Process evaluation
Process evaluation indicators measured intervention implementation and exposure. In year 1 of the intervention, when five out of 16 programs were in the intervention group, at least 1400 flyers were distributed to families (to the 542 enrolled families), 56 Head Start nutrition staff and teachers were trained (71-100% of eligible staff) and 36 PConnect sessions were implemented. In year 2, when 10 out of 16 programs were in the intervention, at least 5000 flyers were distributed (to the 765 enrolled families), 132 Head Start staff were trained (47-100% of eligible staff) and a total of 72 PConnect sessions were implemented.Parents’ reported exposure to nutrition support services and health promotion materials, activities consistent with CHL, were used as proxy indicators for intervention exposure. While we anticipated that parents would report both of these activities in the intervention and control conditions (given Head Start standard practice), we expected they would be reported at significantly higher rates in the intervention. Across all child health behaviors (i.e., nutrition, physical activity, screen time, sleep, and sugary drink intake), a significantly greater proportion of parents in the intervention vs. control reported engaging with nutrition services and exposure to relevant printed materials (