Adapting the Nutrition and Physical Activity Self-Assessment: A cross-country case study of improving early childhood health environments in the United States, Australia, and the United Kingdom

Falon Tilley*, Ruth R Kipping, Serene Yoong, Kimberly Hannam , Rebecca Langford, Courtney Barnes, Jemima Cooper, Miranda Pallan, Melanie Lum, Derek Hales, Regan Burney, Michelle Herr, Erik Willis

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

25 Downloads (Pure)

Abstract

Background:
Child overweight and obesity is a critical global health issue with substantial individual and societal impacts necessitating early intervention to establish healthy habits. Health promoting early childhood education (ECE) settings are important as most young children attend ECEs in high- and middle-income countries. Nutrition and Physical Activity Self-Assessment for Child Care (NAPSACC) is an evidence-based approach to support improvements to ECE environment for improving child health. While adapting proven child obesity prevention interventions from other countries offers efficiency, the process is frequently underreported and insufficiently documented.

Methods:
Guided by the ADAPT framework, this article describes the adaptation of NAPSACC in the United States (US), Australia (AU), and the United Kingdom (UK) from 2012 to 2023. Contextual differences in ECE systems in the US, AU, and UK and reflections on the process of adaptation were explored.

Results:
NAPSACC was successfully adapted, maintaining core theoretical components while allowing for implementation flexibility to meet varying contexts. The iterative adaptation process revealed that a flexible dynamic approach was essential for maintaining the relevance and effectiveness of the NAPSACC intervention in different contexts.

Conclusions:
Our experience highlights the importance of ongoing iteration, international collaboration, research, and responsiveness to evolving circumstances in adaptation processes. Strong and flexible leadership, such as that demonstrated by NAPSACC’s founder, Dr. Dianne S. Ward, facilitates successful adaptation and continuous improvement of public health programs.
Trial registration: This paper includes multiple registered trials - NCT02889198, ACTRN12619001158156, ISRCTN16287377, and ISRCTN33134697
Original languageEnglish
Pages (from-to)200-212
Number of pages13
JournalChildhood Obesity
Volume21
Issue number3
Early online date11 Mar 2025
DOIs
Publication statusE-pub ahead of print - 11 Mar 2025

Bibliographical note

Publisher Copyright:
Copyright 2025, Mary Ann Liebert, Inc., publishers.

Fingerprint

Dive into the research topics of 'Adapting the Nutrition and Physical Activity Self-Assessment: A cross-country case study of improving early childhood health environments in the United States, Australia, and the United Kingdom'. Together they form a unique fingerprint.

Cite this