Before we started this current study, we carried out a smaller one to see if it was feasible and acceptable to use the American programme called NAP SACC (Nutrition And Physical Activity Self Assessment for Child Care). The programme was changed by adding oral health and making the food and activity recommendations the same as UK standards. A website was also developed for parents to make changes at home. Six nurseries were randomly chosen to deliver NAP SACC UK and six continued as usual to provide measurements as a ‘control group’. Health Visitors helped nursery managers to look at what they did at nursery and to set goals to improve physical activity, nutrition and oral health. Nursery staff attended workshops on these topics, led by local experts. We took measurements from 168 children aged 2–4 years. We evaluated the programme over 5 months to check if it was delivered as we hoped it would be and if the staff and parents were happy with it.
We found that the programme and methods we used were acceptable to most nursery staff, health visitors and parents. Five out of the six nurseries using NAP SACC UK followed the programme as we hoped they would (one did not because of staff capacity for out-of-hours training). Health Visitors liked the programme but were concerned that they would not have the time to work with nurseries. The study was small, so we couldn’t be sure whether or not it improved children’s health, but it may help to increase physical activity and reduce snacks, overweight and watching television at home. We are now testing this fully in the current, larger trial.
Feasibility trial publications
Child-care self-assessment to improve physical activity, oral health and nutrition for 2- to 4-year-olds: a feasibility cluster RCT. Kipping R, Langford R, Brockman R, Wells S, Metcalfe C, Papadaki A, White J, Hollingworth W, Moore L, Ward D, Campbell R, Kadir B, Tinner L, Er V, Dias K, Busse H, Collingwood J, Nicholson A, Johnson L, Jago R. Southampton (UK): NIHR Journals Library; 2019 Jul.
A physical activity, nutrition and oral health intervention in nursery settings: process evaluation of the NAP SACC UK feasibility cluster RCT. Langford R, Jago R, White J, Moore L, Papadaki A, Hollingworth W, Metcalfe C, Ward D, Campbell R, Wells S, Kipping R. BMC Public Health. 2019 Jul 3;19(1):865. doi: 10.1186/s12889-019-7102-9.
Cross-sectional analysis of physical activity in 2-4-year-olds in England with paediatric quality of life and family expenditure on physical activity. Tinner L, Kipping R, White J, Jago R, Metcalfe C, Hollingworth W. BMC Public Health. 2019 Jun 28;19(1):846. doi: 10.1186/s12889-019-7129-y.
Acceptability, internal consistency and test-retest reliability of scales to assess parental and nursery staff’s self-efficacy, motivation and knowledge in relation to pre-school children’s nutrition, oral health and physical activity. Dias K, White J, Metcalfe C, Kipping R, Papadaki A, Jago R. Public Health Nutr. 2019 Apr;22(6):967-975. doi: 10.1017/S1368980018004111. Epub 2019 Feb 14.
Association of diet in nurseries and physical activity with zBMI in 2-4-year olds in England: a cross-sectional study. Er V, Dias KI, Papadaki A, White J, Wells S, Ward DS, Metcalfe C, Jago R, Kipping R. BMC Public Health. 2018 Nov 14;18(1):1262. doi: 10.1186/s12889-018-6138-6.
NAP SACC UK: protocol for a feasibility cluster randomised controlled trial in nurseries and at home to increase physical activity and healthy eating in children aged 2-4 years. Kipping R, Jago R, Metcalfe C, White J, Papadaki A, Campbell R, Hollingworth W, Ward D, Wells S, Brockman R, Nicholson A, Moore L. BMJ Open. 2016 Apr 6;6(4):e010622. doi: 10.1136/bmjopen-2015-010622.