (i. Childcare provider staff, ii. Health Visitors from North Somerset and Healthy Preschool Programme staff in Wales, iii. Local Authority staff) and interviews with parents. Changes will be piloted and feedback will be used to further refine the intervention before phase 2.

Phase 2: Pilot cluster RCT.

We will recruit 12 eligible childcare providers (6 in Cardiff, 6 in N Somerset). Six will be randomly assigned to receive the NAP SACC intervention which will take place over 6 months. Six will act as controls and not receive the intervention. Data will be collected at baseline and 12 months at both intervention and control settings.

Data collection will include:

  • Environmental audit of the child care provider
  • Child measurements of zBMI, food intake (CADET tool) and accelerometry measured physical activity/sedentary time
  • Process evaluation of the feasibility and acceptability of the intervention and trial methods using observations, logs and semi-structured interviews.
  • Costs to the public sector, child care providers and parents, intervention related resource use in the form of time and expenses.
Further information & publications
Start date
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