2.7.3. Fidelity, dose received

For this study fidelity and dose received were operationalized as daily delivery of nutrition education, daily time allocated to physical activity (3 h), and reading instruction (3.25 h). Additionally, physical activity opportunities were assessed for their compliance with the LET US Play principles. A description of the LET US Play principles can be found elsewhere (Weaver, Beets, & Webster, 2013). LET US is an acronym for lines, elimination, team size, uninvolved children, and space, equipment and rules. LET US Play was used as a reflective tool for staff to identify and modify components of physical activity opportunities that limit children’s accumulation of physical activity. A modified version of the System for Observing Staff Promotion of Activity and Nutrition (Weaver, Beets, Webster & Huberty, 2014) was used to measure fidelity and dose received. Trained research assistants observed program implementation of each HSL teacher on three randomly selected, non-consecutive days separated by at least one week each summer. Research assistants were trained on systematic observation for an intensive one-hour period to learn procedures. Training included role-playing mock scenarios, practice scans and discussions about operationalized terms (i.e. free play vs. organized physical activity). On observation days, a research assistant arrived unannounced at the HSL site prior to the start of the program day. The research assistant followed a single teacher’s class for the entirety of the program day. Time dedicated to meals/snacks, physical activity opportunities, reading instruction, enrichment, transition between activities, and drop off/pickup times were cataloged. Classroom time was coded as enrichment if it had no observable connection to academic standards (e.g. coloring, board games). Each physical activity opportunity was also coded for observed applications of LET US Play principals (Brazendale et al., 2015; Weaver et al., 2013).