Natalie Garzon Osorio

• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Love, Penelope & Abel, Marianne Hope [Show all 12 contributors for this article] (2026). A Formative Evaluation of Parental Perceptions Related to Acceptability, Appropriateness, Feasibility, and Reported Use of an e-Learning Resource Targeting Diet in the First 1000 Days: Survey Study. JMIR Formative Research. 10, p. 1–13. doi: 10.2196/84277. Full text in Research Archive Show summary

  Background In October 2022, the Nutrition Now (NN) e-learning resource was implemented within Maternal and Child Healthcare centers and Early Childhood Education and Care centers of a southern Norwegian municipality. The e-learning resource targets expectant parents, parents of children aged 0‐2 years, and Early Childhood Education and Care staff, aiming to promote healthy dietary behaviors during the first 1000 days of life. Objective This study aimed to explore parental perceptions related to the acceptability, appropriateness, feasibility, and reported use of the NN e-learning resource among parents. Methods From October 2022 to May 2023, expecting parents and parents of children aged 0‐2 years were recruited from 2 Norwegian municipalities, one intervention group receiving access to the NN e-learning resource, and one control. Participants in the intervention group received a web-based follow-up questionnaire 7 months after gaining access to the NN e-learning resource. Data were analyzed using descriptive statistics. Results Of the 179 participants in the NN study intervention group, 48 completed the web-based follow-up questionnaire administered 7 months after enrollment. Parents rated the e-learning resource positively on items assessing whether they liked and appreciated the resource, perceived it as an appropriate source of information, and found it doable and easy to use. Most respondents reported visiting the resource (38/48, 79%), although only 21% (10/48) reported frequent visits. Less than half of the participants answering the web-based follow-up questionnaire reported having watched the theme films (20/48, 42%), the recipe films (17/48, 35%), or making food using recipes provided in the e-learning resource (20/48, 42%). Conclusions Parents rated the NN e-learning resource positively but reported limited use. These findings point to the need for strategies that enhance engagement with self-guided digital interventions among expectant parents and parents of young children. Future efforts should focus on identifying how to maximize potential adoption of the e-learning resource and evaluate its impact to promote healthy dietary behaviors during the first 1000 days of life.

• Lian, Henrik; Øverby, Nina Cecilie; Vik, Frøydis Nordgård; Medin, Anine Christine; Osorio, Natalie Garzon & Helle, Christine [Show all 12 contributors for this article] (2025). Implementation strategies: lessons learned during an e-learning intervention to improve dietary behaviors and feeding practices in early childhood education and care. BMC Nutrition. 11(1). doi: 10.1186/s40795-024-00990-3. Full text in Research Archive Show summary

  Background Early Childhood Education and Care (ECEC) centers play an important role in fostering healthy dietary habits. The Nutrition Now project focusing on improving dietary habits during the first 1000 days of life. Central to the project is the implementation of an e-learning resource aimed at promoting feeding practices among staff and healthy dietary behaviours for children aged 0–3 years in ECEC. Implementing new interventions often presents challenges. This study explores ECEC staff views and experiences with selected strategies for implementing an e-learning resource in ECEC centers in a municipality in Southern Norway. Methods The study is a part of the Nutrition Now study, a hybrid type 1 non-randomized controlled trial. The implementation process followed the Dynamic Integrated Evaluation Model (DIEM). Implementation strategies were selected from the Expert Recommendations for Implementing Change (ERIC) project and included identify and prepare champions, conduct educational meetings, distribute educational materials, create a learning collaborative, and remind clinicians. ECEC teachers from participating ECEC centers in the intervention municipality were recruited as champions. Brief (5–7 min minutes), semi-structured phone interviews, covering key points, were conducted with the champions 8 times, evenly distributed over six months. The interviews were analysed using qualitative thematic analysis. Results In total, 29 of the invited ECEC centers (53%) participated, and 260 brief interviews (88%) were conducted with champions (n=37). An evaluation of the feedback from the champions suggests that the five selected implementation strategies were acceptable. Five main themes were developed by qualitative analysis: 1) Being a champion resembles what I already do. 2) Educational meetings are fine but take time. I prefer when peers share experiences. 3) Newsletters were helpful and reminded me, but I do not always have enough time to read. 4) Evaluations have increased my awareness, and we do them informally and formally. 5) The regular phone calls reminded me I could receive support and express my opinion Conclusion This study’s findings suggest that several implementation strategies are acceptable for stakeholders in an ECEC e-learning healthy eating intervention. However, time constraints among champions may hinder deep engagement. These results provide valuable insights into how the selected implementation strategies may function in practice and how they are perceived and experienced by the ECECs staff. Trial registration Trial registration on June 6, 2022: ISRCTN10694967.

• Medin, Anine Christine; Vik, Frøydis Nordgård; Helle, Christine; Helland, Sissel Heidi; Wills, Andrew Keith & Osorio, Natalie Garzon [Show all 22 contributors for this article] (2024). Scaling up evidence-based digital early life nutrition interventions in a county setting: an implementation trial – protocol for Phase 2 of the Nutrition Now project. Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1326787. Full text in Research Archive Show summary

  Background: Few effective health interventions transition from smaller efficacy or effectiveness studies to real-world implementation at scale, representing a gap between evidence and practice. Recognising this, we have developed Nutrition Now – a tailored digital resource building on four efficacious dietary interventions, aiming to improve nutrition in the important first 1,000 days of life. Nutrition Now targets and guides expectant parents and parents of 0–2 year olds, serves as a reliable source of evidence-based information for midwives and public health nurses at maternal and child healthcare (MCH) centres, and offers pedagogical tools for early childhood education and care (ECEC) staff. The aim of this study is to implement Nutrition Now at scale and evaluate the impact of different sets of multifaceted implementation strategies on implementation outcomes. Methods: A quasi-experimental design with three study arms will be used, providing either low, medium or high implementation support, when rolled out in 50 municipalities in 2 counties in Norway. Nutrition Now will be implemented in MCH and ECEC settings and made available to expectant parents and parents of 0–2 year olds through social media and MCH. The implementation support builds on strategies described in the Expert Recommendations for Implementing Change (ERIC) implementation framework and is informed by dialogues with stakeholders. Impact of the different degree of implementation support will be assessed by examining reach, adoption, fidelity, and sustainability using usage data generated from the Nutrition Now resource, publicly available municipal data and qualitative interviews with MCH and ECEC staff. Discussion: Nutrition Now Phase 2 will break new ground by scaling up successively delivered and complementary dietary interventions in the first 1,000 days of life in a real-life context. The project also seeks to identify what level of implementation support is most effective when implementing digital, scalable, evidence-based early-life nutrition interventions in community settings. The project will inform implementation research and provide knowledge about effective implementation strategies to be used in a national scale-up of Nutrition Now. Trial registration: The study is registered prospectively (submitted 14/06/2022, registration date: 19/06/2022) in the International Standard Randomised Controlled Trial Number registry (ISRCTN): reg. Number: ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967.

• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Helle, Christine; Hillesund, Elisabet Rudjord; Øverby, Nina Cecilie & Helland, Sissel Heidi [Show all 15 contributors for this article] (2024). Implementing an early-life nutrition intervention through primary healthcare: staff perspectives. BMC Health Services Research. 24(1). doi: 10.1186/s12913-024-11582-z. Full text in Research Archive Show summary

  Background: Nutrition interventions targeting early childhood can be cost-effective and may provide lifelong, intergenerational benefits. From October 2022 to April 2023 the Nutrition Now (NN) e-learning resource was implemented within Early Childhood Education and Care centres and the Maternal and Child Healthcare Centre (MCHC) in a southern Norwegian municipality. As part of the NN project, the present study aims to explore the MCHC staff’s experiences with implementing the NN resource, to gain insights into measures important to scale up digital early-life nutrition interventions. Methods: Three group interviews were conducted among public health nurses and midwives alongside one individual interview with the department leader of a MCHC in May 2023. An inductive thematic analysis, as described by Braun and Clarke, was conducted to generate the key themes and subthemes regarding the implementation process of NN within the MCHC. Results: Three main themes were generated: [1] Important resource but not always utilized; [2] Parents are interested but had issues with access; and [3] Staff and stakeholder buy-in and commitment needed from the start. Overall, the staff viewed the NN resource as a potential tool for promoting diet-related topics and believed it could support the guidance they were already providing parents. However, few staff members fully familiarized themselves with the resource. While staff perceived parents as positive when informed about NN, they believed issues such as access challenges, competing platforms, and time constraints reduced parental engagement. Lastly, staff suggested improvements for NN’s implementation, including enhanced training, better planning, assigning champions, and lowering the threshold for access. Conclusion: The findings of this study suggest that the real-world implementation of digital evidence-based health behaviour interventions is feasible but would be enhanced by employing strategies focusing on engagement and utilization.

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• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Øverby, Nina Cecilie & Medin, Anine Christine (2024). Determinanter for implementering av Matnyttig blant helsestasjonsansatte. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Øverby, Nina Cecilie & Medin, Anine Christine (2024). Facilitators & barriers in implementing early life nutrition interventions in Norwegian primary care: a qualitative assessment using the CFIR. Full text in Research Archive
• Osorio, Natalie Garzon; Vik, Frøydis Nordgård; Medin, Anine Christine & Øverby, Nina Cecilie (2023). The selection and operationalization of implementation strategies in the Nutrition Now project. Full text in Research Archive
• Øverby, Nina Cecilie; Hillesund, Elisabet Rudjord; Helland, Sissel Heidi; Helle, Christine; Wills, Andrew Keith & Lamu, Admassu Nadew [Show all 23 contributors for this article] (2023). Evaluating the effectiveness and implementation of evidence-based early-life nutrition interventions in a community setting a hybrid type 1 non-randomized trial – the Nutrition Now project protocol. Frontiers in Endocrinology. 13. doi: 10.3389/fendo.2022.1071489. Full text in Research Archive Show summary

  Disappointingly few efficacious health interventions are successfully scaled up and implemented in real world settings. This represents an evidence-to-practice gap, with loss of opportunity to improve practice. Aiming to improve nutrition in the first 1000 days of life, we have combined four efficacious dietary interventions into a single adapted digital resource (Nutrition Now) for implementation in a Norwegian community setting. Nutrition Now targets pregnant women and parents of 0–2-year-olds with messages focusing on healthy dietary behaviours. Early childhood education and care (ECEC) staff are provided with pedagogical tools addressing healthy food exposure and child food acceptance. Objectives: a) evaluate the effectiveness of provision of the Nutrition Now resource on child diet and diet-related outcomes, with special attention to the influence of socio-economic position, b) gather information on the effectiveness of the implementation process to inform forthcoming scale-up and c) perform trial- and model-based economic evaluations. This is a hybrid type 1 implementation study, focusing on evaluation of effectiveness. A quasi-experimental design with pre- and post-tests, where one municipality gets access to the resource (n~800), while a matched non-equivalent control municipality (n~800) does not, will be used. Effectiveness will be assessed by examining e.g., diet outcomes, developmental outcomes, and feeding practices. The resource will be implemented in ECEC settings and made available to pregnant women and parents through the Norwegian system of maternal and child health (MCH) care. The implementation process includes iterative adjustments and implementation strategies from the implementation framework Expert Recommendations for Implementing Change (ERIC) informed by dialogues with stakeholders. Implementation outcomes (e.g., acceptability and adoption) will be assessed through questionnaires and interviews with parents, ECEC and MCH staff, with particular attention to ethnic diverse groups. Both within-trial and modelling-based economic evaluation will be performed. Nutrition Now will bridge the existing evidence-to-practice gap through rigorous scientific effectiveness evaluation of municipal scale up and inform subsequent county scale up. The study is the first to implement efficacious nutrition interventions in early life with potential for health improvement using technology to maximise the reach and impact of both parental and MCH dietary guidance and ECEC practice.

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