Table 5.

Implementation strategies targeting Nutrition Now implementation delivered through Early Childhood Education and Care (ECEC).

Category (55, 56)	Strategy (# denotes ERIC implementation strategy)  (57)	The Actor  (deliver strategy)	The Action  (specific action, steps or process)	Action target  (affected by strategy)	Implementation outcome(s)	Temporality and Dose	Justification
Use evaluative and iterative strategies	#4 Assess for readiness and identify barriers and facilitators	Implementation researchers	Conduct individual interviews with 12 ECEC staff and two focus group interviews Conducted meetings with ECEC heads	ECEC staff	Adoption Appropriateness Feasibility	Pre-implementation from project start until the end of September 2022 12 interviews and 2 focus group interviews	Identify factors that may disrupt implementation, and strengths that can be exploited in the implementation effort
	#18 Conduct local needs assessment	Implementation researchers	Conduct individual interviews with ECEC staff to assess needs	ECEC staff	Appropriateness Feasibility	Pre-implementation 12 individual interview and 2 focus group interviews	Use the experiences and key knowledge the ECEC staff have regarding the setting in order to tailor intervention to context
	#14 Conduct cyclical small tests of change	Implementation researcher	Conduct short iterative interviews with one selected champion at each ECEC unit	Champion at ECEC	Appropriateness Feasibility	During the implementation process (first six months) Every third week, 5-7 minutes each time	Optimize implementation strategies to maximize intervention effectiveness
	# 27 Develop and organize quality monitoring systems	Implementation researcher	Monitor implementation process through iterative interviews	Champion at ECEC	Adoption Feasability	During the implementation process (first six months) Every third week, 5-7 minutes each time	Use the input from champions to ensure quality and improvement of intervention strategies
	# 46 Obtain and use patients/consumers and family feedback	ECEC staff	Use advice in e-learning resource regarding parental collaboration and get feedback from parents	ECEC parents	Appropriatedness		Parental feedback to motivate further implementation by ECEC staff
Provide interactive assistance	# 33 Facilitation	Implementation researcher	Supportive researcher available for problem solving and support interpersonal relationship	ECEC Staff, ECEC champions	Feasability Fidelity	Ongoing during implementation	Ensure a positive collaborative environment between ECEC stakeholders at the setting level
Adapt and tailor to context	#63 Tailor strategies	Implementation researchers in collaboration with web designer	Develop ways to convey information about the e-learning resource considered appropriate by ECEC staff	ECEC staff	Acceptability Appropriateness Feasibility	Ongoing during implementation	Tailor implementation strategies and leverage enablers identified
Develop stakeholder interrelationships	#6 Build a coalition	Implementation researchers ECEC leaders Champion	ECEC leaders and champions participated in educational meeting ECEC leaders support champions, through e-mails and meetings Champions are encouraged to build relations with colleagues, through newsletters and the Nutrition Now resource	ECEC leaders and champions	Acceptability Feasibility	Pre implementation until e-learning resource is distributed  Four meetings with ECEC leaders prior to implementation	Ensure a positive collaborative environment between ECEC stakeholders at the setting level
	#35 Identify and prepare champions	ECEC leaders and reseachers	Select a champion at each ECEC and clarify understanding of role as an implementation agent	Champion at ECEC	Adoption Acceptability Appropriateness Feasibility Fidelity	Pre implementation	Anchor and ensure the implementation at each ECEC unit
Train and educate stakeholders	#15 Conduct educational meetings	Implementation researchers	Conduct educational meetings with ECEC leaders prior to implementation about the importance of early childhood nutrition and seminars during implementation about how Nutrition Now is implemented in different ECECs	ECEC leaders and Champion	Acceptability Fidelity	Pre implementation and 2 seminars during the first 6 months of implementation. ECEC leaders: 4-5 hours spent by each, Champions: 1-2 hours	Increase partners’ key knowledge about Nutrition Now resource content and how it can be adopted
	#29 Develop educational materials	Implementation researchers in collaboration with web designer	Develop video and supporting written material (e-mails and messages within the e-learning resource) to support ECEC staff. Educational videos explaining rationale and how to use the resource. Posters to put up in the ECEC units	Champion and ECEC staff	Feasibility	Pre implementation	Need for instructional materials that make it easier for ECEC staff to convey the Nutrition Now resource and how to best use the resource
	#31 Distribute educational materials	Implementation researchers	Distribute educational material digitally and by mail	ECEC leaders and champion	Fidelity Feasibility	Pre implementation	Provide educational materials to staff to facilitate delivering the intervention
Support clinicians	#58 Remind clinicians	Implementation researchers	Reminder e-mails with new resource content at regular intervals and digital newsletters with support on how to progress with the intervention including change processes among ECEC staff	Champions at ECEC	Adoption Sustainability	During implementation	Help ECEC staff to recall information and/or prompt them to use the e-learning resource
Engage consumers	# 41 Involve patients/consumers and family members	ECEC leaders	Post URL to parent part of the e-learning resource on ECEC website	ECEC parents	Feasability Adoption	Start of the implementation, one time	Create synergy that enhance ECEC staff’s motivation to follow up the implementation
Change Infrastructure	# 44 Mandate change	ECEC champions	ECEC champion lead and holds meetings with ECEC staff regularly	ECEC staff	Adoption Feasability Sustainability	During implementation	Create structures (e.g., staff meetings) that enhance the implementation