# Deimplementation of Inappropriate Feeding Practices in Early Care and Education Settings

> **NIH NIH R01** · UNIV OF ARKANSAS FOR MED SCIS · 2024 · $614,450

## Abstract

Project Summary
 More than 12 million children in the U.S. consume up to two-thirds of their dietary intake in early care and
education (ECE) settings.1,2 Yet, educators in ECE often use dietary and feeding practices that are not
evidence-based.3 Given that childhood dietary habits often persist into adulthood,4–6 failure to use evidence-
based practices (EBPs) related to healthy nutrition and feeding patterns can have negative implications for
development of weight trajectories and dietary patterns across the lifespan. The overall objective for this
application is to determine the effectiveness and associated mechanisms of a package of deimplementation
strategies to reduce the use of inappropriate feeding practices in ECE. Demonstrating the effectiveness of
strategies for reducing inappropriate feeding practices in ECE and determining how the strategies work and for
whom will provide new opportunities for building a strong foundation in the ECE setting for lifelong healthy
eating habits. We will conduct a cluster-randomized Hybrid Type III trial with 88 ECE sites serving children
ages 3 and 5. The trial will achieve two specific aims:
 Aim 1: Determine the effectiveness of a package of deimplementation strategies for reducing the
use of inappropriate feeding practices in ECE. Our hypothesis is that, compared to usual practice, the
deimplementation strategies will be effective at reducing the total number of observed inappropriate feeding
practices per meal, our primary deimplementation outcome (N= 88 sites, 528 educators).3 We will also identify
effects on secondary effectiveness outcome measures including child body mass index, willingness to try novel
foods, fear of new foods (i.e., neophobia), and dietary intake (N=1320 children).
 Aim 2: Identify mechanisms of deimplementation using a mixed methods approach. Our hypothesis
is that factors specified by the Implementation Trust Building Theory of Change22 will mediate the effect of
strategies on deimplementation outcomes. Using an explanatory, sequential design, we will collect qualitative
data with purposively selected educators (N = 32) to identify emergent mediators and moderators.
 The project will determine the effectiveness of a blended in-person and virtual approach to
deimplementation with scalable tailoring elements. In addition, we expect to have determined key mechanisms
of our deimplementation strategies, providing practice-relevant information on how and why strategies work to
change behavior in the real world and informing future replication and scale-up. These results are expected to
have a positive impact on the weight and dietary behaviors of young children through the targeted removal of
inappropriate feeding practices in ECE.

## Key facts

- **NIH application ID:** 10781249
- **Project number:** 1R01DK138153-01
- **Recipient organization:** UNIV OF ARKANSAS FOR MED SCIS
- **Principal Investigator:** Julie Rutledge
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $614,450
- **Award type:** 1
- **Project period:** 2024-07-01 → 2025-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10781249

## Citation

> US National Institutes of Health, RePORTER application 10781249, Deimplementation of Inappropriate Feeding Practices in Early Care and Education Settings (1R01DK138153-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10781249. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*