Progress 01/01/22 to 12/31/24
Outputs
Target Audience:During the three-year project, Changing the Culture of Health, we reached the specific target audiences outlined in our proposal, through efforts that were also described in the proposal. Using community engaged research practices, we collaborated with our community partners in the design and implementation of the "HEART at Head Start" intervention and trained the next generation of agriculture and nutrition leaders by actively engaging graduate and undergraduate students in all phases of the research. We reached these audiences consistently throughout the project with efforts detailed below. We reached the following target audiences during the project: -Graduate and undergraduate students (50 students): through our directed seminar, we reached graduate students with hands-on experiential education opportunities over five semesters. For four semesters, we offered a directed seminar that combined formal classroom education with hands on experiential learning opportunities and outreach to the community. Graduate students participated in formative data collection, literature reviews, and supported the design and distribution of the National Health and Wellness Survey; in trainings, data collection, cleaning and analysis during the randomized control trial (RCT), HEART at Head Start; and with dissemination of findings through co-authorship and a poster presentation at a SNEB Conference (2024). We piloted one semester of an inter-disciplinary independent study, working with a graduate student who analyzed data and presented a paper for a public health practicum. In addition to the directed seminar and independent study, we hired 29 graduate and undergraduate students as research assistants, data collectors and data analysts throughout the study. These students, from disciplines including Nutrition, Public Health, Medicine and Community Health, gained experiential education while working on the study. -Head Start educators: (3024 educators) We worked closely with our partners at the National Head Start Association to reach Head Start educators (teachers and assistant teachers) throughout the project. We gathered formative data from Head Start directors and educators during year 1 of the project (18 educators); fielded the first National Health and Wellness Survey during year 2 (2,661 educators); and conducted a Randomized controlled trial (RCT) -- HEART at Head Start -- during year 3 (92 educators in Greater Boston). Additionally we presented information about the research study at the ABCD Head Start CityWide Conferences (February, August, 2023), which includes all Head Start educators within the organization (253). -National Head Start Association and ABCD Head Start leadership (15 people): Over the course of three years, we held monthly meetings with the NHSA, including their Research Committee; and ABCD Head Start managers and leadership. These meetings served to inform several aspects of the study such as the topics to include in the national survey, interpretation and dissemination of findings, approach to designing the RCT, identifying Head Start educators for pilot testing the RCT, contextualizing the findings, etc. -Colleagues and professionals in the field: through conferences, workshops and presentations (both in person and virtual) we shared findings from our study over a period of three years: Tufts University Excellence in Learning Conference (July 2023); the Society for Nutrition Education and Behavior (SNEB) Conferences (2023, 2024); ChildObesity180 Team meeting (February 2024); the ISBNPA Conference in Omaha, Nebraska (May, 2024); the National Head Start Association National Conference in Portland Oregon (April, 2024); the NOPREN ECE Workplace Wellness subcommittee (September 2024). Changes/Problems:Throughout the study, we received guidance from our partners (NHSA and ABCD Boston) and from the findings of our National Health and Wellness Survey which helped ensure that our focus was aligned with the interests and concerns of Head Start educators. Based on this information, the focus of our intervention evolved from individual weight loss through a center-based intervention, to a more expansive emphasis on healthy lifestyle and wellness goals (healthy eating, physical activity, sleep/relaxation) for early childhood educators (ECE). During year 1, we experienced time delays based on Head Start ECE schedules and availability for formative data collection interviews. The development of the National Health and Wellness Survey required additional planning and pilot testing, which delayed our launch by a few months. We offered the National Health and Wellness Survey (NHWS) in both English and Spanish, based on guidance from our partners and findings from the PIR data regarding the two most prominent languages spoken by teachers/assistant teachers. Additionally, we opted to provide the NHWS as a completely online survey (only) to decrease the burden on potential participants. During year 2, we experienced a setback when our named advisor, Dr. Dianne S. Ward from UNC Chapel Hill, passed away unexpectedly. Additionally, we experienced changes in our study timeline. We had planned an 8-week field period for the NHWS, and we were excited to reach the target completes within two weeks of the start date. Responses from the NHWS informed the development of the HEART at Head Start Randomized Control Trial (RCT) intervention, which launched in late 2023. Due to time spent negotiating contracts and guidance from our community partners, recruitment for the RCT was delayed by three months; we sent out invitation emails in December 2023. This positioned us to run the RCT through end of October 2024, including both our intervention and delayed intervention cohorts with limited time for analysis and synthesis. Additionally, by delaying the implementation date for the HEART at Head Start we could better reflect the school year for Head Start/Early Head Start and make it easier for us to maintain continuity with our cohorts (intervention and control). During year 3, we experienced challenges with recruitment and enrollment of Head Start educators in HEART at Head Start RCT. While we recruited 92 participants (target recruitment was 100 participants - 50 Intervention, 50 Control), only 48 participated in baseline Health Fairs. Our community partner (ABCD Head Start) indicated that they experienced similar challenges in recruiting participants in health and wellness initiatives and research studies. We were unable to obtain health care and absenteeism data from our community partner (ABCD Head Start) within the timeframe of the study. We note that this might be a fruitful area for future research. Additionally, our shortened RCT timeline compressed the timeline for data cleaning and analysis. We plan to continue analyses and dissemination of findings through conferences and peer-reviewed journals in the next few months. What opportunities for training and professional development has the project provided?The research study, Changing the Culture of Health, was designed to center training and professional development, primarily for nutrition and agricultural policy graduate students - the next generation of professionals. Beginning in Y1, we provided multiple opportunities for training and professional development. During Spring and Fall 2022, the PI led a directed seminar, open to all graduate level students at the Friedman School. The 7 students who enrolled worked directly with our team of investigators, our partners at NHSA and ABCD Boston, our content advisors and other content area experts. In addition to student-led research and discussions, students participated in workshops about best practices in community engaged research as part of the seminar. All students worked directly with researchers, consultants, subject area experts and other students as part of their coursework. They conducted data collection and informal interviews with Head Start and Early Head Start educators; and presented their findings to the rest of the research team. The students received feedback on their work from our investigator team at the end of the semester. Additionally, our research team worked with the Tufts Institute for Global Obesity Research (TIGOR) summer internship program and provided professional training to a graduate student who worked with us full time. We hired 3 students as research assistants who learned and worked on the research study. In Y2 we continued to provide opportunities for training and professional development for the graduate students in nutrition and agricultural policy. In Fall 2023, the PI led a directed seminar, open to all graduate level students at the Friedman School. The 6 students who enrolled, plus our student Teaching Assistant (TA), gained hands-on experience working directly with the investigator team and our partners at NHSA and ABCD Head Start on intervention design and preparing to launch the RCT in Y3. Their work included research into ABCD Head Start classroom practices (through interviews with leadership and site visits); formative data collection with teachers to test the health and wellness app which is central to the intervention design; literature reviews; classroom discussion and reflection; and training in skills needed for the intervention launch. In the Fall of 2023, all study team members as well as students in the directed seminar received 14 hours of training in Motivational Interviewing from a certified trainer; and training in conducting Dietary Intake interviews from one of the investigators. Additionally, we offered research assistant positions to 3 students to support the analysis of the NHWS data; seminar design and implementation; and the intervention design and implementation plans. One Research Assistant, who also worked as a TA for the directed study in Fall 2023, co-presented a workshop at the Tufts University-wide Conference on Teaching and Learning in July 2023 about the directed seminar, which provided professional development. During Y3 we provided training and professional development opportunities for a wide range of nutrition and agricultural students to enhance their understanding of best practices in community engaged research and policy implications. In Spring 2024, our PI led a graduate level directed seminar, open to all students at the Friedman School. Enrolled students and the student Teaching Assistant gained skills and hands-on field experience through direct involvement in the HEART at Head Start RCT health fairs. Students received training and collected anthropometric data - height, weight, blood pressure; conducted finger prick blood samples and used the Cholestech machine to obtain results for non-fasting blood cholesterol and glucose levels. Students also received training and conducted 24-hour dietary recall with participants. At the end of each day of data collection at the Health Fairs, students participated in debriefings to identify challenges and successes and prepare for the next day of data collection. Students received training and entered Health Fair data in Qualtrics as well as 24-hour dietary recall data in the ASA24 system. In Fall, 2024, our PI led an interdisciplinary independent study with a student who is earning her MS in Nutrition and her MPH degree simultaneously. The student worked with dietary recall data, creating a presentation to address her public health competencies. Additional students worked as part of the study team - one student tracked and analyzed the monthly Wellable engagement data, three students analyzed 24-hour dietary recall data, and seven students logged Guide calls, and transcribed the qualitative data. Additionally, two research assistants received training in qualitative coding techniques by a faculty member who created a codebook, and the RAs were responsible for coding qualitative data. One student designed and presented a poster at the SNEB Conference (2024) and other students assisted in writing and dissemination of findings through informal and formal presentations. How have the results been disseminated to communities of interest?Throughout the study, we have disseminated results to communities of interest in a variety of ways. We shared our results from developing the Directed Study with interested educators by presenting at the Tufts University-wide Conference on Teaching and Learning in July 2023. The project manager and a student research assistant co-presented a hands-on workshop about student-led, experiential learning in a hybrid format. The workshop attracted educators from across the University to discuss innovative, experiential based teaching methods and ways to fully engage students in the teaching and learning process. We disseminated information about the study (February 2023) and early findings from the National Health and Wellness Survey to educators at ABCD Head Start through a presentation at their semi-annual CityWide event (August 2023). A co-investigator presented a poster at the SNEB Conference (July 2023), highlighting our goals and milestones in the project. The Senior Program Manager and ABCD Head Start Health Services Manager disseminated findings from the National Health and Wellness Survey in a workshop at the National Head Start Association National Conference in April 2024. A co-investigator presented findings from the National Health and Wellness Survey at the ISBNPA Conference in May 2024. A nutrition/agriculture PhD candidate presented an update on findings from the National Health and Wellness Survey and further research study progress in a poster at the SNEB Conference in July 2024. The Senior Program Manager presented preliminary findings from HEART at Head Start to the NHSA research committee in November 2024. Members of the study team shared information with colleagues through participation in the NOPREN subcommittee for Early Childhood Educators (ECE) workplace wellness committee meetings throughout the study, and a presentation in October 2024. The Senior Program Manager and other study team members met regularly with partners at the National Head Start Association and ABCD Head Start to share progress and lessons learned. The Senior Program Manager and other study team members shared progress with the Tufts Friedman community through community team meetings and informal conversations. We have shared findings with the National Head Start Association leadership and ABCD Head Start leadership, as well as graduate students at the Friedman School through presentations. We submitted a manuscript for peer-reviewed publication (Childhood Obesity) sharing findings from the NHWS. Two other manuscripts are in progress, along with submission of an abstract for dissemination at 2025 Conferences (American Society of Nutrition, National Head Start Association.) What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
The project, Changing the Culture of Health, was designed to improve the health and well-being of early childcare educators (ECE) by developing, implementing, and evaluating an integrated workplace wellness program at diverse Head Start centers; while simultaneously incorporating experiential educational and training opportunities for future nutrition and agriculture professionals. In collaboration with the National Head Start Association (NHSA) our study team accomplished milestones in each of our three aims during the study: Aim 1 - Over the course of the study, we developed, delivered and evaluated an innovative graduate-level trainee course with an experiential education component for 17 students in the nutrition and agriculture policy track. We worked closely with a consultant from the Tufts Center for Excellence in Learning and Teaching (CELT), who has served as an advisor in all phases of the seminar development, supporting us in incorporating online education and hands-on training for graduate level students. Students were active and integral participants in every phase of the study, from design of the experiential education component, through the National Health and Wellness Survey (NHWS) and the design, implementation and evaluation of our RCT, HEART at Head Start. They engaged with community partners, conducted literature reviews, attended trainings, synthesized information and presented it to the researcher team, and attended an intensive weekend training in Motivational Interviewing in preparation for their role as data collectors during the RCT. During the RCT, 33 additional students participated in data collection at all Health Fairs, including conducting interviews, collecting biometric data and entering data into databases. Students participated in data cleaning and analysis of all collected data and provided feedback to study team leadership about the strengths and opportunities to improve the seminar. Aim 2 - Over the course of the study, the development of an innovative workplace wellness health and wellness program for Head Start educators encompassed many phases. We began by conducting formative research with Head Start educators to clarify the health and wellness concerns that were most critical to them, and that they were most eager to address. In spring 2023, we fielded a web-based National Health and Wellness Survey (NHWS) of Head Start teachers (estimated completion time was 10 minutes). Using a national list of emails of Head Start licensees provided by our partner, the National Head Start Association (NHSA), we contacted half the randomly selected licensees with a request to share information about the upcoming Health and Wellness Survey with teachers in their programs. The NHSA also forwarded our recruitment emails to teachers on the NHSA membership roster. In accordance with our incentive budget ($25 per survey response), we targeted 2,500 survey completes. Our anticipated field period was eight weeks, which included one invitation email and two reminder emails. In the event we did not reach the target completes, we planned to deploy the second half (reserve) sample and repeat the procedures until we reached our goal. By the end of the second week, we had exceeded our goal of completed surveys and closed the survey; we did not send any reminder emails. We received more than 2661 responses from a diverse group of Head Start and Early Head Start educators from all 50 states and territories. The novel design of HEART at Head Start, detailed in Aim 3, addressed what we learned from the NHWS: high teacher interest in having flexibility and independent access to health and wellness resources, while providing opportunities for guidance and knowledge about behavior change theory. For this aim, our accomplishments demonstrated that our research team gained new knowledge, enabling them to shape the design and implementation of the RCT. Aim 3 - In year 3, we utilized the results from the National Health and Wellness Survey and formative interviews from Head Start educators to design and implement the Healthy Eating Activity Relaxation Trial (HEART) at Head Start Randomized Controlled Trial (RCT) at ABCD Head Start in the greater Boston area. Findings from the NHWS guided us to focus on themes of nutrition, physical activity and sleep/relaxation rather than on weight loss to better align with teachers' needs and interests; confirmed that an onsite or outside of work hours intervention would align with teachers' availability if it was delivered digitally and flexibly, with autonomy for participants; and demonstrated the potential impact of an intervention that combined opportunities for engagement and education with support from a trained guide or coach to work towards individual goals. Based on these findings, HEART at Head Start was designed to provide participants with two distinct elements: free, unlimited access to a commercially available health and wellness app, which could be downloaded onto mobile phones or accessed via the web; and free, unlimited access to a trained Tufts Guide who worked closely with each participant to facilitate their goal setting in an area of their choosing (healthy eating, physical activity, or sleep hygiene) and support their efforts towards these goals. App Users received access to a wide range of health and wellness resources, webinars, and specialized coaching, in addition to having the option to track their physical activity and special activities within the app. All eligible participants were invited to attend up to three health fairs (baseline, 6 months after baseline and 9 months after baseline). We recruited 92 Head Start educators from a pool of 253. Baseline Health Fairs were scheduled at Head Start centers in the Boston area and included collection of height, weight, blood pressure, and glucose and lipids (from a finger prick) along with participant completed health behavior survey and an interviewer administered dietary intake interview. Data collection activities took approximately 45 minutes per participant. All participants received a $50 e-gift card and a copy of their anthropometric measures, blood pressure, as well as non-fasting blood lipid and glucose levels. Following the baseline Health Fair, 48 teachers were randomized, at the Head Start center level, into intervention (n = 28) and control/delayed intervention (n = 20) cohorts. Participants in the intervention cohort received free unlimited access to a health and wellness app (Wellable) for up to nine months and regular Zoom calls with a guide trained in Motivational Interviewing techniques for up to six months. Control cohort received access to Wellable and Guides after the six-month health fair for up to three months. With participant consent, usage data were collected from the Wellable app; and Zoom calls with the trained guides were recorded and transcribed. At six months, participating teachers were invited to a second Health Fair where all measures were repeated to create pre and post measurements for each participant in the longitudinal cohort. Trained graduate and undergraduate students collected data at the Health Fairs and worked with the research team to enter, clean and analyze data. Motivational Interviewing trained graduate students served as guides for teacher participants, recording Zoom calls and providing support for participant-led behavior change. All aspects of the intervention were tracked, and data were collected and cleaned. Analysis is ongoing.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2024
Citation:
Changing the Culture of Health at Head Start: Combining research and education to create and test a sustainable, scalable wellness program for Head Start educators - Year 2 report
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2023
Citation:
Unlearning the Learning Environment: A Virtual Experiment in Student-Centered Learning in a Professor-led academic setting - A Workshop
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2024
Citation:
Healthy teachers, healthy children: insights about ECE wellness from a 2023 national survey
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2023
Citation:
Changing the Culture of Health at Head Start: Combining research and education to create and test a sustainable, scalable wellness program for Head Start educators - Year 1 report
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2024
Citation:
Research to Impact: Engaging Head Start Educators in Designing a Workplace Wellness Program
|
Progress 01/01/23 to 12/31/23
Outputs
Target Audience:In Y2, we reached the following members of the target audiences outlined in our proposal: 10 graduate students: Through one semester of our directed seminar, we enrolled 6 graduate students from the Friedman School of Nutrition Science and Policy in a hands-on experiential learning experience. Additionally, we offered research assistant positions to 4 graduate students and a teaching assistant position during the year. 250 Head Start educators: Dr. Christina Economos (PI), presented information about the research study and some early findings from the National Health and Wellness Survey to a diverse coalition of Head Start educators at a CityWide event in Boston, hosted by ABCD Head Start (August 2023). 25 Tufts University professors and instructors: Through a hybrid workshop presentation at the Tufts University-wide Excellence in Learning Conference (July 2023) about student-centered learning and experiential education, providing insights about our project implementation and outcomes to other educators at the University. 2,500 Head Start teachers: Through participation in our National Health and Wellness (online) Survey. 5 Head Start teachers: Through pilot testing of the Health and Wellness App, including weekly phone calls for qualitative feedback. National Head Start Association (NHSA) and ABCD Head Start leadership: through regular meetings and updates about the state of our research study throughout the year. Attendees at SNEB Conference: Reached fellow researchers and colleagues through a poster presentation at the SNEB Conference in Washington DC in July 2023. Colleagues and researchers as part of NOPREN ECE Workplace Wellness subcommittee meetings. Changes/Problems:We did not experience any major changes/problems in Y2. Unfortunately, our named advisor, Dr. Dianne S. Ward from UNC Chapel Hill, passed away in summer 2023 and will be missed by the entire study team. We experienced some changes in our study timeline. We had planned an 8-week field period for the NHWS, and we were excited to reach the target completes within two weeks of the start date. Responses from the NHWS informed the development of the Randomized Control Trial (RCT) intervention, which also launched in 2023. Due to time spent negotiating contracts and guidance from our community partners, recruitment for the RCT was delayed by three months; we sent out invitation emails in December 2023 (instead of September 2023). This positions us to run the RCT through end of October 2024, including both our intervention and delayed intervention cohorts with limited time for analysis and synthesis. What opportunities for training and professional development has the project provided?During Y2 we continued to provide opportunities for training and professional development for the graduate students in nutrition and agricultural policy. In Fall 2023, we led a directed seminar, open to all graduate level students at the Friedman School. The 6 students who enrolled, plus our student Teaching Assistant (TA), gained hands-on experience working directly with the investigator team and our partners at NHSA and ABCD Head Start on intervention design and preparing to launch the RCT in Y3. Their work included research into ABCD Head Start classroom practices (through interviews with leadership and site visits); formative data collection with teachers to test the health and wellness app which is central to the intervention design; literature reviews; classroom discussion and reflection; and training in skills needed for the intervention launch. In the Fall of 2023, all study team members as well as students in the directed seminar received 14 hours of training in Motivational Interviewing from a certified trainer; and training in conducting Dietary Intake interviews from one of the investigators. Additionally, we offered research assistant positions to 3 students to support the analysis of the NHWS data; seminar design and implementation; and the intervention design and implementation plans. One Research Assistant, who also worked as a TA for the directed study in Fall 2023, co-presented a workshop at the Tufts University-wide Conference on Teaching and Learning in July 2023 about the directed seminar, which provided professional development. How have the results been disseminated to communities of interest?During Y2, we disseminated results to communities of interest in a variety of ways. (1) We shared our results from developing the Directed Study with interested educators by presenting at the Tufts University-wide Conference on Teaching and Learning (July 2023). The project manager and a student research assistant co-presented a hands-on workshop about student-led, experiential learning in a hybrid format. The workshop attracted educators from across the University to discuss innovative, experiential based teaching methods and ways to fully engage students in the teaching and learning process. (2) We disseminated early findings from the National Health and Wellness Survey to a diverse group of leadership and educators at ABCD Head Start through a presentation at their semi-annual CityWide event (August 2023). (3) We presented a poster at the SNEB Conference in July 2023, highlighting our goals and milestones in the project at that point. (4) We met regularly with partners from the National Head Start Association to keep them updated about our progress; and shared progress with colleagues at the Friedman School of Nutrition Science and Policy through informal presentations at community meetings. (5) Members of the study team shared information about the study with colleague through participation in the NOPREN subcommittee for ECE workplace wellness research meetings. What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period: Aim 1 - We plan to offer the experiential course/seminar for nutrition and agricultural policy students at the Friedman School in Spring and Fall 2024. With input from students and our investigator team, we will continue to evolve the design and goals of the seminar in line with current thinking about equity-centered education and student-led experiential learning. We anticipate that this innovative course will provide Friedman students with the opportunity to participate in and contribute to multiple phases of our ongoing research study (implementation, evaluation) as the study culminates. We will also work with leadership at Friedman to explore ways to incorporate experiential education components and student-led learning into the curriculum more broadly. Aim 2 - We plan to analyze the NHWS data to generate white papers and peer-reviewed journal articles. We will work with colleagues at the NHSA to share the information with a broader audience. Aim 3 - We plan to implement our novel workplace wellness RCT (HEART at Head Start) in collaboration with our community partner, ABCD Head Start and affiliated centers. At each of the three health fairs, we will collect cardiometabolic and anthropometric measures, administer a health behavior survey (self-administered), and conduct a 24-hour dietary recall. We will randomize the participants into intervention and delayed intervention groups and track app use for the entire duration of the trial for those in the intervention group and for the final three months for those in the delayed intervention group. We will also track data on engagement with Tufts Guides. We will analyze and synthesize the data to understand app and guide use over the study period, types of goals set, and changes in nutrition, physical activity, and sleep habits over the course of the study. We will analyze and synthesize data from the RCT and generate a report, white paper, and peer-reviewed journal articles. We will also present the findings at conferences.
Impacts
What was accomplished under these goals?
During Y2, we accomplished milestones on all three of our aims, as detailed below: Aim 1: We continued to develop and offer an innovative graduate-level trainee course with an experiential education component for students in the nutrition and agriculture policy track. During Spring 2023, we reviewed our course syllabus and feedback from students in 2022 and iterated our seminar design. During Fall 2023, we offered an experiential education directed seminar for 6 agriculture and behavior change graduate students, who read, discussed, and contributed to the refinement of the study design. Additionally, we provided them a 2-day in-person training in Motivational interviewing, 1-day training on anthropometry, blood pressure measurement, conducting a finger prick to obtain a blood sample for processing in the Cholestech machine, and 24-hour dietary recall. Students were provided opportunities to practice following the training. All trained students conducted formative work as we pilot-tested the health and wellness app with 5 Head Start teachers in other areas of the country. Students also assisted in the main trial preparation for the baseline health fairs (including a site visit to meet with the leadership at ABCD Head Start to discuss logistics for the health fair), following which participated in all health fair data collection activities. Following the baseline health fair, students served as Guides, and used the principles of motivational interviewing to support goal setting for study participants (see Aim 3). Aim 2: In spring 2023, we fielded a web-based National Health and Wellness Survey (NHWS) of Head Start teachers (estimated completion time was 10 minutes). Using a national list of emails of Head Start licensees provided by our partner, the National Head Start Association (NHSA), we contacted half the randomly selected licensees with a request to share information about the upcoming Health and Wellness Survey with teachers in their programs. The NHSA also forwarded our recruitment emails to teachers on the NHSA membership roster. In accordance with our incentive budget ($25 per survey response), we targeted 2,500 survey completes. Our anticipated field period was eight weeks, which included one invitation email and two reminder emails. In the event we did not reach the target completes, we planned to deploy the second half (reserve) sample and repeat the procedures until we obtained 2,500 completes. By the end of the second week, we had reached the target sample size and closed the survey; we did not send any reminder emails. We received responses from a diverse group of Head Start and Early Head Start educators from all 50 states. We plan to disseminate our findings during Y3. Aim 3: We utilized the results from the National Health and Wellness Survey about interest in workplace wellness activities and barriers to participation to design and implement the HEART (Healthy Eating Activity Relaxation Trial) at Head Start Randomized Controlled Trial (RCT) at ABCD Head Start in the greater Boston area. Importantly, all of our formative work confirmed that an onsite or outside of work hours intervention would only work if it was delivered digitally and flexibly. Participants will be provided access to a health and wellness app, which can either be downloaded onto mobile phones or accessed via the web. App Users will be able to use a variety of health and wellness resources, webinars, as specialized coaching through this app. All participants will be invited to attend three health fairs (baseline, midpoint (6 months after baseline), and endpoint (9 months after baseline). Additionally, Tufts guides will work closely with study participants to facilitate individual goal setting in an area of their choosing (healthy eating, physical activity, or sleep hygiene) and to support work towards these set goals. Following the baseline health fair, those in the intervention centers will have access to the app for up to nine months (end of trial) and access to the guide for up to six months (second health fair). Following the second health fair, those in the delayed intervention centers will have access to the app and the guide for up to three months (end of trial). We prepared to launch the intervention, including pilot testing a Health and Wellness App with 5 teachers; working with our community partners ABCD Head Start to prepare for recruitment and enrollment of teachers at their centers and affiliate centers; and training students to participate in intake and the intervention (as described in Aim 1). In December 2023 we invited teachers at ABCD Head Start to complete a screener and enroll in the study if eligible. In Jan/Feb 2024, we plan to conduct a baseline health fair at various ABCD centers, randomize centers in the intervention and delayed intervention groups, give teachers in the intervention group access to the health and wellness app, and begin guide discussions.
Publications
|
Progress 01/01/22 to 12/31/22
Outputs
Target Audience:In Y1, we reached members of several of the target audiences outlined in our proposal. - 10 graduate students, 1 undergraduate: Through two semesters of our directed seminar, we enrolled 7 graduate students at Friedman School of Nutrition Science and Policy in a hands-on, experiential learning experience. Additionally, we hired 3 students as research assistants (2 graduate, 1 undergraduate) including a summer intern through the Tufts Institute for Global Obesity Research (TIGOR). - 18 Head Start/Early Head Start educators: we conducted outreach to Head Start and Early Head Start teachers/assistant teachers and center directors across the country, resulting in formative interviews with 4 Head Start educators and informal conversations with 6 center directors and 8 teachers/assistant teachers to inform the design of our national health and wellness survey and intervention design. - National Head Start Association (NHSA) and ABCD Boston leadership: Through outreach and regular meetings, we reached NHSA and ABCD Boston leaders.? Changes/Problems:We did not experience any major changes/problems in Y1. We received important guidance from our community partners (NHSA and ABCD Boston) which helped us calibrate our approach and our research focus to include overall health and wellness goals for early childhood educators (ECE) and lessen our focus on weight loss as a primary goal. We intend to track teacher level outcomes such as absentee rates and cardio-metabolic health indicators, as well as center level cost savings from the novel intervention. Based on guidance and feedback we received from our community partners, we pushed out the implementation date for the worksite wellness trial from January 2023 to September 2023. This change better reflects the school year for Head Start/Early Head Start and makes it easier for us to maintain continuity with our cohorts (intervention and control). Additionally, the development of the national health and wellness survey required more planning than we had expected, with a launch planned in Spring 2023 (March - May). With guidance from our partners and based on findings from the PIR data regarding the language spoken by teachers/assistant teachers, we are providing our web-based national needs survey in English and Spanish, to better address the diverse educators who work in Head Start/Early Head Start. What opportunities for training and professional development has the project provided?The research study, specifically Aim 1, is designed to center training and professional development, primarily for graduate students in nutrition and agricultural policy. During Y1, we provided multiple opportunities for training and professional development. During Spring and Fall 2022, the PI taught a directed seminar, open to all graduate level students at the Friedman School. The 7 students who enrolled worked directly with our team of investigators, our partners at NHSA and ABCD Boston, our content advisors and other content area experts. In addition to student-led research and discussions, students participated in a workshop about racial equity in research as part of the seminar. All the students gained hands-on experience working directly with researchers, consultants, subject area experts and other students in community engaged research. They interviewed volunteers to learn about the experience of Head Start and Early Head Start educators; and gained experience working as part of a research team. The students received feedback on their work from our investigator team at the end of the semester. Additionally, the project worked with the TIGOR summer internship program and provided professional training to a graduate student who worked full time. We hired 3 students as research assistants who learned and worked on the research study. How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals?During the next reporting period: Aim 1 - We plan to incorporate an experiential course or seminar into the curriculum for nutrition and agricultural policy students at the Friedman School. We plan to continue to evolve the design and goals of the seminar in line with current thinking about equity-centered education and student-led experiential learning. We anticipate that this innovative course will provide Friedman students with the opportunity to participate and contribute to multiple phases of our ongoing research study (implementation and survey analysis in Fall 2023) as the study evolves. Aim 2 - In Spring 2023, we plan to disseminate the national health and wellness survey to Head Start and Early Head Start educators around the country, with support from our partners at the National Head Start Association. We will monitor the inbound web survey completion over the course of the seven-week period and plan to deploy a reserve frame if we do not obtain the 2,300 target completes. We will analyze the data using descriptive statistics. The results of this survey will be combined with the results from the formative research findings and guidance from community partners (Y1) and used to inform the development of our innovative RCT intervention. We will also work collaboratively with the National Head Start Association to analyze the survey data and identify findings that may inform policy recommendations and guidance for Head Start directors and centers across the country. Aim 3 - We plan to implement our novel workplace wellness trial in Fall, 2023, in collaboration with our community partners, ABCD Boston and the NHSA. We will conduct process and outcome evaluation to understand implementation and outcome measures such as cost savings to the center as well as teacher level outcomes including absentee rates, and cardio-metabolic health indicators.
Impacts
What was accomplished under these goals?
During Y1, as we had anticipated in our grant application, we primarily addressed Aims 1 and 2: Aim 1 - We developed, delivered and evaluated two semesters of an innovative graduate-level trainee course with an experiential education component for 7 students in the nutrition and agriculture policy track. During Spring semester (January - May 2022) the PI taught a directed seminar which focused on development and design of an innovate experiential education course, including study of current teaching pedagogy, experiential education best practices, health equity, and the importance of student-led assessment and evaluation. In Fall (September - December 2022) the PI taught a directed seminar which provided an experiential education experience for 5 students, including hands-on work on the formative work and background research to inform the national needs survey and the intervention design. During year 1, we worked closely with a consultant from the Tufts Center for Excellence in Learning and Teaching (CELT), who has served as an advisor in all phases of the class development. At the end of each semester, we received course evaluations from the students, which will be factored into the next evolution of the course offering in Fall, 2023. Aim 2 - We researched and designed a national "health and wellness" survey for Head Start and Early Head Start teachers and assistant teachers, which will inform the design of our workplace wellness RCT in Year 2. This survey was informed by (i) extensive formative research with Head Start and Early Head Start educators, as well as formal and informal conversations with this group and (ii) review of literature to identify factors that influence childcare (ECE) providers' health and weight management behaviors and engagement in workplace wellness programs. The survey is scheduled to be fielded in Y2 (Spring 2023) and will gather data from 2300 Head Start educators about health and wellness, as well as workplace wellness strategies and existing/preferred options. Aim 3 - We did not implement or evaluate the impact of the workplace wellness trial. This is scheduled for Y2 (2023).
Publications
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