Page Contents
Overview
- supports for breastfeeding, healthy meals, farm to ECE, and oral health;
- amount and quality of indoor and outdoor physical activity;
- provider–child interactions around food and physical activity;
- educational opportunities for children, parents, and providers; and
- program policies related to breastfeeding, nutrition, oral health, indoor and outdoor physical activity, and screen time.
Target Behavior: Breastfeeding, Healthy Eating, Physical Activity
Intervention Type: Direct Education, PSE Change
Intervention Reach and Adoption
Setting: Child care
Target Audience: Preschool (<5 years old)
Race/Ethnicity: All
Intervention Components

The 5 Steps of Go NAPSACC
1. Assess: Take a Self-Assessment and see how your program can improve.
2. Plan: Use our Action Planning tool to set yourself up for success!
3. Take Action: Use our Tips and Materials to put your plan into action!
4. Learn More: Take a Training and learn new skills to help kids be healthy.
5. Keep It Up: Celebrate your progress and plan your next move.
Follow these steps to success in child nutrition, breastfeeding and infant feeding, farm to ECE, oral health, infant and child physical activity, outdoor play and learning, and screen time.
Technical assistance consultants can offer great guidance every step of the way.
Intervention Materials
Go NAPSACC is an updated, interactive version of the original program, including online self-assessments, interactive goal-setting and action planning support, and an online library of helpful documents and videos. Go NAPSACC is available to ECE programs in regions or states in which a state agency or other organization has contracted with the UNC Center for Health Promotion and Disease Prevention for access to the site. Along with site access for ECE programs, partnering agencies/organizations receive reports of self-assessment score and action planning goal data for ECE programs who participate under their contract. Please contact Go NAPSACC at gonapsacc@unc.edu for more information about pricing and features.
Intervention Costs
Annual membership price for contracts is $30,000
Evidence Summary
Intervention Effect (overall environment and policy assessment): Child care centers completing most or all of the intervention components improved their nutrition and physical activity policies and practices more than control facilities. Changes in the total child care nutrition environment scores (16% increase) were statistically significant.
Individual Item Scores in Nutrition and Physical Activity: Because the NAPSACC intervention allows some flexibility in the areas centers could target for change and because the observation instrument is scored using averages of sub-areas to obtain the Nutrition and Physical Activity scores, an additional assessment of an intervention effect was measured using all of the individual 75-items from the observation instrument. Nutrition effects were assessed with 51 items and physical activity with 24 items. The mean change in nutrition scores was a 4.3 point improvement in the intervention centers compared to -0.5 change in the controls; for physical activity, scores increased by 3.6 in the intervention centers compared to a -0.2 change in the controls. Both nutrition and physical activity improvements were statistically significant.
The impact of the original NAPSACC model has also been shown through studies by Drummond (2009) and Alkon (2014).
Between 2014 and 2015, a small randomized control trial was conducted to evaluate the impact of Go NAPSACC, specifically in the area of Child Nutrition. Over a period or four months, thirty-one center directors in rural North Carolina used the online tools with low-intensity support (average of 1 hour/month/provider) from trained local technical assistance consultants. Centers that participated in Go NAPSACC saw a 7.5% increase in their overall nutrition environment scores, which approached statistical significance when compared to control centers.
Healthy Eating Research has labeled NAPSACC as showing the best evidence for reducing childhood obesity risk in children under age 5 (Kenney, 2019). A recent CHOICES (Childhood Obesity Intervention Cost-Effectiveness Study) analysis found the integration of NAPSACC into Arkansas Better Beginnings Quality Rating Improvement System to be an investment in child health, that could result in the training of over 1,300 child care directors and staff and lead to healthier ECE environments for 116,000 children over the next decade (Adams, 2021).
- Kenney E, Cradock A, Resch S, Giles C, Gortmaker S. The Cost-Effectiveness of Interventions for Reducing Obesity among Young Children through Healthy Eating, Physical Activity, and Screen Time. Durham, NC: Healthy Eating Research; 2019. Available at: https://healthyeatingresearch.org.
- Adams B, Sutphin B, Betancourt K, Balamurugan A, Kim H, Bolton A, Barrett J, Reiner J, Cradock AL. Arkansas: Creating Healthier Child Care Environments: Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) in the Quality Rating Improvement System (QRIS) {Issue Brief}. Arkansas Department of Health, Little Rock, AR, and the CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; May 2021. For more information, please visit www.choicesproject.org
Classification: Research-tested
Evaluation Indicators
Readiness and Capacity – Short Term (ST) | Changes – Medium Term (MT) | Effectiveness and Maintenance – Long Term (LT) | Population Results (R) | |
---|---|---|---|---|
Individual | ST1, ST3, ST4 | MT1, MT3, MT4 | LT1, LT3, LT4 | |
Environmental Settings | ST5 | MT5, MT6 | LT5, LT6, LT10 | |
Sectors of Influence | MT9 |
Evaluation Materials
Success Story
SNAP-Ed Helps Kids be More Active by Transforming Playgrounds!:
Additional Information
Contact Person:
Falon Tilley Smith, PhD
Managing Director of Research Dissemination
UNC Center for Health Promotion and Disease Prevention
Phone: 919-843-3863
Email: ftilley@unc.edu
gonapsacc@unc.edu