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Table 5 Formative interview themes related to participant-identified strengths and weaknesses of each implementation strategy

From: Stakeholder selected strategies for obesity prevention in childcare: results from a small-scale cluster randomized hybrid type III trial

Implementation strategy Weaknesses Strengths
Formal Commitment Form “I think any discussions that are held with site managers or whatever, the staff should be included so if they have questions at the very beginning, I think if those questions are answered, that they would buy into it a little bit better, and they wouldn’t be so I don’t know if “standoffish”.
“I’m not sure what my commitment said.”
“And so, it was still being explained to me you know…what it was and making sure that I had an understanding of the form before I even signed it.”
Blueprint None identified. That [implementation blueprint] was very helpful to me and to the staff because I had to share this in the staff meeting because they would ask a question so, you know, they couldn’t remember what they did so I went and made copies of this. And gave everybody a copy. And we did have our training on this.
Cutting Board “Well, to be honest, I seen that thing, but I didn’t know what it was for. And we had brought our own cutting board to use. Yea. We got it. But we didn’t know it was a cutting board. But we didn’t know it was a cutting board until about two weeks ago.” “I love it. I use it for cutting the food, preparing the food on that. It’s so easy because you can just take it to the kitchen and get hot water and just you know wash it and wipe it off and re-use it again. It’s just nice….They said that it is Windy’s cutting board and you can’t touch it.”
Champion None identified. “On Wednesday, when we have our staff meetings, she’ll…She asks us how’s it going. She gives us some tips, ‘cause she gave us some good tips on, cause she said, the last thing she gave us was tips with what to do with our food experience. And she was talking about the small group time too, having them in small group. Which is help out, it does help out though with smaller group… She’ll come in here and ask me, you know, different tips on the WISE experience, what did we do, and what kind of activities did I do with the kids.”
Handouts (resources) “I think the lady that delivered them came on a bad day. The day that she did it, we didn’t accept them very well. So, we just kind of picked them up and stuck them in the corner.”
“Some of it I have [read]… but I have probably got it though because I get so many…”
“Also, and then I would know…. I can look at those objectives. And think about how it applies…”
Video (resources) “I haven't been online…” “Okay. Well, I mean, they were helpful looking at different things telling us how different classrooms or other people did things, and it was just informative. Like especially the one this morning I looked at. And I was like, you know, I put my food on the plate, you know, ‘cause we have to eat the same things with them. And it was just on the plate, and I’m talking to them and stuff, but every once in a while, they say, “___, are you gonna… you don’t like it?” you know. So really go ahead and eating, tasting, you know, ‘cause we want them to taste it, we gotta taste it. They were very appealing. There’s nothing I would change. They’re short enough, you know, enough time you can look at it and go on and grab the information. I think there was a part where I read and then the video came through.”
Incentives “I don’t know who she gave it (bad report) to because she came back and she gave the other classroom a gift, an award, and a certificate, and didn’t give ______ nothing. Well you all didn’t do what you were supposed to do. We were like what were we supposed to do? The kids were engaged, we talked to them, and we encouraged them. They at the taste test, we did math with the apples, we did this and you still gave us a bad report. Oh no something is wrong with this picture...and the teachers don’t even know how they got them (incentives) because they said “We didn’t do nothing”.” “I love it. Keep bringing it in, we need more stuff. [Unintelligible] we got so excited. And ____ got the stamp, the Windy Wise stamp, and when I took it over there to her, I was like “look what you got for using Windy!” She was like, “wow! You know it’s real, like…I don’t think the people expected they were going to get incentives or whatever. But I think they’re real nice, just keep them coming… So I’m pretty sure the other teachers are kind of grateful. I would just say grateful, but they’re probably glad that they are receiving something, because then they’re showing their efforts are being appreciated.”
Facilitation “You have to get WISE in and you have to get this in. And then people coming in to observe you. It’s like the magnifying glass is on you. You know…and then they are going to find something wrong. You not doing this the right way. Then um you like…when the lady came in to us we were doing apples right? And I don’t know if we didn’t do it the right way, or we did something wrong, or whatever. She gave us a bad report. I feel like we did good because the kids were engaging and they were doing everything. They did the taste test and they cut, and they counted, and they did all of that and she gave us a bad report. So I don’t know if it was because we didn’t do the activity that she had planned on seeing from us I don’t know who she gave it to because she came back and she gave the other classroom a gift, an award, and a certificate, and didn’t give ____nothing. Well you all didn’t do what you were supposed to do. We were like what were we supposed to do? The kids were engaged, we talked to them, and we encouraged them. They ate the taste test, we did math with the apples, we did this and you still gave us a bad report. Oh no something is wrong with this picture.” “They were pretty communicative. Yeah, they pretty much communicated with me about everything. If I asked for something, I think I asked for something one time, they brought it back over.”
“Well, they give us good support. I can’t say that they don’t give us good support because they do. And when they come if we have any questions or anything, they are right here to answer it for us so that’s great. They are great resources and support for us.”
WISE innovation “It says as a small group, I kind of like it better as a large group because I guess it's better for me. But like I'm going to try with the smaller group.”
“Ooh, the hardest part, if it’s something that I don’t like… most times I put it towards my mouth, and [?] you know, chewing, like I’m really eating it and stuff like that. But most times, the stuff that we have, most times I try it.”
“Being able to taste the...well giving the children that experience, the tasting of fresh fruits and vegetables.”
“The best thing so far is that we have to have cooking experience, we don’t have to come up with anything, we’re getting the supplies that we need for the cooking experience, and they’re healthy.”
“And I think that once the children get used to having Windy to bring vegetables and fruits and if you all stop, then I think that besides at school they might not get it. So, I would say just keep on doing it because that may would encourage children to eat healthier and less obesity.”
“Well the best thing that I figure with WISE is that the children get to experiment or participate in different types of fruit and vegetables that they may not eat at home. So that’s a good thing and introducing it to them. Some of them don’t even know what it is so…we introduce that fruit and vegetable to them and they get to taste it, feel it, and touch it. The parents don’t cook it or use it at home or make it.”
Context “The worst thing is not getting the supplies on time. We do it on Tuesday’s. Mm-hmm. Or sometimes it comes after the time that we are supposed to have it… We just fill the time with something else, or we will go ahead and talk about that vegetable or fruit or whatever it is and we will just talk about it, but we won’t… we will do something small, but not the activity that is actually planned for that day…We don’t go back.”
“The hardest thing for me was just getting started, being the only person, the only teacher in here. But that’s about it. It’s not really too hard this far. Like we have all the supplies, we have Windy Wise, and I like talking with the puppet with them. So, not too hard. Just having another person in here. When I did the experience, maybe someone else be in here with me. Sometimes I did have another TA like me, but just explaining and all that, it still kind of fell on me to do the whole thing.”
“There’s no input from my site manager. There’s no input or like, coming to see if we, you know, just sitting in on the class to see what we’re doing or something, so… No that’s just it, being involved in the whole thing when we’re doing it, just to see how we’re doing and how the kids are enjoying it.”
“We don’t really [talk about WISE]…well when it first got started we would talk about it. I think a lot of us were complaining about it, but we would just do it you know…kind of getting used to it now so.”
“She [director] will come in sometime. Well I don't know what she did in the rooms. But she will come in and she would actually sit down and join us for the experience or you know, and sometimes she would help because it was hard to do in small groups and she would kind of help micro manage stuff.”
“We have teachers’ meetings on every Tuesday, and we talk about WISE. All of them like it. They are really fascinated over it.”
“We [teachers] do it [talk about WISE] almost every day. Cause we, you know, we wanna, that way we know what we’re supposed to do for that day. And it helps us, it helps us, you know, along, cause that way she might be doing something different activity with her kids, and helping, you know, with my kids. You know, I may be doing something different I may help her with, but it’s not like every day.”
“And she [director] reminds us and if we don't have the supplies we need, she do make sure we get them.”