NAP SACC (UK): Nutrition and physical activity self-assessment for childcare

Conditions

Physical activity, sedentary time and diet Other

Jemima Cooper, Kim Hannam, Stephanie Chambers, Tom Reid, Russell Jago et al. (11 authors)

International Journal of Behavioral Nutrition and Physical Activity2026-02-13

Effectiveness of an environmental nutrition and physical activity intervention in early childhood education and care settings (NAPSACC UK): a multicentre cluster randomised controlled trial

Ruth Kipping, Sharon Anne Simpson, Kim Hannam, Peter S. Blair, Russell Jago et al. (26 authors)

The Lancet Regional Health - Europe2025-12-01

10.1016/j.lanepe.2025.101550

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 Smith, Ruth Kipping, Sze Lin Yoong, Kim Hannam, Rebecca Langford et al. (13 authors)

Childhood Obesity2025-03-11

10.1089/chi.2024.0371

Protocol to evaluate the effectiveness and cost-effectiveness of an environmental nutrition and physical activity intervention in nurseries (Nutrition and Physical Activity Self Assessment for Child Care - NAP SACC UK): a multicentre cluster randomised controlled trial.

Kipping R, Pallan M, Hannam K, Willis K, Dobell A, Metcalfe C, Jago R, Johnson L, Langford R, Martin CK, Hollingworth W, Cochrane M, White J, Blair P, Toumpakari Z, Taylor J, Ward D, Moore L, Reid T, Pardoe M, Wen L, Murphy M, Murphy M, Martin A, Chambers S, Simpson SA.

2023-08-025 citations

10.1186/s12889-023-16229-y

Interventions

Randomisation Within each study area, nurseries will be randomly allocated to the intervention or control group once all data has been collected from child and parents at T0 from participating nurseri

three nutrition, three physical activity and a further two of the nursery’s choice. The programme is a five-stage process: 1. Self-Assessment 2. Workshop delivery: Specialised staff deliver workshop

ii) Physical Activity 3. Goal setting and Action Planning: The NAP SACC UK Partner works with the nursery manager to develop an action plan, listing eight goals for improvement 4. Tailored technical a

Eligibility

Sex/Gender

All

Age

2 Years to 120 Years

Inclusion criteria

Inclusion criteria: 1. Setting: Day nurseries, private nursery schools, maintained nurseries (including nurseries within Children’s Centres), nursery classes attached to primary schools and pre-schools where children consume at least one meal per day (provided by the nursery or family) in the four geographical areas outlined in this section 2. Staff: Child care managers and staff in participating nurseries 3. Parents/carers: Parents/carers in the participating nurseries with children aged 2 years or over at the time of assessment, who are not yet attending Reception (England) or Primary One (Scotland) 4. Children: Children aged 2-years or over at the time of assessment, who are not yet attending Reception (England) or Primary One (Scotland), and who are attending the participating nurseries for a minimum of 12 hours per week across the year or 15 hours during term time and who consume at least one meal (provided by nursery or from home)

Exclusion criteria

Exclusion criteria: 1. Settings: Child care settings which are: childminders; crèches; playgroups; primary school reception classes, where schools operate an early admission policy to admit four year olds; solely outdoor nursery settings; solely Special Educational Needs and Disabilities (SEND) nursery settings; and au pairs. Nurseries taking part in a research study or other initiative that would interfere with the NAP SACC UK study. 2. Children: 2.1. Attending participating nurseries under 2 years old at the time of assessment, or who have started attending Reception (England) or Primary One (Scotland). 2.2. Whose parents/carers refuse consent for measurements 2.3. Attending fewer than 12 hours per week across the year or 15 hours during term time 2.4. Attending participating nurseries under 2 years old at the time of assessment, or who have started attending Reception (England) or Primary One (Scotland)

Design outcomes

Primary

Measure	Time frame
Current primary outcome measures as of 18/02/2022: Measured at T0: baseline and T1: immediately after the 12-month intervention, which will be between 12-16 months after T0: 1. Mean total activity measured by Actigraph accelerometer and/or 2. Total energy (kcal) per snack and lunch eating occasion averaged across all snack and lunch eating occasions that occur within nurseries Previous primary outcome measures: 1. Mean total activity measured by Actigraph accelerometer and/or 2. Mean energy (kcal) per eating occasion averaged across all eating occasions at 12 months measured by remote food photography	—

Measure

Time frame

Current primary outcome measures as of 18/02/2022: Measured at T0: baseline and T1: immediately after the 12-month intervention, which will be between 12-16 months after T0: 1. Mean total activity measured by Actigraph accelerometer and/or 2. Total energy (kcal) per snack and lunch eating occasion averaged across all snack and lunch eating occasions that occur within nurseries Previous primary outcome measures: 1. Mean total activity measured by Actigraph accelerometer and/or 2. Mean energy (kcal) per eating occasion averaged across all eating occasions at 12 months measured by remote food photography

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Secondary

Measure	Time frame
Current secondary outcome measures as of 18/02/2022: Measured at T0: baseline and T1: immediately after the 12-month intervention, which will be between 12-16 months after T0: 1. Moderate-to-vigorous physical activity measured using ActiGraph accelerometers 2. Sedentary time measured using ActiGraph accelerometers 3. The average serving size of lunch (kcal per occasion) measured using remote food photography 4. The average serving size of snacks (kcal per occasion) measured using remote food photography 5. The average size of lunch (kcal per occasion) consumed by children measured using remote food photography 6. The average size of snacks (kcal per occasion) consumed by children measured using remote food photography 7. The average percentage of total energy (kcal) in lunch from non-core food served consumed by children measured using remote food photography 8. The average percentage of total energy (kcal) in snacks from non-core food served consumed by children measured using remote food photography 9. Child BMI-for-age z-score (zBMI) calculated using height and weight 10. Proportion of children with overweight/obesity determined by zBMI scores using UK 1990, WHO-UK and International Obesity Task Force (IOTF) criteria 11. Child quality of life measured using parent-reported PedsQL 12. Cost-effectiveness measured using cost consequences analysis methodology (CCA) 13. Fidelity, acceptability and sustainability of the intervention assessed by undertaking process evaluation using observations, semi-structured interviews, questionnaires, document analysis and fieldnotes Previous secondary outcome measures: 1. Accelerometer assessed mean daily moderate to vigorous physical activity 2. Accelerometer assessed mean daily sedentary time 3. Average size (calories) of food served, using remote food photography, across all eating occasions in nursery per day 4. Balance of core food to non-core food consumed using remote food photography 5. zBMI determined by weight and heigh	—

Measure

Time frame

Current secondary outcome measures as of 18/02/2022: Measured at T0: baseline and T1: immediately after the 12-month intervention, which will be between 12-16 months after T0: 1. Moderate-to-vigorous physical activity measured using ActiGraph accelerometers 2. Sedentary time measured using ActiGraph accelerometers 3. The average serving size of lunch (kcal per occasion) measured using remote food photography 4. The average serving size of snacks (kcal per occasion) measured using remote food photography 5. The average size of lunch (kcal per occasion) consumed by children measured using remote food photography 6. The average size of snacks (kcal per occasion) consumed by children measured using remote food photography 7. The average percentage of total energy (kcal) in lunch from non-core food served consumed by children measured using remote food photography 8. The average percentage of total energy (kcal) in snacks from non-core food served consumed by children measured using remote food photography 9. Child BMI-for-age z-score (zBMI) calculated using height and weight 10. Proportion of children with overweight/obesity determined by zBMI scores using UK 1990, WHO-UK and International Obesity Task Force (IOTF) criteria 11. Child quality of life measured using parent-reported PedsQL 12. Cost-effectiveness measured using cost consequences analysis methodology (CCA) 13. Fidelity, acceptability and sustainability of the intervention assessed by undertaking process evaluation using observations, semi-structured interviews, questionnaires, document analysis and fieldnotes Previous secondary outcome measures: 1. Accelerometer assessed mean daily moderate to vigorous physical activity 2. Accelerometer assessed mean daily sedentary time 3. Average size (calories) of food served, using remote food photography, across all eating occasions in nursery per day 4. Balance of core food to non-core food consumed using remote food photography 5. zBMI determined by weight and heigh

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Countries

England, Scotland, United Kingdom

Outcome results

None listed