Implementation of a workplace physical activity intervention in child care: process evaluation results from the Care2BWell trial

2021 ◽  
Author(s):  
Cody D Neshteruk ◽  
Erik Willis ◽  
Falon Smith ◽  
Amber E Vaughn ◽  
Anna H Grummon ◽  
...  
Keyword(s):  
Physical Activity ◽  
Social Support ◽  
Health Promotion ◽  
Child Care ◽  
Process Evaluation ◽  
Physical Activity Intervention ◽  
Care Process ◽  
Child Care Workers ◽  
Self Monitoring ◽  
Care Workers

Abstract Care2BWell was designed to evaluate the efficacy of Healthy Lifestyles (HL), a worksite health promotion intervention to increase child care workers’ physical activity. The purpose of this study was to use process evaluation to describe the implementation of HL and determine if different levels of implementation are associated with changes in workers’ physical activity. Data were collected from 250 workers randomized to HL, a 6 month, multilevel intervention that included an educational workshop followed by three 8 week campaigns that included self-monitoring and feedback, raffle incentive, social support, and center director coaching. Process evaluation data collection included direct observation, self-reported evaluation surveys, website analytics and user test account data, tracking databases and semi-structured interviews. Implementation scores were calculated for each intervention component and compared at the center and individual levels. Nearly a third of workers never self-monitored and few (16%) met self-monitoring goals. Only 39% of centers engaged with the social support component as intended. Raffle and social support components were perceived as the least useful. Implementation varied widely by center (25%–76%) and individual workers (0%–94%). No within- or between-group differences for high compared to low implementation groups for change in physical activity were evident. Interview themes included limited sustainability, competing priorities, importance of social support, and desire for a more intensive, personalized intervention. Wide variation in implementation may explain limited effects on intervention outcomes. Future worksite interventions designed for child care workers can use these findings to optimize health promotion in this setting.

scholarly journals Results of Caring and Reaching for Health (CARE): A Cluster-Randomized Controlled Trial Assessing a Worksite Wellness Intervention for Child Care Staff

2020 ◽  
Author(s):  
Laura A Linnan ◽  
Amber E Vaughn ◽  
Falon Smith ◽  
Philip Westgate ◽  
Derek Hales ◽  
...  
Keyword(s):  
Physical Activity ◽  
Child Care ◽  
Health Behaviors ◽  
Care Staff ◽  
Worksite Wellness ◽  
Healthy Lifestyles ◽  
Child Care Workers ◽  
Workplace Health ◽  
Care Workers ◽  
Cluster Randomized

Abstract Background: Child care workers are among the lowest paid US workers and experience a wide array of health concerns. The physical and mental demands of their job and the lack of employer-provided health-insurance increase health risks. The Caring and Reaching for Health (CARE) study evaluated a 6-month Healthy Lifestyles intervention targeting child care workers’ physical activity (primary outcome), other health behaviors, and their workplace health environment. Methods: Eligible child care centers, defined as being in operation for at least two years and employing at least four staff, were enrolled into CARE’s cluster-randomized trial. Centers and their child care staff were randomly assigned to either the Healthy Lifestyles (HL) intervention arm or the Healthy Finances (HF) attention control arm using a block randomization approach. Intervention components were delivered through in-person workshops, center-level displays, informational magazines, director coaching, electronic messaging, and an interactive website. Outcome measures were collected during center visits at baseline and immediately post-intervention by trained data collectors blinded to center arm assignment. Workers’ physical activity was assessed with accelerometers, worn for seven days. Secondary outcome measures included biometric assessments of health and fitness, web-based surveys about health behaviors, and an environmental audit of workplace supports for health. Multi-level linear mixed models assessed worker- and center-level changes in these outcomes. Results: Participants included 553 child care workers representing 56 centers (HL=250 staff/28 centers, HF=303 staff/28 centers). At six months, moderate-to-vigorous physical activity declined slightly in both arms (-1.3 minutes/day, 95% CI: -3.0, 0.3 in HL; -1.9 minutes/day, 95% CI: -3.3, -0.5 in HF), but there was no significant group by time interaction. Several secondary outcomes for other health behaviors and workplace health environment showed improvements in favor of the intervention arm, yet differences did not remain statistically significant after adjustment for multiple comparisons. Conclusions: While the Healthy Lifestyles intervention did not improve health behaviors or the workplace health environment, results confirmed the pressing need to focus on the health of child care workers. Future interventions should focus on prevalent health issues (e.g., weight, stress), include both high-tech and high-touch intervention strategies, and address work conditions or other social determinants of health (e.g. wages) as a means of improving the health of these essential workers. Trial Registration: Care2BWell: Worksite Wellness for Child Care (NCT02381938)

scholarly journals Results of Caring and Reaching for Health (CARE): A Cluster-Randomized Controlled Trial Assessing a Worksite Wellness Intervention for Child Care Staff

2020 ◽  
Author(s):  
Laura A Linnan ◽  
Amber E Vaughn ◽  
Falon Smith ◽  
Philip Westgate ◽  
Derek Hales ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Child Care ◽  
Health Behaviors ◽  
Care Staff ◽  
Healthy Lifestyles ◽  
Child Care Workers ◽  
Workplace Health ◽  
Care Workers ◽  
Cluster Randomized

Abstract Background: Child care workers are among the lowest paid US workers and experience a wide array of health concerns. The physical and mental demands of their job and the lack of employer-provided health-insurance increase health risks. The Caring and Reaching for Health (CARE) study evaluated a 6-month Healthy Lifestyles intervention targeting child care workers’ physical activity (primary outcome), other health behaviors, and their workplace health environment. Methods: Eligible child care centers, defined as being in operation for at least two years and employing at least four staff, were enrolled into CARE’s cluster-randomized trial. Centers and their child care staff were randomly assigned to either the Healthy Lifestyles (HL) intervention arm or the Healthy Finances (HF) attention control arm using a block randomization approach. Intervention components were delivered through in-person workshops, center-level displays, informational magazines, director coaching, electronic messaging, and an interactive website. Outcome measures were collected during center visits at baseline and immediately post-intervention by trained data collectors blinded to center arm assignment. Workers’ physical activity was assessed with accelerometers, worn for seven days. Secondary outcome measures included biometric assessments of health and fitness, web-based surveys about health behaviors, and an environmental audit of workplace supports for health. Multi-level linear mixed models assessed worker- and center-level changes in these outcomes. Results: Participants included 553 child care workers representing 56 centers (HL=250 staff/28 centers, HF=303 staff/28 centers). At six months, moderate-to-vigorous physical activity declined slightly in both arms (-1.3 minutes/day, 95% CI: -3.0, 0.3 in HL; -1.9 minutes/day, 95% CI: -3.3, -0.5 in HF), but there was no significant group by time interaction. Several secondary outcomes for other health behaviors and workplace health environment showed improvements in favor of the intervention arm, yet differences did not remain statistically significant after adjustment for multiple comparisons. Conclusions: While the Healthy Lifestyles intervention did not improve health behaviors or the workplace health environment, results confirmed the pressing need to focus on the health of child care workers. Future interventions should focus on prevalent health issues (e.g., weight, stress), include both high-tech and high-touch intervention strategies, and address work conditions or other social determinants of health (e.g. wages) as a means of improving the health of these important workers.

scholarly journals Results of Caring and Reaching for Health (CARE): A Cluster-Randomized Controlled Trial Assessing a Worksite Wellness Intervention for Child Care Staff

2019 ◽  
Author(s):  
Laura A Linnan ◽  
Amber E Vaughn ◽  
Falon Smith ◽  
Philip Westgate ◽  
Derek Hales ◽  
...  
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Child Care ◽  
Health Behaviors ◽  
Care Staff ◽  
Healthy Lifestyles ◽  
Child Care Workers ◽  
Workplace Health ◽  
Care Workers ◽  
Cluster Randomized

Abstract BackgroundChild care workers are among the lowest paid US workers and experience a wide array of health concerns. The physical and mental demands of their job and the lack of employer-provided health-insurance increase health risks. The Caring and Reaching for Health (CARE) study evaluated a 6-month Healthy Lifestyles intervention targeting child care workers’ physical activity (primary outcome), other health behaviors, and their workplace health environment.MethodsEligible child care centers, defined as being in operation for at least two years and employing a least four staff, were enrolled into CARE’s cluster-randomized trial. Centers and their child care staff were randomly assigned to either the Healthy Lifestyles (HL) intervention arm or the Healthy Finances (HF) attention control arm using a block randomization approach. Outcome measures were collected during center visits at baseline and immediately post-intervention by trained data collectors blinded to center arm assignment. Workers’ physical activity was assessed with accelerometers, worn for seven days. Secondary outcome measures included biometric assessments of health and fitness, web-based surveys about health behaviors, and an environmental audit of workplace supports for health. Multi-level linear mixed models assessed worker- and center-level changes in these outcomes.ResultsParticipants included 553 child care workers representing 56 centers (HL=250 staff/28 centers, HF=303 staff/28 centers). At six months, moderate-to-vigorous physical activity declined slightly in both arms (-1.3 minutes/day, 95% CI: -3.0, 0.3 in HL; -1.9 minutes/day, 95% CI: -3.3, -0.5 in HF), but there was no significant group by time interaction. Several secondary outcomes for other health behaviors and workplace health environment showed improvements in favor of the intervention arm, yet differences did not remain statistically significant after adjustment for multiple comparisons.ConclusionsWhile the Healthy Lifestyles intervention did not improve health behaviors or the workplace health environment, results confirmed the pressing need to focus on the health of child care workers. Future interventions should focus on prevalent health issues (e.g., weight, stress), include both high-tech and high-touch intervention strategies, and address work conditions or other social determinants of health (e.g. wages) as a means of improving the health of these important workers.

Child care workers’ perception of job worth

1991 ◽  
Vol 68 (1) ◽  
pp. 133-140 ◽  
Author(s):  
Pauline Davey Zeece ◽  
Robert W. Fuqua
Keyword(s):  
Child Care ◽  
Child Care Workers ◽  
Care Workers

Selection and Training of Child-Care Workers

1969 ◽  
Vol 20 (8) ◽  
pp. 227-229
Author(s):  
John B. Mordock ◽  
Henry Platt
Keyword(s):  
Child Care ◽  
Child Care Workers ◽  
Care Workers ◽  
And Training

scholarly journals What Happened in ‘The HERizon Project’?—Process Evaluation of a Multi-Arm Remote Physical Activity Intervention for Adolescent Girls

2022 ◽  
Vol 19 (2) ◽  
pp. 966
Author(s):  
Emma S. Cowley ◽  
Lawrence Foweather ◽  
Paula M. Watson ◽  
Sarahjane Belton ◽  
Andrew Thompson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Process Evaluation ◽  
Adolescent Girls ◽  
Physical Activity Intervention ◽  
Self Report ◽  
Group Facilitation ◽  
Online Social Media ◽  
Group Data ◽  
Group A ◽  
Combined Intervention

This mixed-methods process evaluation examines the reach, recruitment, fidelity, adherence, acceptability, mechanisms of impact, and context of remote 12-week physical activity (PA) interventions for adolescent girls named The HERizon Project. The study was comprised of four arms—a PA programme group, a behaviour change support group, a combined group, and a comparison group. Data sources included intervention deliverer and participant logbooks (100 and 71% respective response rates, respectively), exit surveys (72% response rate), and semi-structured focus groups/interviews conducted with a random subsample of participants from each of the intervention arms (n = 34). All intervention deliverers received standardised training and successfully completed pre-intervention competency tasks. Based on self-report logs, 99% of mentors adhered to the call guide, and 100% of calls and live workouts were offered. Participant adherence and intervention receipt were also high for all intervention arms. Participants were generally satisfied with the intervention components; however, improvements were recommended for the online social media community within the PA programme and combined intervention arms. Autonomy, sense of accomplishment, accountability, and routine were identified as factors facilitating participant willingness to adhere to the intervention across all intervention arms. Future remote interventions should consider structured group facilitation to encourage a genuine sense of community among participants.

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