Table of Figures

WATCH has adapted to the COVID 19 pandemic. These lessons include the understanding the HCPs may not be available due to shifts strictly related to COVID, meetings have shifted from in person to ZOOM, and in person observations have halted due to COVID protocols at each ECE and HCP site. WATCH does adhere to COVID 19 protocols and mandates at all participating centers, and we have learned that delays in meetings may be interrupted to a shift in schedule due to quarantine, site closures, and full dedication of HCPs to COVID operations within their health systems. COVID has allowed WATCH baseline measures, pre and post, to be selfreported by each participating group, which has cut the need to do EPAO/DOCC observations in person.

The final lesson staff would like to mention is the implementation of the best practice menu. In the earliest community, this process was not feasible in any of the ECEs. Challenges that WATCH staff encountered were related to changes in leadership, some center menus were not provided, and menus were not consistent across all centers. These challenges led WATCH staff to the development of tools to measure readiness and capacity for the implementation of the best practice menu. This was helpful and guided scheduling conversations with partners within the ECEs that had firsthand experience with menu item purchasing and preparing the meals at each center. A Community Capacity survey was developed and is sent via email to ECE staff. Once it is filled out and completed, WATCH staff reviews the submissions and prepares an additional meeting that is a focus group style meeting. At this meeting, WATCH staff has learned what is needed to get the menu created and implemented within each center. An additional lesson learned is to have monthly check-ins with the center to work through any challenges that the centers may face, and this provides a way to make real time changes to following menus. This process has led to the success of implementation of the best practice menu.