Addressing Obesity in Early Care and Education Settings
Phase: NA
Conditions: Obesity
Sponsor: University of California, Los Angeles

 
 
 
 
 
Addressing Obesity in Early Care and Education Settings 
 
NCT04140032 
 
December 17, 2024 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

2 
 
Addressing Childhood Obesity in Early Care and Education Settings 
UCLA Center for Cancer Prevention and Control Research and Child Care 
Resource Center 
 
 
 
Table of Contents 
Abbreviations 
4 
Project Personnel 
4 
Proposed Project Timeline 
5 
Proposed Data Collection Timeline 
5 
Data Collection Timeline Modifications from Cohort 1 
5 
Data Collection Timeline Modifications due to COVID-19 
6 
Project Phases 
6 
Phase I: Recruitment 
7 
Recruitment Flow Sheet 
7 
Recruitment of Sites Cohort 1 
7 
Recruitment of Sites Modifications from Cohort 1 
8 
Recruitment of Sites Modifications due to COVID-19 
8 
Recruitment of Sites Cohort 3 
8 
Initial Recruitment Call 
8 
Initial Recruitment Call Modifications from Cohort 1: 
8 
In-Person Meeting 1 
9 
In-Person Meeting 1 Planned Modifications from Cohort 1 
9 
In-Person Meeting 1 Modifications due to COVID-19 
9 
Site Demographics Data Collection Meeting 
9 
Site Demographics Collection Meeting Modifications due to COVID-19 
9 
Phase II: Baseline Data Collection 
10 
Site Director Survey Distribution and Collection 
10 
Site Director Survey Distribution and Collection Modifications due to COVID-19 
10 
Teacher Survey Distribution and Collection 
10 
Teacher Survey Distribution and Collection Modifications due to COVID-19 
10 
Teacher Survey Distribution and Collection Modifications due to COVID-19 
11 
Parent Survey Distribution and Collection 
11 
Parent Survey Distribution and Collection Modifications due to COVID-19 
11 
Survey Reminder Emails 
12 
Parent On-site Recruitment/ Tabling Events Cohort 1 Data Collection: 
13 
Pilot Testing Parent Survey Procedure 
13 
Survey Entry 
13 

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Unique IDs 
13 
Unique ID Modifications due to COVID-19 
14 
Site Director Survey Entry 
14 
Teacher Survey Entry 
14 
Parent Survey Entry 
14 
EPAO 
15 
EPAO Modifications due to COVID-19 
15 
Height and Weight Measurements 
15 
Height and Weight Modifications due to COVID-19 
16 
Gift Cards 
16 
Gift Card Amounts 
17 
Phase III: Randomization and Implementation 
17 
Randomization of Sites 
17 
Implementation 
18 
Implementation Tracking 
18 
Coaching 
19 
Coaching Modifications due to COVID-19 
19 
Family Child Care (FCC) Coaching – Cohort 2 
20 
Coaching Data Entry 
20 
Parent Engagement 
20 
Parent Engagement Modifications due to COVID-19 
20 
Parent Website 
20 
Phase IV: Follow-up Data Collection 
21 
Follow-Up Data Collection 
21 
Cohort 1 Follow-up Data Collection Modifications due to COVID-19 
21 
Cohort 2 Data Collection Modifications due to COVID-19 
21 
Follow-up Surveys 
21 
Paper Follow-up Surveys 
21 
Electronic Follow-Up Surveys- Cohort 1 Follow-up 
22 
Follow-up EPAO 
22 
Follow-up Height and Weight 
22 
Phase V: Evaluation 
23 
Program Evaluation 
23 
Process Evaluation 
23 
Outcome Evaluation 
23 
APPENDIX I: Initial Director Call Talking Points 
24 

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APPENDIX II: Initial Call 
25 
APPENDIX III: In-Person Meeting 1 
26 
APPENDIX IV: Participant Survey Packets 
27 
APPENDIX V: How to Enter Preschool Project Data 
28 
APPENDIX VI: How to Generate a Unique ID 
30 
APPENDIX VII: EPAO 
32 
APPENDIX VIII: Height and Weight Materials 
33 
APPENDIX IX: Scale Calibration Summary 
34 
 BOX SEARCH TERMS ARE BOLD, UNDERLINED, AND ITALICIZED THROUGHOUT DOCUMENT 
Abbreviations 
CACFP – Child and Adult Care Food Program (a.k.a. the food program) 
CCRC – Child Care Resource Center 
CPCR – Cancer Prevention and Control Research Center (at UCLA) 
EPAO – Environment and Policy Assessment and Observation (observation tool) 
FCC – Family Child Care home/provider 
H&W – Height and Weight 
NAPSACC – Nutrition and Physical Activity Self-Assessment for Child Care (Site Director survey) 
Project Personnel 
UCLA: 
CCRC: 
Roshan Bastani - Primary Investigator (PI) 
Ana (Lily) Duarte - Supervisor, Coaching, Resource and Referral 
Cindy Chang – Senior Statistician 
Paul Chung – PI 
Brianna Briones – Senior Research Analyst, Research and 
Evaluation 
Jennie Coleman - Project Coordinator  
Adriana Garcia – Coach, Resource and Referral 
 
Burt Cowgill - Co-Investigator 
Elizabeth (Liz) Melendrez - Manager, Resource and Referral 
Kate Crespi – Statistician  
Jared Nineberg – Senior GIS Analyst, Research and Evaluation 
Mayte Cruz - Project Staff (2019- Aug 2020) 
Olivia Pillado - Manager, Research and Evaluation 
Beth Glenn - Co-Investigator 
Cynthia Renteria - Assistant Director, Resource and Referral 
Michelle Guerra – Field Staff (2019- Aug 2020) 
Susan Savage - Director, Research and Evaluation 
Alison Herrmann - Co-Investigator 
Lindsay du Plessis – Research Scientist  
Cyndi Trujillo –Manager, Resource and Referral 
Chris Johansen - Post-Doc Fellow 
UCLA Interns:  
Varduhi Niksalyan – Project Staff (2020 – Aug 2021) 
Roline Dahl – undergraduate intern (2019-2020) 
Alexandra Nordyke – Project Assistant (Aug 2020-
present) 
Celeste Martinez – undergraduate intern (2019-2020) 
Bernadett Leggis – Field Staff 
Vincent Liu – Project Assistant (2019-Aug 2020) 
Mominah Subhan – undergraduate intern (2019-2020) 
Ayushi Bommireddipalli – undergraduate intern (2021 - present) 
Jessica Richardson – Field Staff (2019-2020) 
 
Maria Santos – Project Staff (Sept 2020 – July 2021) 
Djosy Charles – Project Staff (Feb 2021 – Oct 2021)  
Diana Trujillo – Project Staff (Aug 2021 – present) 
 

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Protocol 
NIH R01 Clinical Trial R01HD091136.  
UCLA IRB approval number:  19-000570-CR-00002.  
 
The purpose of this protocol is to guide the recruitment of sites/participants and implementation of program 
activities for University of California-Los Angeles (UCLA) and Child Care Resource Center (CCRC)’s A-B-C Healthy Me/Soy 
Saludable Project to Address[ing] Obesity in Early Care and Education Settings.  
 
This project will recruit preschools from LA County’s San Fernando Valley, Santa Clarita Valley, and Antelope 
Valley, specifically targeting preschools in low to medium-income zip codes. Three cohorts of 20 schools (n=60) over 
three instructional years (~Sept 1 – June 30) will be recruited and randomized (10 intervention; 10 control/delayed 
intervention per year).  
Program activities were designed in line with the Healthy-by-Default framework and include the following:  
● Integration of Sesame Street Healthy Habits for Life curriculum 
● Teacher and site director coaching 
● Nutrition and physical activity policy support including family-style meals and healthy celebrations 
● Parent engagement sessions 
● Implementation Activity Table (word doc):Box Project misc.-->Research Plan Component 
Table_Preschool Policy, Teacher, Parent Activities  
Proposed Project Timeline 
Cohort 1: September 2019-June2020  
Cohort 2: May 2020-June 2021 
Cohort 3: May 2021-June 2022 
Follow-up (post) surveys will occur immediately after intervention completion each year.  
Proposed Data Collection Timeline 
Week 1 
Week 2 
Week 3 
Week 4 
Week 5 
Week 6 
Week 7 
Initial Recruitment Call/Email from CCRC 
 
 
 
 
 
In-person Meeting with Site, CCRC, and UCLA 
 
 
 
Site director and teacher surveys 
 
 
 
 
EPAO Observations 
 
 
 
 
Parent Recruitment 
 
 
 
 
Height and Weight Measurements 
 
Data Collection Timeline Modifications from Cohort 1  
The proposed data collection timeline has been updated from cohort 1. The cohort 1 data collection strategy was 
staggered by participant pool; the site director survey was delivered and collected a week later. At collection, the 
teacher surveys were delivered and collected a week later or at EPAO. At teacher survey collection, parent surveys were 
delivered and left with site staff to distribute. We originally structured recruitment this way as to not overwhelm the site 
and to give the director time to digest the program and complete site level data before engaging teachers. However, 
after meeting with site directors in cohort 1, we realized that this staggering pushed recruitment back by at least 3 
weeks. By combining the site director and teacher survey distribution in cohort 2, we will be able to more efficiently 
collect site director and teacher data thus allowing more time for the intervention.  

6 
 
Data Collection Timeline Modifications due to COVID-19 
Data Collection Timeline Modifications due to COVID-19—Cohort 1 Follow-up and Cohort 2 baseline 
Due to COVID-19, all participant surveys for cohort 1 follow-up and cohort 2 baseline will be available online via 
Qualtrics; paper surveys will be available to those sites that do not communicate with parents via email. All participants 
will need to provide an email for us to provide them directly with the survey link and their unique password. In order to 
protect the privacy of each survey, UCLA will have to pre-assign an ID and password to each participant. The link and 
unique password will then be emailed to each participant at the email provided by the site.  
Email addresses were collected from the site. An opt-out model was used to notify site participants of the 
program and that their email will be shared with UCLA for more information on participation. A flyer with this 
information was given to the site director to distribute to parents. After a week to review/notify with parents, UCLA 
would ask the site director to provide parent and teacher emails that the site has on file. If a parent or teacher verbally 
opted out, their email will not be shared.  
Paper surveys were also delivered to all sites. Some sites only returned paper surveys and 2 sites did not collect 
parent emails but went straight to paper.  
Additionally, the EPAO will not be conducted as long as social distancing orders are in effect.  
Data Collection Timeline Modifications– Cohort 2 Follow-up and Cohort 3 baseline 
 
Majority of Cohort 2 sites preferred paper and the paper response rate was better for all sites, starting 
5/25/21(cohort 2 follow-up) all data collection will be conducted via paper only. 
Project Phases 
Phase I: Recruitment 
Phase II: Baseline Data Collection  
Phase III: Randomization and Implementation 
Phase IV: Follow-up Data Collection 
Phase V: Evaluation 
 
 

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Phase I: Recruitment 
Recruitment Flow Sheet 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Recruitment of Sites Cohort 1 
CCRC provided UCLA with a list of center-based preschools in their network, which are in low to middle-income 
zip codes in the San Fernando Valley. Additional information included: location, size (i.e., capacity) and CACFP 
participation.  
UCLA then randomized the list for CCRC to contact.  
Centers must have more than 20 preschool aged children (2-5 years old) enrolled. The schools that participated 
in the formative data collection were contacted first. If a school was unable or unwilling to participate, that it is noted, 
and another site is contacted for recruitment.  
CCRC will email Site Director program flyer and 
call Site Director to gauge interest. 
Site declines 
participation 
In-person meeting 1 with site, CCRC and UCLA to 
discuss project. 
*Some sites may require two in-person meetings 
before agreement 
Maintain 
contact for 
future year 
Remove 
from study 
pool 
Site agrees to be in study 
Site Director and teacher survey collection and 
EPAO Site Observations (n=20). 
Parent recruitment 
Child H/W 
Measurements 
(20 sites) 
Site randomization  
(10 case; 10 control) 
Intervention 
Delayed Intervention 
Collect site data demographics  
COVID-19 MODIFICATIONS: 
1) EPAO observations on 
pause 
2) All meetings conducted via 
Zoom 
3) Site director will complete 
height and weight 
measurements and collect 
consents ahead of time 

8 
 
For sites that decline initial participation, we will determine if they would be interested in participating in future 
years. A deferred list of sites will be maintained for contact in the next program year.   
For cohort 1, recruitment began September 9, 2019. For cohort 2, recruitment began May 20, 2020. For cohort 
3, recruitment began April 19, 2021. 
Recruitment of Sites Modifications from Cohort 1 
 
Since CCRC provided UCLA with a provider list during cohort 1, all centers not contacted during cohort 1 were 
added to the cohort 2 contact list. Additionally, Centers in the Santa Clarita and Antelope Valleys were included. Age 
range was expanded to include 2-6 years old since siblings may be in the same classroom due to COVID-19. Zip code 
income was dropped as a stratifying variable. 
The cohort 2 contact list was broken down into three recruitment rounds: 1) centers that 'deferred year 1' and 
'CACFP participants’, 2) centers that receive CCRC subsidy but non-CACFP'; and 3) 'unsubsidized, non-CACFP'. CCRC 
contacted schools from this list. 
Family Child Care (FCC) providers were included in cohort 2 as a pilot for this population. FCCs should have a 
minimum of 6 eligible participants. 4 FCCs were recruited in cohort 2.  
See APPENDIX I: Initial Director Call Talking Points for more information on what to bring to the initial call and talking 
points. 
Recruitment of Sites Modifications due to COVID-19 
Additionally, with widespread preschool closures due to COVID-19, we decided to offer our control sites from 
cohort 1 the opportunity to convert into intervention sites for cohort 2. This offer was extended to the cohort 2 control 
sites as well.  Control sites were added back into the recruitment pool to confirm interest in another year of 
participation. Due to low participation during follow-up data collection (August 2021) at the cohort 2 control sites, these 
sites did not convert to cohort 3 intervention sites, but instead received coaching every other month.  
Recruitment of Sites Cohort 3 
 
Deferred cohort 2 sites were contacted first for cohort 3 (~n=54). Once CCRC contacted all schools on the 
deferred list, CCRC pulled from the original list for additional centers not yet contacted.  
Initial Recruitment Call 
CCRC contacted the identified schools via phone to recruit and answer questions. CCRC initially sent an interest 
email to the site directors explaining the study, its components, and the expectations of each site. Within the next few 
days, CCRC followed up the email with a phone call to discuss the program. Interested sites then scheduled an in-person 
meeting. 
See APPENDIX II: Initial Recruitment Call for what to bring for Initial Recruitment Call 
Initial Recruitment Call Modifications from Cohort 1: 
For cohort 2, we began with an initial call rather than an email since it took multiple attempts to connect with 
site directors, as many site directors reported not getting the email or asked it to be re-sent after the initial call. In 
cohort 1, many sites agreed to the in-person meeting after the initial call. However, we understand that some sites will 
require follow-up calls to confirm interest since they often take this information back to their owners/ teachers. Follow-
up calls are scheduled during the initial call to ensure the site director’s availability. We believe condensing this 
recruitment step will allow us to enroll sites more efficiently.  
 
 

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After Site Agrees to Participate 
In-Person Meeting 1 
The purpose of an in-person meeting 1 is to meet with the site to review the project, address any site questions 
or concerns, and enroll interested sites in participation.  The in-person meeting 1 is scheduled during the initial call, and 
communication is documented in the initial call log. We encourage site directors to review all materials with teachers to 
ensure teacher buy-in.  
Program activities and logistics are discussed at the in-person meeting 1. If a site is interested, a second data 
meeting is scheduled a week later with UCLA staff to collect site demographics and the site director survey is given to 
site director. A week later, the director survey is collected, and the teacher surveys are delivered. 
See APPENDIX III: In-Person Meeting 1 for what to bring for In-person Meeting 1 
In-Person Meeting 1 Planned Modifications from Cohort 1 
For cohort 2, we plan to deliver the site director and teacher surveys at the first in-person meeting. At this time, 
we will also schedule the EPAO for 1-2 weeks from the in-person meeting. By scheduling the EPAO at the first in-person 
meeting, we are setting a stricter timeline for data collection, since the EPAO is to be done within 2 weeks of enrollment. 
During the in-person meeting, we will also discuss each data collection activity and outline site specific plans for how to 
deliver each survey efficiently to their participation pool. At the EPAO, we will collect the site director and teacher 
surveys as well as deliver the parent surveys. At some sites, we may be able to collect teacher and site director surveys 
and deliver parent surveys in between the first in-person meeting and the EPAO; if we are able to do so, this will allow 
for  more time to recruit parents. Condensing the survey delivery into one visit will allow us to collect data more 
efficiently as well as limit interference with site activities.  
In-Person Meeting 1 Modifications due to COVID-19 
Cohorts 2 and 3 
 
Due to COVID-19, the first in-person meetings for Cohorts 2 and 3 are held via Zoom. UCLA and CCRC will meet 
with the site director to review the RECRUITMENT POWERPOINT and answer any questions. If the site director would 
like to enroll, UCLA will then schedule a data collection meeting within the next week to collect site demographics.  
Follow-up in-person meeting 1 with an email to the site director containing: 1) Calendar invite for site 
demographics data collection meeting, 2) Director and teacher participation letters, 3) Participation agreement, and 4) 
List of policy documents to submit. 
Site Demographics Data Collection Meeting 
After a site agrees to participate, a follow-up meeting to collect basic site demographics and finalize the data 
collection plan with UCLA is scheduled. The purpose of this meeting is for UCLA to collect baseline demographic 
information about the site (i.e. Enrollment numbers, food patterns, CACFP/menu guidelines, etc.…) and discuss how best 
to collect data from the site. Data is logged in the Site Demographics excel sheet on Box. 
Site Demographics Collection Meeting Modifications due to COVID-19  
Site Demographics Collection Meeting Modifications - Cohorts 2 and 3 
Due to COVID-19, data collection meetings for cohorts 2 and 3 were conducted via Zoom instead of in-person. 
UCLA staff uses the ABC HEALTH ME INTRODUCTION DATA POWERPOINT to help guide the meeting.  

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Phase II: Baseline Data Collection 
1) 
Survey Collection 
Cohort 1 Baseline survey collection began 9/18/21 (conducted via paper) 
Cohort 1 Follow-up survey collection began 7/8/20: 
Data collection for Cohort 1 Follow-up sites was conducted electronically. Two Cohort 1 Control sites converted 
to Cohort 2 intervention sites. These 2 “converted” sites requested data collection to be conducted via paper.  
Cohort 2 Baseline survey collection began 9/15/2020 
Data collection for Cohort 2 baseline survey was conducted via paper and electronically (protocols below). 
Cohort 2 sites could request data collection to be conducted via paper in addition to electronically.  
Cohort 2 Follow-up survey collection began 5/25/2021 (conducted via paper) 
Cohort 3 Baseline survey collection began 9/29/2021 (conducted via paper) 
Site Director Survey Distribution and Collection 
Director surveys is an abridged version of NAPSACC (gonapsacc.com). The site director should receive a paper 
survey at the first in-person meeting and should return the survey to UCLA at the next site visit.  
See APPENDIX IV: Participant Survey Packets 
Site Director Survey Distribution and Collection Modifications due to COVID-19  
Cohort 1 Follow-up and Cohort 2 Baseline Data collection: 
 
Due to COVID-19, in-person data collection paused, leaving surveys to be distributed electronically. After the 
first in-person meeting, UCLA will email the site director with the survey link and unique password. All SURVEY LINKS are 
on Box.  
 
Paper versions were delivered to site directors who preferred paper or did not complete online.  
Site Director Survey Distribution and Collection Modifications – Cohort 2 Follow-up and Cohort 3 
Baseline 
Since majority of site directors preferred paper, paper will be the primary survey collection mode moving 
forward. For cohort 2 follow-up and cohort 3, data collection will be conducted via paper only. 
Teacher Survey Distribution and Collection 
Teacher materials should be delivered at the same time as or when picking up the site director survey. The site 
director will act as the primary conduit for teacher communication. Teachers will submit completed surveys in a sealed 
envelope to the site director for UCLA collection. The site director will keep the sealed surveys in a locked cabinet until 
UCLA staff picks them up.  
See APPENDIX IV: Participant Survey Packets 
Teacher Survey Distribution and Collection Modifications due to COVID-19  
Cohort 1 Follow-up and Cohort 2 Baseline 
Due to COVID-19, in-person data collection paused, leaving surveys to be distributed electronically. All SURVEY 
LINKS are on Box. In order to protect the privacy of each electronic survey, UCLA staff will have to pre-assign an ID and 
password to each participant. The link and unique password will then be emailed to each participant. Paper surveys can 
be provided to sites that prefer. 

11 
 
Teacher emails must be collected from the site in order to provide teachers with a survey link and unique 
password. A TEACHER EMAIL COLLECTION FLYER sheet will be emailed to the site director to provide to the teachers. 
The flyer provides information about  the program and explains the opt-out model of email collection. If a teacher does 
not want to participate, they are told to let their director know. After a week, UCLA will reach out to collect teacher 
emails from the director.  
 
Once teacher emails have been collected, UCLA will send each teacher the TEACHER BASELINE SURVEY LINK 
AND PASSWORD EMAIL explaining the program as well as providing the survey link and password.  
 
Since the online priority was parent enrollment, teacher emails were collected after parent emails. Some sites 
chose to do paper surveys with their teachers.  
Depending on the response rate, UCLA paper surveys may be delivered to sites in order to increase 
participation. During Cohort 2 baseline data collection, most teachers preferred paper surveys. Beginning 10/19/20, 
paper surveys were the primary survey collection method. 
Teacher Survey Distribution and Collection Modifications due to COVID-19 
Cohort 2 Follow-up and Cohort 3 
During Cohort 2 baseline data collection, most teachers preferred paper surveys. Cohort 2 follow-up and cohort 
3 data collection will be conducted via paper only. 
Parent Survey Distribution and Collection 
Parent surveys and consent forms are delivered in envelopes to the site and distributed by teachers in their 
classrooms. Some sites elect to have the director hand out the surveys to parents directly. Parent materials are provided 
to teachers during EPAO to hand out to their parents. UCLA staff should discuss the distribution process with teachers 
and/or the site director before leaving the surveys (e.g. Put parent surveys in cubbies during naptime or slip envelopes 
with child’s name into sign out log.) Additional surveys can be delivered if the site needs more copies. The PARENT 
NOTIFICATION FLYER is available for sites who would like to let parents know to keep an eye out for what’s to come. 
Teachers turn in all submitted parent envelopes to the site director to keep in a locked cabinet until pick-up by 
UCLA staff. Materials are collected weekly. UCLA staff delivers gift cards within 48 hours if not on the same day. Due to 
shipping delays, gift cards are scheduled for delivery within 48 hours of UCLA project staff receiving gift cards.  
See APPENDIX IV: Participant Survey Packets 
Parent Survey Distribution and Collection Modifications due to COVID-19  
Cohort 1 Follow-up and Cohort 2 Baseline 
Due to COVID-19, in-person data collection has been paused for Cohort 1 Follow-up and Cohort 2 Baseline, 
leaving surveys to be distributed electronically. All SURVEY LINKS are on Box. In order to protect the privacy of each 
electronic survey, UCLA staff will have to pre-assign an ID and password to each participant. The link and unique 
password will then be emailed to each participant. Paper surveys were delivered to sites that do not communicate via 
email with parents or do not believe their parents will participate electronically.  
Parent emails must be collected from the site in order to provide parents with the survey link and unique 
password. A PARENT EMAIL COLLECTION FLYER and PARENT EMAIL COLLECTION TEMPLATE will be emailed to the site 
director to email to their parents. The flyer provides information about the program and explains the opt-out model of 
email collection. If a parent does not want to participate, they are told to let their site director know. After a week, UCLA 
staff will reach out to collect parent emails from the site director.  
 
Once parent emails have been collected, UCLA staff will send each parent the PARENT BASELINE SURVEY LINK 
AND PASSWORD email explaining the program and providing the survey link and password. Email addresses and unique 
survey information will be extracted from our Unique ID tacking data and compiled using a Python code.  Emails will be 

12 
 
sent to participating parents via the webhost MailChimp. The email will contain a link to the survey as well as a required 
password to enter the survey. The link and password will be assigned to their unique ID.  
In the event of two emails provided for one child, we will send the first email to the mother. If we cannot discern 
which email belongs to the child’s mother, we will send the emails to the first email address listed alphabetically. If we 
have trouble contacting a family with two emails, we may send follow-up emails to the second provided address.  
In the event of one parent having two or more children participating in the study, we will use a different email 
template and provide the passwords for all the children in one email (e.g., “your unique passwords: (Child1) P-XX-X-XX-
B-pass1, (Child2) P-XX-X-XX-B-pass2”).  
If we can continue on-site recruitment for follow-up, we will use a mixed-method approach; both paper and 
online surveys will be available to parents for follow-up. 
Depending on the response rate, UCLA paper surveys may be delivered to sites in order to increase 
participation. Since most sites preferred paper and the paper response rate was better for all sites, for cohort 2 follow-
up and cohort 3, data collection will be conducted via paper only. 
In order to expedite height and weight adipose measurements (and instrument turn around), parent consent 
sheets were distributed separately from parent surveys.  During height and weight equipment dropoff/instrument 
training with preschool staff, preschool staff were instructed to ask parents to complete and return the consents on-site 
(prior to their child taking part in height and weight data collection), while parents were allowed to bring the parent 
survey home with them to complete.  
Survey Reminder Emails 
 Cohort 1 Follow-up and Cohort 2 Baseline 
Parent:  
1. UCLA Statistician compiled a list of IDs that have completed the survey/consent form as well as IDs that are in 
progress.  UCLA Statistician sent the compiled list to the project coordinator and project assistant on Monday 
(previously Tuesday). Project assistant updated password tracking documents (“Year 2 Unique ID Tracker”, 
"Year 2 - For MailChimp", "Baseline Year 2 Parent Email Tracking").   
a. If a parent returned a completed paper survey in the previous week, and has an email on file, their email 
was removed from the email list.   
Due to multiple types of completion (types following), UCLA created multiple unique reminder emails for parents to fit 
their completion type. Types of completion status and reminder emails following: 
Families with one child: 
• 
Parents did not complete either the survey or consent form 
• 
Parents completed the survey but not the consent form 
• 
Parents completed the consent form but not the survey 
• 
Parents started the survey but did not complete the consent form 
Families with multiple children at participating preschool: 
 
Parents completed both consent and survey for one child but did not complete either document for 
their second/third child  
 
Parents completed consent forms for all their children but did not complete the surveys for any of their 
children 
 
Parents completed surveys for all their children but did not complete the consent forms for any of their 
children 
 

13 
 
2. Once tracking documents are updated per UCLA Statistician’s compiled report (#1 above), reminders are sent 
in the following order on Tuesday and Wednesday:  
1. Families with one child enrolled at the participating preschool: 
■ With multiple completion types (above), email reminders were sent in the following “sub-
order”: 
i. 
Parents have not completed the survey or consent form 
ii. 
Parents completed the consent form but not the survey  
iii. 
Parents completed the survey but not the consent form  
iv. 
Because most parents fall into one of the above 3 categories, the last group(s) that the 
project assistant emails are the parents that have completed any other combination of 
the above (e.g. [one kid]: completed consent and survey is in progress, [mult kids]: 
completed both documents for one child, neither document completed for other child) 
2. Families with two children enrolled at the participating preschool: (sub order above) 
3. Families with three children enrolled at the participating preschool: (sub order above) 
● Once sent, the dates on which the reminders are sent are added to tracking documents.  
 
Teacher reminders are sent out after all parent reminders are sent out (Wednesday/Thursday) 
1. Same as Parent #1 
2. Send after all Parent reminders are sent out 
●  Order: 1st - nothing completed, 2nd- no survey, 3rd - no consent, 4th- "special" (e.g., completed consent and 
survey in progress)  
Parent On-site Recruitment/ Tabling Events Cohort 1 Data Collection: 
Depending on the site response rate, UCLA research staff may conduct on-site parent recruitment events in 
order to distribute and/or collect materials during drop-off and pick-up. Since the primary outcome is BMI, we will 
encourage parents to complete the H&W consent on-site as well as the survey. The survey takes approximately 5-10 
minutes for parents to complete (slightly longer for Spanish language surveys). It can be provided as a take-home as 
well. Parents would receive a gift card on the spot if they completed the survey on-site.  
H&W measurements can be done during parent recruitment events, but measurements should not be shared 
with parents until after survey completion.  
Pilot Testing Parent Survey Procedure 
Pilot testing was conducted prior to launching the parent survey in order to obtain parent feedback and make 
any necessary adjustments.  
All piloting materials, including procedure, can be found: Box Data Collection InstrumentsPilot Testing 
Survey Entry 
Surveys are conducted on paper and entered into Qualtrics by UCLA research staff and/or interns. All paper 
copies are retained in the UCLA project coordinator’s or project assistant’s office. Due to COVID-19, electronic surveys 
are available and emailed directly to participants who provide an email address. 
See APPENDIX V: How to Enter Preschool Project Data 
Unique IDs 
UCLA assigns all surveys a unique ID in order to link 1) pre and post-test data and 2) parent survey data with 
child measurements. Unique IDs are assigned by site, by classroom/teacher, and tracked in the Unique ID Tracker-List. 

14 
 
All surveys receive a unique ID before being entered into Qualtrics and a running list of unique IDs is kept to ensure no 
duplication.  
As surveys are received, they are immediately given a unique 7-digit ID for teacher, parents, and children and a 
4-digit ID for site directors and EPAO Observations. Sites will receive a unique numeric identifier upon signing of the 
commitment letter, which is used to generate IDs. Participant’s unique IDs are issued in the order of enrollment.  
See APPENDIX VI: How to Generate a Unique ID 
Unique ID Modifications due to COVID-19  
Unique ID Modifications due to COVID-19 – Cohort 1 Follow-up and Cohort 2 Baseline  
 
In order to protect the privacy of each electronic survey, UCLA staff will have to pre-assign an ID and password 
to each participant. The link and unique password will then be emailed to each participant. 
 
A unique ID and password list will be generated by the UCLA Statistician. Once parent emails have been 
obtained from site, parents will be assigned an ID.  All unique IDs will be tracked in a Unique ID document maintained by 
UCLA.  
Unique ID Modifications starting Cohort 2 Follow-up (5/25/21): 
Since most Cohort 2 sites preferred paper and the paper response rate was better for all Cohort 2 sites at 
baseline, beginning at Cohort 2 Follow-up (5/25/2021), data collection will be conducted via paper only. Unique IDs are 
assigned to participants following their enrollment.  
Site Director Survey Entry 
 Site director IDs are assigned when a site enrolls in the program. Site director IDs are assigned in the order in 
which sites enroll. Site director IDs are used on the site director survey only. Once a site director ID is assigned, the site 
director survey is entered in Qualtrics. Surveys conducted on paper and entered into Qualtrics by UCLA research staff 
and/or interns. Data will be maintained by the UCLA statistician.  
Cohort 1 Follow-up and Cohort 2 Baseline Survey Entry 
Electronic surveys will automatically be logged into the Qualtrics system.  
Teacher Survey Entry 
 
Teacher IDs are assigned based on the classroom. If multiple teachers are in one classroom, lead teacher is 
assigned first ID for the classroom. If there are multiple teachers in one classroom but no lead teacher, teacher IDs are 
assigned at random. Teacher IDs are used to link pre-post data as well as link teacher survey data to teacher height and 
weight data. Once a teacher ID is assigned, teacher survey is entered in Qualtrics. Data will be maintained by the UCLA 
statistician. 
Cohort 1 Follow-up and Cohort 2 Baseline Survey Entry 
 
Electronic surveys will automatically be logged into the Qualtrics system. 
Starting 5/25/21 (Cohort 2 Follow-up and Cohort 3), all teacher surveys were collected via paper.  
Parent Survey Entry 
 
Parent IDs are assigned based on their child’s preschool classroom/teacher. This allows us to see if the 
intervention had an impact on each classroom. Parent IDs are used to link pre-post data as well as parent self-report 
data to child height and weight measurements. Once a parent-child unique ID is assigned, the parent survey is entered in 
Qualtrics. Parent ID and child are assigned a matching ID. Surveys conducted on paper and entered into Qualtrics by 
UCLA research staff and/or interns. Data will be maintained by the UCLA statistician. 
Cohort 1 Follow-up and Cohort 2 Baseline Survey Entry 
 
Electronic surveys will automatically be logged into the Qualtrics system.  

15 
 
2) 
EPAO and Policy Review 
EPAO 
EPAO citation: Ward DS, Hales D, Haverly K, Marks J, Benjamin S, Ball S, et al. An instrument to assess the obesogenic 
environment of childcare centers. Am J Health Behav 2008; 32(4): 380-6. 
EPAOs should be scheduled for 1-2 weeks from In-person Meeting 1. All scheduled dates and completion dates 
of an EPAO logged in SITE DEMOGRAPHICS AND SITE NOTES. Observations take 5-6 hours each. All observations are 
done in teams of two. Only trained UCLA staff can conduct an EPAO. UCLA staff conducted an EPAO training August 12–
14 at CPCR. EPAO TRAINING documents can be found on Box. All observers must complete the EPAO certification 
training, provided by University of North Carolina, and receive a certification score of 85% or better. 
While scheduling an EPAO with the site director, UCLA research staff also send a request for policy documents. A 
week before a scheduled EPAO, UCLA research staff send a follow-up reminder email. Upon arrival to preschool site for 
an EPAO, UCLA staff requests documents again. It is ideal to have at least 3 months of menus when conducting a 
document review. The next steps are to collect teacher surveys and deliver parent surveys.  
If a preschool has multiple preschool classrooms, the site director designates which classroom will be observed. 
One classroom per site; same classroom pre and post.  
EPAO paperwork should be turned in to UCLA staff no later than the following business day.  
University of North Carolina provided an Excel data log for entering data. They also provided the SAS 
programming. The main excel database has each section of the observations broken out into different tabs along the 
bottom. SAS combines the tabs and calculates the outcomes. Data is entered by UCLA research staff and analysis is 
conducted by the UCLA statistician using UNC’s provided SAS code.   
All EPAOs are logged on the EPAO DATA ENTRY TABLE. 
See APPENDIX VII: EPAO 
EPAO Modifications due to COVID-19 
 
Due to COVID-19, the EPAO will not be conducted for cohorts 2 and 3. Policy documents will be requested 
after in-person meeting 1. 
As of January 2022, preschools are still implementing social distancing practices and not allowing any visitors 
inside campus buildings. The EPAO was not included at any of the project sites due to COVID regulations.  
3) 
Height and Weight Measurements 
Height and Weight Measurements 
 
Height and Weight (H&W) measurements should be scheduled to occur within 2-4 weeks of parent survey 
packets delivery. H&W measurements can be conducted during parent engagement events, but measurements should 
not be shared with parents until after the survey has been completed.  
Height is measured using a calibrated portable stadiometer. Weight is measured using a research quality 
calibrated digital scale. Research staff ensures calibration prior to measurement collection. Calibration is established by 
measuring a test subject three times on each piece of equipment to ensure all measurements are consistent across and 
within each piece of equipment. All height measurements are documented in INCHES to the nearest 1/8 inch and weight 
measurements are documented in POUNDS. Additionally, we collect each child’s gender and birth date while collecting 
the measurements.  
 
As students return H&W consents, a running list of who can be measured (identified by name and unique ID) is 
created: The HEIGHT AND WEIGHT IDENTIFIER (word doc) (only used at baseline cohort 1; see COVID-19 Modifications). 

16 
 
Identifier doc links participant name to unique ID. Unique ID is entered on the HEIGHT AND WEIGHT DATA COLLECTION 
SHEET to keep documented measurements anonymous.  Only students who have returned a consent form are able to 
participate in H&W.  
 
See Gift Cards section for height and weight distribution envelopes, which are given to the teacher to give to the 
parents of children who participated that day. A follow-up measurement collection is scheduled for the children that 
were absent that day.  Data are entered into HEIGHT AND WEIGHT DATA ENTRY. 
See APPENDIX VIII: Height and Weight Materials 
Height and Weight Modifications due to COVID-19  
Height and Weight Modifications due to COVID-19 - March 2020 – September 2021, Cohort 1 
Follow-up through Cohort 2 follow-up 
 
Due to COVID-19, if UCLA staff is not allowed onto preschool property, preschool directors and teachers will be 
asked to conduct the measurements. A scale and stadiometer will be delivered to the preschool by UCLA staff. A training 
PowerPoint has been put together to train the preschool staff. The PowerPoint can be sent ahead of time to a site and 
must be reviewed with whomever will be conducting the measurements during equipment drop-off. A link to complete 
a 5-question comprehension check is provided at the end of the PowerPoint. All staff collecting the measurements will 
be asked to review the training. A list of the students who have consented will be provided to the site in order to collect 
data. The participant name’s will be provided, rather than the unique ID, for ease of data collection for the site director. 
Data will be logged by Unique ID in the Data entry excel spreadsheet.  
In order to expedite height and weight adipose measurements (and instrument turn around), parent consent 
sheets were distributed separately from parent surveys. During height and weight equipment dropoff/instrument 
training with preschool staff, preschool staff were instructed to ask parents to complete and return the consents on-site 
(prior to their child taking part in height/weight data collection). Parents were allowed to bring the parent survey home 
with them to complete. 
 
Scales and stadiometers were calibrated to assess validity.  
Height and Weight Modifications - UCLA field research restrictions lifted September 2021, 
Cohort 3 baseline 
UCLA’s restrictions for field research activities were lifted in the Fall of 2021, allowing the project to return to 
the originally planned approach of having UCLA staff members conduct the height and weight measurements. All UCLA 
staff members are fully vaccinated against COVID-19 and complete a daily symptom monitoring survey prior to entering 
UCLA campus and any participating study sites. Participating sites that had on-going height and weight consent 
collection prior to the lifted restrictions, were notified of the lifted field restrictions via phone. UCLA research staff 
followed a script (hyperlinked script:  “Preschool_Cohort 3_Height weight measurements by UCLA staff_FINAL 9 30 21”.) 
to notify sites 
If a participating site has policies against off-campus visitors, preschool directors and teachers will be asked to 
conduct the measurements following the above COVID-19 modifications. If this approach is used, UCLA staff members 
will observe the measurements either in person, via Zoom, or another video conferencing program in order to provide 
any necessary guidance to the teachers as they conduct the measurements.  
 
See APPENDIX IX: SCALE CALIBRATION PROTOCOL 
Gift Cards 
All gift cards must be documented before distributed in GIFT CARD TRACKING. The gift card 15-digit serial 
number is documented, and a corresponding shorthand number is assigned.  

17 
 
Once participant surveys have been received by UCLA, gift cards will be distributed to the preschool. Gift cards 
are placed in an envelope along with a thank you note, sealed, and labeled with the site, parent name, and child’s name.  
Prior to delivering gift cards to sites, UCLA staff prepare a gift card sign-out sheet (GIFT CARD LOG). The gift card 
sign-out sheet is prefilled out by UCLA staff with the participant’s name and pre-assigned gift card number. Two copies 
of the sign-out log are delivered to the site (one for the director to sign as proof of delivery from UCLA, and the second 
to leave with the director to have participants sign for their gift card). All participants must sign for a gift card next to the 
corresponding number on their card.  
Gift Card Amounts 
For: 
Pre Amount: 
Post Amount: 
Parent survey 
$10 
$20 
Child height and weight 
$5 
$5 
Teacher survey 
$10 
$25 
Teacher height and weight 
$5 
$5 
Site Director survey 
$10 
$25 
Phase III: Randomization and Implementation 
Randomization of Sites 
 
Randomization will occur once most sites have completed the EPAO and the NAPSACC surveys. Sites are 
stratified by the following: CACFP (aka food program) participation, number of site provided meals, and preschool size.  
Regardless of randomization, all sites will participate in pre/baseline (at beginning of the school year) and post/follow-up 
(at the end of the school year) data collection activities, including: 
1) Site Director/ NAPSACC survey 
2) Teacher surveys 
3) Parent surveys 
4) Height and Weight Measurements 
5) EPAO and Policy Review (Cohorts 2 and 3 only Policy Review due to COVID) 
Sites that are randomized to the intervention arm will receive materials at the beginning of the school year. Materials 
include:  
1) Intervention materials (Sesame Street binder and parent materials) 
2) Program banner 
3) 2-liter pump hand sanitizer (with ABC Healthy Me Sticker) 
4) Coaching (1-2 times a month per teacher per site for up to an hour) 
5) Stipend and supply allotment  
Sites that are randomized to the delayed-intervention arm will receive materials at the end of the school year. Materials 
include:  
1) Intervention materials (Sesame Street binder and parent materials) 
2) Stipend and supply allotment  
3) Abridged coaching (1-2 sessions at the end of the school year) 
a. Cohort 2 sites that were randomized to the delayed-intervention arm are to receive abridged coaching 
throughout the following school year. (1 session every other month throughout the school year). This 
group will receive coaching through our “cohort coaching model”; sites will receive coaching in the same 

18 
 
sessions as other sites in order to promote support between schools during the months they will not 
receive nutrition and physical activity coaching.  
Implementation 
Implementation is guided by the A-B-C Healthy Me Required and Supplemental Component Table and the RE-AIM table.  
● A-B-C HEALTHY ME REQUIRED AND SUPPLEMENTAL COMPONENT TABLE  
● RE_AIM TABLE 
*Since this is an implementation science project, the goal of this implementation is to apply a gentle touch in guiding 
sites to make permanent, sustainable change.  
Implementation begins with an initial coaching session to introduce the program to teachers and discuss the 
curriculum. The coach works with the site director to establish if the first coaching session occurs with the site director 
and the teachers together or separately. At least one coaching session occurs with the site director to address the 
supplemental components of interest and address policy changes to be made. During the initial coaching session, the 
site staff and the coach review the Component Table and select targeted activities.  
Implementation focuses on: 
● Improving health policies per the A-B-C COMPONENT TABLE 
● Integration of SESAME STREET HEALTH HABITS FOR LIFE into curriculum 
● Teacher modeling of healthy behaviors 
● Parent engagement via events and monthly handouts 
o PARENT ENGAGEMENT TRACKER 
o PARENT MONTHLY HANDOUTS 
o PARENT MONTHLY BOOKLETS 
Implementation Tracking 
Implementation monitored and documented via: 
● COACHING SITE SUMMARY: meant for the coach to document the subject matter of the coaching 
session, the action plan to attain goals, and next steps. Multiple subject matters may be discussed 
during one coaching session. Subject matters include: curriculum and learning activities, resources, 
family engagement, education or professional development, policy, practice, and environment.  
o The coach completes this with whomever is receiving the coaching, which is most often the 
teachers.  
o The coach will enter the data into SurveyMonkey, which is managed by CCRC.  
● QIP FORM(S): the quality improvement plan. This is the plan the teacher will use to implement what 
they learned in coaching and how they will achieve the plan goal.  
o The coach completes this with whomever is receiving the coaching, which is most often the 
teachers.  
o The coach will enter the data into SurveyMonkey, which is managed by CCRC.  
● TEACHER TRACKER: a weekly report of activities the teacher conducted in the classroom. Planned 
activities are captured and submitted on the lesson plan. This will allow us to know the fidelity of 
implementation. 
o The teacher fills this out and submits weekly via email or google doc, per site preference.  
o UCLA will enter the data into the COACHING DATA TRACKER 
● LESSON PLANS: allows teachers to plan for how to integrate Sesame Street into their planned activities. 
Teachers will work with the coach to identify which lessons and where in their existing schedule they 
can integrate these activities.  

19 
 
o The teacher fills out either on their own or with the coach at first. The teacher submits via email 
weekly (preferred, but site dependent). 
o Lesson plans will be scanned and uploaded to Box.  
● COACHING VISIT TRACKER: allows the coach to track how many visits they have had with each teacher 
from each site. 
● PROGRESS NOTES: kept to maintain notes of what is going on at each site. 
Coaching 
The coach will ideally meet with each teacher at a site, twice monthly, for one hour each visit, depending on 
availability. The coaching happens on a strength base approach and meeting the teacher where he/she is. Building a 
relationship is part of the coaching as it helps teachers feel supported and connected. The initial coaching visit is about 
the coach and the teacher establishing a connection and talking about classroom routines and program structure. 
Logistics about what coaching sessions will look like is also discussed with the teacher. 
Coaching has a few moving parts. There are goals that are created by the teacher with the support of the coach. 
These goals are specific, measurable, attainable, relevant and time bound. The goals are also developed based on the 
requirements of the program and the need of the classroom from the coach’s observation. These goals are developed 
and tracked on our Quality Improvement Plan (QIP) as well as every follow up for that goal. Depending on the goals, a 
teacher may be working on more than one goal at one given time, considering that some goals will have a very short 
timeline. 
After every visit the coach completes a site summary visit where data on the one-hour visit is completed; this 
data consists of duration of the visit, the number of adults in the classroom during the visit as well as the number of 
children in attendance during the visit, if children are present. The coach also connects with the center director after 
each coaching session with teachers to keep the director informed of all of the coaching activities, teacher goals and 
provides resources and coaching in the administrative aspect of the program.  
Once the control sites have completed their site director and teacher surveys, they will be contacted for 
coaching. Coaching will be abridged, approximately two 1-hour sessions, to help teachers get an understanding of the 
Sesame Street curriculum and how to implement it themselves as well as meeting with each site director to discuss 
policy recommendations.  
Coaching Modifications due to COVID-19 
 Coaching Modifications due to COVID-19- March 2020 – present (January 2022) 
Coaching has currently shifted to accommodate the current situation with the COVID-19 pandemic, being 
sheltered in place and not being able to conduct visits. Coaching is now being done virtually and over the phone and it 
looks a little different. Teachers are experiencing uncertainty, anxiety and stress, most of the coaching conversations 
begin with the coach listening and offering support in any way possible. We are currently working to develop a different 
approach to engage not only teachers but also the families. As of January 2022, coaching for cohort 3 is still conducted 
virtually.  
All Teacher materials were moved to a website: abchealthymeteacher.wordpress.com 
Coaching Modifications for Cohort 2 
Cohort 1 control sites are being given the opportunity to enroll for a second year as an intervention site. Their 
follow-up data from their first year will act as baseline data for their second year. Once control sites have started their 
data collection and are scheduling their height and weight measurements, they will be contacted for coaching. If a site 
does not participate in follow-up data collection, they will not be allowed to receive coaching. 
Additionally, control sites will be provided Health and Safety Coaching. In general, the coach could possibly 
facilitate training addressing some of the most common deficiencies found by Community Care Licensing and by the 

20 
 
most common trends amongst providers found by the coach during visits. This would help support and enhance Health 
and Safety practices on a daily basis by doing the following: 
● Conduct Health and Safety screenings 
● Identify areas of focus based on the needs of the site and implement corrective action plans 
● Support in implementing Community Care Licensing Title 22, best practices and Caring for Our Children 
National Health and Safety Performance Standards as well as new regulations and compliance with Health 
and state post COVID 19  
● Collaborate with provider/teachers and program coach to ensure high quality operation of program 
based on findings and recommendations 
● Provide resources to support the implementation of Health and Safety practices 
● Support providers/teachers with any updates made by Community Care Licensing, Centers for Disease 
Control and Department of Public Health 
● Maintain communication with provider and program coach to ensure compliance 
Family Child Care (FCC) Coaching – Cohort 2  
FCC coaching will be scheduled as a group, bringing together FCCs to collaborate as a cohort. Cohort sessions 
will begin after the first individual coaching visit with each site and occur monthly. Coaching visits with individual 
providers will happen based on the need of the provider and the discretion of the coach if she feels providers need 
additional support. 
Goals addressing the need and requirement of the program will be created in order to conduct the cohort 
coaching (all providers will be coached on implementing the same goals at the same time). The strategy behind the 
cohort coaching is to be able to conduct visits with providers as a group so that they may also be of support to each 
other throughout the program year.  
Coaching Data Entry 
 Data collected from coaching forms (site summary and QIP) is entered into SurveyMonkey and run by CCRC. The 
teacher tracker and lesson plans are submitted weekly by the teacher to the coach and scanned and uploaded to Box.  A 
tracking system allows the coach to know which sites have turned in their lesson and plans and trackers.  
Parent Engagement 
As part of the program, sites are required to host two parent engagements each school year. Parent 
engagement events are meant to bring preschool parents together to engage in a physical activity or nutrition learning. 
Depending on the site, each classroom may hold a parent engagement event for the parents of that classroom or the 
whole school may host for all parents. Events may include: Zumba, yoga, dance cardio, healthy snacks, rethink your 
drink, etc. 
Parent Engagement Modifications due to COVID-19 
Starting May 2020: Due to COVID-19, parent engagement events are available via Zoom.  
Starting March 2021, Cohort 2 sites conducted parent engagement events in-person, online, or as a “take-
home” option in accordance with their school’s social distancing policies. Coaches work with the site directors to 
schedule events, send event flyers, and notify parents. CCRC coaches lead these events. CCRC may also reach out to 
outside contractors who may be willing to lead an event.  
Parent Website 
The A-B-C Healthy Me website (www.abchealthyme.wordpress.com) provides our intervention sites with 
resources they can share with parents and parents can come back to for relevant health information. The information 
available on the website has been created by the A-B-C Healthy Me team and/or was recommended for use by the CCRC 
coaching team. Links to external resources are provided throughout the website so parents can choose which content to 

21 
 
use. Resources and links can be updated by UCLA at any time to provide our participants with up-to-date health 
information.  
The main pages of the website include: Nutrition Resources; Physical Activity Resources; downloadable versions 
of all the A-B-C Healthy Me Parent Booklets (in English and Spanish); and at-home learning resources. Additionally, there 
is a COVID-19 page with links to helpful family COVID-19 resources including the Center for Health Equity resource page 
and the CA Department of Health COVID website.  
The A-B-C Healthy Me website will be made available to parents through their preschool site. Sites selected for 
intervention will be provided with the URL to share with parents. It will also be included in all A-B-C Healthy Me 
resources sent to parents. Parents can then access resources, find helpful information, and download parent booklets.  
We have selected to launch the website in “hidden” mode so that the URL will not be searchable or available on 
major search engines (such as Google or Yahoo). In order to limit barriers to access, password protections will not be 
required for participants to gain access to this website. We do not expect participants to share this information outside 
of their school and we will discuss limiting sharing of this resource with the site director during the coaching meeting. 
Phase IV: Follow-up Data Collection 
Follow-Up Data Collection 
Follow-up data collection will begin with control sites and then rollout at intervention sites. This will allow us to 
efficiently collect follow-up data at each site while allowing the intervention to continue with as much time as possible.  
Cohort 1 Follow-up Data Collection Modifications due to COVID-19 
Due to COVID-19, in-person cohort 1 follow-up data collection paused, leaving surveys to be distributed 
electronically. In order to protect the privacy of each electronic survey, UCLA will have to pre-assign an ID and password 
to each participant. The link and unique password will then be emailed to each participant. Paper surveys can be 
delivered to sites that do not communicate via email with parents or do not believe their parents will participate 
electronically.  
Cohort 2 Data Collection Modifications due to COVID-19 
Cohort 2 baseline data collection initially was collected electronically. However, many sites requested that paper 
surveys also be distributed to their parents and teachers. Most Cohort 2 sites preferred paper and the paper response 
rate was better for all Cohort 2 sites at baseline.  Beginning at Cohort 2 Follow-up data collection (5/25/2021), will be 
conducted via paper only. Unique IDs are assigned to participants following their enrollment   
Additionally, parents that did not participate in baseline data collection activities will be eligible to participate in 
follow-up activities. Many sites saw great turn over in children during the start of the pandemic, leaving many of the 
baseline participants to no longer be enrolled at the site for follow-up. However, new parents have enrolled and thus 
may still be able to provide insights into the preschool environment.   
Follow-up Surveys 
Paper Follow-up Surveys 
All surveys will be delivered at the same time to a site (parent, teacher, and site director). Teacher and site 
director surveys will be collected one week after delivery. Parent surveys will also begin collection one week after 
delivery and last for 2-3 weeks with a weekly pick up from the site director. Parents who did not participate in the 
baseline survey may still participate in the follow-up survey.  
Starting 5/25/21 (cohort 2 follow-up and cohort 3), data collection will be conducted via paper only. 

22 
 
Electronic Follow-Up Surveys- Cohort 1 Follow-up  
In the event we are unable to distribute surveys directly to participants on-site (i.e., COVID-19), we will ask site 
directors if they are able to circulate surveys through their parent contact network (i.e., Email, app-based, etc.) and to 
their teachers. For parents who provided their contact information at enrollment, we will directly send their survey link 
to them via email. The email will contain the link to the survey as well as required password to enter the survey. The link 
and password will be assigned to their unique ID. 
Otherwise, other parent emails must be collected from the site in order to provide parents with the survey link 
and unique password. A PARENT or TEACHER EMAIL COLLECTION FLYER will be emailed to the site director to email to 
their parents. The flyer provides information on the program and explains the opt-out model of email collection. If a 
parent does not want to participate, they are told to let their site director know. After a week, UCLA will reach out to 
collect parent emails from the site director.  
 
Once parent emails have been collected, UCLA will send each parent the PARENT BASELINE SURVEY LINK AND 
PASSWORD EMAIL explaining the program and providing the survey link and password. Email addresses and unique 
survey information will be extracted from our Unique ID tracking data and compiled using a Python code.  Emails will be 
sent to participating parents via the webhost, MailChimp, and will contain the link to the survey as well as the required 
password to enter the survey. The link and password will be assigned to their unique ID.  
If we are able to continue on-site recruitment for follow-up, we will use a mixed-method approach; both paper 
and online surveys will be available to parents, teachers, and directors for follow-up.  
Beginning 5/25/21, cohort 2 follow-up and cohort 3 data collection will be conducted via paper only. 
Follow-up EPAO  
Control EPAOs will occur at the beginning of the month and intervention site EPAOs will be conducted at the end 
of the month. Ideally, the same team that conducted the baseline EPAO will conduct the follow-up EPAO. Follow-up 
EPAOs for intervention sites may be conducted while coaching activities are still on-going; however, control sites follow-
up EPAO must be conducted before contact with coaching.  
In the event the follow-up EPAO cannot be conducted in the same “school year” as the baseline (i.e., COVID-19), 
follow-up EPAOs will be conducted as soon as possible. Ideally, the same teacher will be observed at both the baseline 
and follow-up. If the same teacher is unavailable, another preschool teacher will be selected by the site director for 
observation.  
Follow-up Height and Weight  
Follow-up height and weight measurements will follow the same protocol as baseline measurements. Multiple 
sessions may occur at each site in order to collect all children’s measurements. Participants who did not participate in 
baseline measurements may still participate in follow-up measurements. UCLA research staff will distribute consent 
forms on-site at measurements.   
In the event the follow-up height and weight measurements cannot be conducted in the same “school year” as 
the baseline (i.e., COVID-19), follow-up height and weight measurements will be conducted as soon as possible. Children 
who participated in baseline may still be on-site but in a different classroom. Additionally, new participants will be 
recruited to participate in the follow-up measurements.  

23 
 
Phase V: Evaluation 
Program Evaluation 
Program evaluation will be assessed periodically during the intervention period and will be guided by the RE-
AIM table 
Process Evaluation 
Implementation monitored and documented via: 
● COACHING SITE SUMMARY 
o This summary is meant for coaches to document the subject matter of the coaching session, the 
action plan to attain goals, and next steps. Multiple subject matters may be discussed during 
one coaching session. Subject matters include: curriculum and learning activities, resources, 
family engagement, education or professional development, policy, practice, and environment.  
o The coach completes this with whomever is receiving the coaching, most often the teachers.  
o The coach will enter data into SurveyMonkey, managed by CCRC.  
● QIP FORM  
o This form is the quality improvement plan. This is the plan the teacher will use to implement 
what they learned in coaching and how they will achieve planned goals.  
o The coach completes this with whomever is receiving the coaching, most often the teachers.  
o The coach will enter data into SurveyMonkey, managed by CCRC.  
● TEACHER TRACKER  
o This is a weekly report of what activities the teacher conducted in the classroom. Planned 
activities are captured and submitted in the lesson plan. This will allow us to know the fidelity of 
implementation. 
o The teacher fills this out and submits weekly via email or google doc, per site. preference.  
● LESSON PLAN DOCUMENTS 
o These documents allow the teacher to figure out how to integrate Sesame Street into their 
planned activities. Teachers will work with the coach to identify which lessons and where in 
their existing schedule they can integrate these activities.  
o The teacher fills out either on their own or with the coach at first. The teacher then submits via 
email weekly (preferred, but site dependent). 
Outcome Evaluation 
Program outcomes include the following: 
● Effectiveness: 
o Primary: Change in zBMI of preschool students 
o Secondary:  
▪ 
Change in preschool student nutrition as reported by parents 
▪ 
Change in preschool student physical activity as reported by parents 
▪ 
Change in zBMI of preschool teachers 
▪ 
Change in preschool teacher nutrition  
▪ 
Change in preschool teacher physical activity 
● Implementation: 
o Primary: EPAO scores (discontinued due to COVID) 
o Secondary: NAP SACC scores 
 

24 
 
APPENDIX I: Initial Director Call Talking Points 
The initial call entails: 
□ Explaining the partnership between UCLA and CCRC 
□ Reviewing program goals and expectations 
o Program goals are meant to be flexible to the needs of each site 
□ Clearly explaining that sites will be randomized into two arms (intervention and delayed intervention) 
o All sites will eventually receive the intervention and stipend.  
o Sites that are randomized into the delayed-intervention group will complete surveys, height and weight 
measurements, and observations at the beginning and end of the year; however, they will not receive 
program materials or stipends until the end of the school year. This also means these sites will receive 
abridged coaching.  
□ Assessing readiness to agree to participation 
□ Referring to “Why Should a Site Participate?” section below for additional information 
o Sites that do not agree to participation during the initial call will receive a follow-up call a week later to 
gauge interest. 
o Encourage site directors who are unsure to discuss with their teachers 
Why Should a Site Participate? 
● Sites will set own nutrition and physical activity goals  
● Sesame Street Healthy Habits for Life is a nationally recommended and evidence-based curriculum 
● Sites will receive support throughout the duration of the intervention as well as $500 to purchase 
supplies/resources to support the implementation of nutrition and physical activity policies 
● Trusted CCRC coaches will assist with curriculum/lesson planning to support classroom learning 
● Childhood obesity can affect development, brain function, self-esteem, and increase disease risk  
● Childhood nutrition and physical activity preferences are typically established during preschool years and track into 
adulthood, leaving children who become overweight/obese to be at a fivefold increased risk of being 
overweight/obese adults2 
● 20% of preschool aged children in Los Angeles County are overweight or obese1 
● Nearly 61% of children under the age of 5 in the U.S. are enrolled in nonrelative, center-based care where they 
spend an average of 33 hours per week and receive majority (2/3) of meals2 
● CACFP new recommendations (effective as of Oct. 1, 2017) include3: 
o Both fruits and vegetables (or two different vegetables) served at lunch  
o Juice may be served and counted as fruit component of the meal, but is limited to once per day 
o One serving of whole grain-rich grains must be served each day 
o Grain-based desserts, such as cookies, cakes, pies, are no longer reimbursable as a grain 
o Meal patterns limit added sugar by requiring unflavored milk only for children 0-5 and limiting sugar in ready-
to-eat cereals and yogurt 
● Staff modeling (specifically sitting with children and eating the same food as children) associated with higher 
vegetable and fruit intake2 
 
 

25 
 
APPENDIX II: Initial Call 
When reaching out to a site to set up an initial call: 
1. Copy and paste the site recruitment script in the body of an email and attach the site recruitment flyer to 
the email and send to the site director before the initial call.  
● SITE RECRUITMENT SCRIPT  
● SITE RECRUITMENT FLYER 
During the initial call: 
1. Complete the INITIAL RECRUITMENT CALL COLLECTION. This needs to be filled out during each call to a 
site.  
● Have the site recruitment script and flyer available to review. (SITE RECRUITMENT SCRIPT and SITE 
RECRUITMENT FLYER on Box) 
2. Schedule in-person meeting 1 
After Initial call (within 24 hours),  
1. Initial call data logged in the INITIAL CALL/RECRUITMENT DATA LOG 
2. Send email containing: 
▪ Calendar invite for in-person meeting 1 
▪ Copy and paste: 
o SITE AGREEMENT SCRIPT   
o SITE DIRECTOR PARTICIPATION LETTER  
o TEACHER PARTICIPATION LETTER*  
*The site director will forward to teachers and paper copies are also brought to in-person 
meeting 1 
 
 
 

26 
 
APPENDIX III: In-Person Meeting 1 
Cohort 1: At In-Person Meeting 1: 
1. Bring Teacher Sample Binder and Site Folder containing: 
● At least 3 copies of the TEACHER RECRUITMENT LETTER (remember to add the name of the school 
and date)  
● SITE COMMITMENT LETTER  
● ACTIVITY TABLE 
● SITE DEMOGRAPHICS PAPERWORK 
● SITE DATA COLLECTION PROCESS FORM 
2. Deliver: 
● Site director Survey Packet: 
● Teacher Survey Packet: 
i. Teacher participation letter 
*Document date of delivery in INITIAL CALL/RECRUITMENT DATA LOG 
3. Complete: 
● Schedule EPAO observation day for within two weeks of in-person meeting 1 
▪ 
SITE COMMITMENT LETTER  
▪ 
SITE DEMOGRAPHICS PAPERWORK  
▪ 
SITE DATA COLLECTION PROCESS  
Site Demographics and Data Collection form logged in Site Demographics and Site Notes 
Cohort 2: At In-person Meeting 1: 
 
RECRUITMENT POWERPOINT 
After in-person meeting 1, email (link script) site directors: 
 
1. Calendar invite for data collection meeting 
2. Site director and teacher participation letters 
3. Participation agreement 
4. List of documents to submit 
 

27 
 
APPENDIX IV: Participant Survey Packets 
● Site director Survey Packet: 
i. SITE DIRECTOR PARTICIPATION LETTER 
ii. SITE DIRECTOR SURVEY CONSENT  
iii. NAPSACC SURVEY  
● Teacher Survey Packet: 
i. TEACHER PARTICIPATION LETTER 
ii. TEACHER SURVEY CONSENT  
iii. TEACHER H&W CONSENT  
iv. TEACHER SURVEY (*Remember to add name of school and date) 
PARENTS: 
*Parent materials for print and a sample envelope can be found in the top cabinet of the filing cabinet at the back of A2-
125E 
o ENGLISH 
o SPANISH 
● PARENT PARTICIPATION LETTER  
▪ 
Print in color on white paper 
● PARENT INFORMATION SHEET  
▪ 
Print on white paper 
● PARENT SURVEY  
▪ 
Print on green paper 
● CHILD HEIGHT AND WEIGHT CONSENT  
▪ 
Print on blue paper 
● CONTACT SHEET  
▪ 
Print on yellow paper 
*Put “PARENT SURVEY ENVELOPE LABELS” label and “EARN $25 IN GIFT CARDS. LOOK INSIDE.” sticker on front of each 
parent survey packet 
 
 
 

28 
 
APPENDIX V: How to Enter Preschool Project Data 
There are 3 surveys for each preschool project site: 
1. Site Director (NAPSACC) 
2. Teacher 
3. Parent 
When entering surveys: 
● Enter all data AS IS (to the best of your ability).  
● When entering survey ID, include dashes. 
● If two answers are selected, default to the right most answer. Definition of “right most answer” following: 
o   If answer choices available are:  □ agree □neither agree nor disagree □ disagree 
And participant checks two boxes (e.g.:  □ agree ☑ neither agree nor disagree ☑ disagree), key the right 
most answer: “disagree” 
● If two answers are selected but are opposing (i.e., agree and disagree) or have a gap between them in answer 
choices, key the average and put a note in the notes section.  
▪ 
Ex. If someone keys both ‘Never’ and ‘Sometimes’, average to ‘Rarely’ 
▪ 
Ex. If someone keys both ‘Agree’ and ‘Disagree’, average to ‘Neither agree nor disagree’  
● If an answer is blank, key ‘refused to answer’ unless otherwise specified 
● If a range is written in (i.e., 60-90 minutes), feel free to key the average (75) but note the range in the notes 
section as such: ex. = #9: 60-90 
● Refused to answer vs. don’t know 
o Refused to answer (99):  
▪ 
If something is blank or missing, but all other data in the section has been filled out 
▪ 
If something is blank or missing because it is sensitive information a participant might not want 
to share with us 
o Don’t know (88): 
▪ 
If something is blank or missing because it might not be available information to the participant 
(i.e., height and weight). 
● ALWAYS initial and date a survey after completion.  
● Please do not abandon a survey in the middle of entry. 
● If entering SPANISH surveys, enter all notes in Spanish. They will be translated on the back end.  
o During Cohort 2 follow-up data collection, project team transitioned to translating notes before entering 
data in order to expedite analysis at a later date.  
● When entering multiple teacher or site director surveys, fully close internet browser (including all open 
windows) to reset the link. 
● If height has a fraction, ½ or > = round up; less than ½, round down.  
● If only feet for height is entered and inches is left blank, assume it is a whole number. Do not put refused to 
answer (99) for inches.  
● If parent enters child’s age as parent’s age, mark as refused to answer (99) and write a note.  
 
How to Write a Note: 
● Please keep notes to no more than 92 characters. 
● We need to know exactly how the question was answered; we will know what you inputted because we will see 
it in the data report.  
o Here is an example: 
▪ 
Instead of keying this (256 characters). 
For #11, participant answered 60+, I inputted 60. For #12, participant answered 3+, I inputted 3. 
For #13, participant answered 1+, I inputted 1. For #14, participant answered 7+, I inputted 7. 
For #15 weight, participant put in parenthesis (I'm pregnant) 

29 
 
▪ 
Use this (63 characters). 
#11: 60+, #12: 3+, #13: 1+, #14: 7+, #15weight: (I'm pregnant) 
● Abbreviations: 
o Hour = hr 
o Week = wk 
o Minute = min 
o Month = mon 
o Never = nvr 
o Several Times per month = svrl x/ mon 
o Several Times per week = svrl x/ wk 
o Every day = evry day 
o More than once a day = > 1/ day 
o Disagree = dagr 
o Somewhat disagree = swdagr 
o Neither agree nor disagree = nor 
o Somewhat agree = swagr 
o Agree = agr 
▪ 
Ex. Abbreviation note: #5: swdagr & swagr 
 
EPAO: 
● If variable is numeric and answer is blank, no, or N/A, enter 0.  
● If variable is character and answer is blank, missing, or NA, enter space space (or enter space (x2).  
● If outdoor time was cancelled due to fire related atmosphere, mark the reason as “It was too hot” 
● EPAO_C14_1t5_J on excel sheet should be space space (or two spaces)  
o It says EPAO_C14_1t5_I on the data dictionary, which should be a character variable 
● Decimals are OK 
 
 

30 
 
APPENDIX VI: How to Generate a Unique ID 
Format for site director and EPAO observations: X-XX-X 
1. Digit 1: Participant type: 
● D = Site Director 
● E = Observation/EPAO 
2. Digit 2-3: Site ID (01-99) 
a. Schools assigned ID at In-person meeting 1  
3. Digit 4: Pre/Post A = Pre; B = Post 
For site directors: pre-post survey 
For observation: pre/post EPAO 
Ex. E-01-A = Observation, Site 1, pre-implementation survey 
Ex. D-02-B = Site Director, Site 2, post-survey 
Format for survey: X-XX-X-XX-X 
1. Digit 1: Participant type: 
● T = Teacher 
● P = Parent 
● C = Child 
2. Digit 2-3: Site ID (01-99) 
a. Schools assigned ID at In-person meeting 1  
3. Digit 4: Participant Classroom (1-9) 
a. Classrooms assigned number at site enrollment 
4. Digit 5-6: Participant # (01-99) 
5. Digit 7: Pre/Post A = Pre; B = Post, C = Post-Follow-up Only (participant recruited at follow-up, did not participate in 
baseline data collection (examples for post-IDs ending in C below) 
For teachers and parents: pre-post survey 
For children: pre/post height and weight measurement 
Ex. T-01-1-03-A = Teacher, Site 1, Classroom 1, Teacher 3, Pre-survey 
Ex. T-06-1-02-A = Teacher, Site 6, Classroom 1, Teacher 2, Pre-survey 
Ex. P-01-2-11-B = Parent, Site 1, Classroom 2, Parent 11, Post-survey 
Ex. C-01-2-11-B = Child, Site 1, Classroom 2, Child 11, Post-survey 
Post ID ending in C:  
If a participant is newly recruited at follow-up (no baseline participation), their follow-up ID will end in -C rather 
than ending in -B. ID format follows the above convention for linking participant to site number and classroom.  

31 
 
Ex. If we receive a consent form, a survey, and/or height weight measurements for a participant at baseline, 
their Follow-up ID will end in -B. If we do not receive any materials or data on a participant, their follow-up ID 
will end in a -C.  
Example: ID assignment follows above convention to link participant to site and classroom  
 
X = received, blank = not received  
 
 
Baseline 
Unique ID 
Baseline 
survey  
Consent 
Baseline ht/wt 
measured 
Follow-up 
Unique ID 
 
T-01-1-03-A 
X 
X 
X 
T-01-1-03-B 
All materials/data received at baseline = 
follow-up ID ending in B 
T-06-1-02-A 
 
X 
X 
T-06-1-02-B 
Consent + ht/wt measured at baseline = 
follow-up ID ending in B 
T-07-5-01-A 
X 
 
 
T-07-5-01-B 
Survey received at baseline = follow-up 
ID ending in B 
C-07-6-02-A 
 
X 
 
C-07-6-02-B 
Consent received at baseline = follow-up 
ID ending in B 
C-01-2-11-A 
 
 
 
C-01-2-11-C 
No baseline data/participation = follow-
up ID ending in C 
 
 
 
 
 

32 
 
APPENDIX VII: EPAO 
At EPAO: 
1) Collect site director and teacher surveys.  
a. Deliver site director and teacher GIFT CARD LOG 
2) Conduct EPAO:  
a. Each observer must have an EPAO binder containing: 
▪ 
EPAO OBSERVATION PACKET 
▪ 
EPAO DOCUMENT REVIEW PACKET 
▪ 
EPAO TABLE OF CONTENTS 
▪ 
EPAO REFERENCE DOCUMENT 
▪ 
EPAO PROTOCOL AND PROCEDURE 
▪ 
EPAO INFO SHEET 
3) Deliver Parent Survey Packets 
 
 

33 
 
APPENDIX VIII: Height and Weight Materials 
When conducting H&W measurements at sites, make sure to have the following:  
o HEIGHT AND WEIGHT IDENTIFIER  
o HEIGHT AND WEIGHT DATA COLLECTION  
o HEIGHT AND WEIGHT PROCEDURE DOCUMENT 
o HEIGHT AND WEIGHT PROVIDER TRAINING 
o HEIGHT AND WEIGHT ACTIVITY SHEET  
o Weight scale 
o Stadiometers  
o At least 2 pens 
o Envelopes with gift cards and gift card log 
o Equipment disinfectant 
o Extra height and weight consent forms 
 
 

34 
 
APPENDIX IX: Scale Calibration Summary 
Scale Summary – 5/13/21 
• 
Cohort 1 baseline: 
o CPCR had three scales at the start of the project.  
 
Scales came research calibrated. 
 
Internal weight comparison across the three scales yielded same outcome weight across all 
three scales.  
 
Only UCLA research staff handled the scales. UCLA research staff conducted onsite 
measurements for all Cohort 1 baseline height and weight measurements. 
• 
Cohort 1 follow-up/Cohort 2 baseline: 
o COVID-19 change: 
 
UCLA research staff decided to leave scale at sites for preschool staff to collect measurements 
given the COVID-19 social distancing protocols.  
• 
Scales were numbered and labeled following the decision to leave scales at sites to 
adhere to social distancing protocols. 
• 
UCLA staff delivered scales to participating sites and trained the preschool staff 
following the project’s anthropometric data collection procedures.  
 
 UCLA research staff purchased 3 additional Detecto 550 scales.  
• 
Detecto accidentally sent 6 scales in shipment (the 3 DR550C that we ordered and 3 
additional DR400C. DR400Cs were stored at CPCR and not deployed into the field). 
• 
Total of 9 scales as of 5/12/21 – present: 
1. Detecto DR550C (n = 5) = scales 1-3, 5, and 6 
2. Tanita BWB-800 (n=1) = scale 4 
3. Detecto DR400C (n = 3) = scales 7-9 
o Scales #1-5 were stored in the office between 02/19/2020 – 10/07/2020 and 02/26/2021 – present. 
o Scale #6 was stored in the office between 02/19/2020 – 10/07/2020 and has been with a UCLA staff 
member for delivery from 01/26/2021 – 5/13/2021. 
o Scales #7-9 have not been in the field and have remained in storage at CPCR.  
As of September 2021- present: (Beginning of cohort 3 baseline height and weight data 
collection), scales #7-9 were used in the field 
Scale Calibration Summary 
 
• 
Cohort 1 baseline/Cohort 1 follow-up/Cohort 2 baseline: 
o Before scales were deployed in the field, an internal weight comparison across the research calibrated 
scales was conducted by the Project Coordinator and Project Assistant using own body weight. All scales 
yielded the same outcome weight. 
• 
Cohort 2 follow-up/Cohort 3 baseline:  
o 05/04/2021 - 05/06/2021: During Cohort 2 Follow-up preparation, scales #1-5, #7-9 were assessed for 
reliability within each scale and between scales. Following the project’s data collection procedure, two 
UCLA staff members weighed themselves three times on each scale, allowing the scale to zero out 
between measurements. Staff members repeated this procedure over 3 days to assess instrument drift. 
This assessment yielded consistent readings within each of the scales 1-5, 7,8 and between these 7 
scales. Scale #9 consistently read staff members’ weight around 2 lbs. below the average reading of 
scales 1-5,7-8. Scale 6 was unavailable for comparison. 
 
o 05/10/2021: UCLA staff contacted Detecto and Tanita technical support via phone to inquire about 
lowering the scales’ calibration limits (listed below). Technical support staff at both companies informed 
staff members that calibration limits cannot be adjusted to a lower threshold.  

35 
 
 
Scale Brand and 
Model 
Required Calibration 
weight (kg) 
Required  
Calibration weight (lbs.) 
Detecto DR400C 
120 
440 
Detecto DR550C 
200 
441 
Tanita BWB-800 
200 
440 
 
• 
05/11/2021: Scales assessed with 50 kg calibration weights. Assessment was repeated twice for each scale. This 
assessment found that scales 1-4 and 6-8 were calibrated. Scale #5 read 0.1kg below calibration weight. Scale #9 was 
found to be out of calibration (below). Scale #6 was with a UCLA staff member and was assessed on 5/13/21.  
Scale 
Number 
Scale Brand and model 
Calibration 
weight 
Output 
Measurement 1 
Output 
Measurement 2 
1 
Detecto 550 
50kg 
50 kg 
50 kg 
2 
Detecto 550 
50kg 
50 kg 
50 kg 
3 
Detecto 550 
50kg 
50 kg 
50 kg 
4 
Tanita BWB 800 
50kg 
50 kg 
50 kg 
5 
Detecto 550 
50kg 
49.9 kg 
49.9 kg 
6 
Detecto 550 
50kg 
50kg 
50kg 
          7* 
Detecto 400 
50kg 
50 kg 
50 kg 
          8* 
Detecto 400 
50kg 
50 kg 
50 kg 
          9* 
Detecto 400 
50kg 
49.4 kg 
49.4 kg 
*Scale has not been in field 
 
 
 
 
Number of Measurements Conducted by Scale 
• 
Cohort 1 baseline height and weight were conducted by UCLA staff using scales 4-6. Scales were not individually labeled. 
o 236 preschool children and 40 Teachers over 9 sites between 12/05/2019 – 02/19/2020  
 
• 
Cohort 1 follow-up/Cohort 2 baseline were conducted by preschool staff using scales #1-6. 
o 362 preschool children and 84 teachers at 26 sites between 10/07/2020 - 02/26/ 2021 
  
Cohort 1 Follow-up and Cohort 2 Baseline data collection 
Scale Number 
Number of Sites 
Children weight 
assessments (n) 
Teacher weight 
assessments (n) 
Dates in the Field 
1 
4 
55 
16 
10/16/20 - 1/13/21 
2 
4 
61 
16 
10/20/20 - 02/19/21 
3 
6 
89 
24 
10/07/20 - 02/16/21 
4 
4 
40 
12 
11/05/20 - 02/26/21 
5 
3 
40 
3 
10/20/20 - 02/26/21 
6 
5 
77 
13 
10/27/20 - 02/16/21 
TOTAL 
26 
362 
84 
 
 
Scale summary as of December 2021:  
At each assessment, UCLA research staff track scale readings in FORM TO CHECK ACCURACY 
In September 2021, UCLA’s restrictions on field work lifted; the project returned to the originally planned approach of 
having UCLA staff members conduct the height and weight measurements.  

36 
 
UCLA Research staff continued to ensure scale accuracy prior to measurement collection. Before height and weight 
equipment are used in the field, UCLA research staff asses the scales at each of the following calibration weights: 10kg, 
20kg, 30kg, 40kg, and 50kg. If the scale is out of calibration at 50kg, the scale was also assessed at 70kg to determine 
drift (e.g., if a scale read 10kg, 20kg, 30kg, and 40kg accurately, but read 50kg as 49.9kg, the scale was also assessed at 
70kg.)  
All research scales were in calibration before they were stored in the CPCR office over UCLA’s 2021-2022 winter closure.