Classification of Early Childhood Educators’ Behaviors to Improve WISE Implementation

Together, We Inspire Smart Eating (WISE) is a curriculum focused on increasing fruit and vegetable consumption among preschoolers. Early Childhood Educators’ (ECEs) fidelity to WISE, attitudes toward WISE, and workplace influence are important for promoting successful implementation, in accordance with the established Fidelity, Attitude, and Influence Typology (FAIT). This study explores change, from baseline to midpoint, in FAIT of ECEs in centers utilizing WISE. Using baseline FAIT classification, ECEs were targeted with tailored implementation facilitation to improve fidelity and attitude. We hypothesized this strategy would increase the proportion of ECEs with high fidelity. At baseline and midpoint: Research assistants coded fidelity on a 1 (“Not at all”) to 4 (“Very much”) scale for 4 WISE evidence-based practices (EBPs; role modeling, mascot use, positive feeding practices, and hand-on exposure); and ECEs completed self-report surveys to measure their workplace influence and attitude toward WISE on a 5-point scale (higher scores reflect more positive attitude and greater influence). ECE participants (N=57) were mostly female (98.2%) and Black (91.2%), with an average age of 44.5 (SD=11.7). ECEs with an average fidelity score ≥3 on 3 or more EBPs were deemed as meeting fidelity. ECEs with attitude and influence scores >4 were designated as positive and influential, respectively. Baseline to midpoint change was compared on FAIT. At baseline, 40% of ECEs were in a desired typology (ie, adopting with fidelity). From baseline to mid-point, 42% of teachers improved their FAIT category; 32% remained the same. Instances of worsening typology (27%) were mostly attributed to losses in fidelity. These midpoint results were used to update implementation facilitation targets for the remaining 3.5 months of WISE to improve in FAIT across the school year. These results suggest that using FAIT to inform facilitation supports ECEs to move toward adoption with high fidelity. We expect these improvements to correlate with improved child health outcomes and program sustainment. NIH