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Table 6 Key events affecting study process and outcomes

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

Key Event category Observed event
1. Personnel Changes 1.1. There was high turnover during the implementation year; 43% of teacher positions experienced turnover during the school year (range of 0 to 72% by site). This corresponded to 61% of classrooms affected by turnover (range of 0 to 100% by site). Turnover rates did not differ between the Basic and Enhanced groups.
1.2. Director layoffs between implementation and maintenance year; all directors were reassigned or their employment terminated between the 2 years.
2.  Facilitator Activities 2.1. Facilitators met with each site’s leadership for onboarding, attended and supported the 6-h training on WISE, and provided coaching for the Enhanced condition in the implementation year.
2.2. A facilitator was trained and added mid-year when one of the two study facilitators required shoulder surgery.
3. Site Events 3.1. All teachers were required to change the location of their classroom between the implementation and maintenance year; most moved sites.
3.2. All classroom teacher pairs (lead and assistant) were changed between the implementation and maintenance year such that no teaching pair remained intact in the treatment group.
4. Broader Context Events 4.1 The organization experienced funding uncertainty beginning near the end of the implementation year. No teacher was assured the ability to return to a position for the following year (study maintenance assessment year). The organization was unable to communicate about funding to the staff until the start of the next school year. This uncertainty contributed to more staff turnover and layoffs, leaving only 19 of 75 teachers (25%) for maintenance assessment.