The authors declare that they have no competing interests.
CMM coordinated the intervention and drafted the manuscript. DSW conceived of and helped design the study, oversaw the implementation of the study, and assisted with the development of the manuscript. AV helped oversee the implementation of the overall study and critically reviewed and edited the manuscript. SEBN helped design the study, assisted with the development and implementation of the study, and critically reviewed and edited the manuscript. JLV and SO delivered the intervention and critically reviewed and edited the manuscript. RJNB contributed to the development and implementation of the study and critically reviewed and edited the manuscript. TO conceived of and helped design the study, oversaw the implementation of the intervention, and critically reviewed and edited the manuscript. All authors reviewed and approved the final manuscript.
Many families rely on child care outside the home, making these settings important influences on child development. Nearly 1.5 million children in the U.S. spend time in family child care homes (FCCHs), where providers care for children in their own residences. There is some evidence that children in FCCHs are heavier than those cared for in centers. However, few interventions have targeted FCCHs for obesity prevention. This paper will describe the application of the Intervention Mapping (IM) framework to the development of a childhood obesity prevention intervention for FCCHs
Following the IM protocol, six steps were completed in the planning and development of an intervention targeting FCCHs: needs assessment, formulation of change objectives matrices, selection of theory-based methods and strategies, creation of intervention components and materials, adoption and implementation planning, and evaluation planning
Application of the IM process resulted in the creation of the Keys to Healthy Family Child Care Homes program (Keys), which includes three modules: Healthy You, Healthy Home, and Healthy Business. Delivery of each module includes a workshop, educational binder and tool-kit resources, and four coaching contacts. Social Cognitive Theory and Self-Determination Theory helped guide development of change objective matrices, selection of behavior change strategies, and identification of outcome measures. The Keys program is currently being evaluated through a cluster-randomized controlled trial
The IM process, while time-consuming, enabled rigorous and systematic development of intervention components that are directly tied to behavior change theory and may increase the potential for behavior change within the FCCHs.