JMIR Publications

ABSTRACT

Background:

Foods provided in childcare services are not consistent with dietary guideline recommendations. Online systems offer unique opportunities to support the implementation of such guidelines.

Objective:

This study aimed to assess the effectiveness of a web-based menu planning intervention in increasing the mean number of food groups on childcare service menus that comply with dietary guidelines. Secondary aims assessed the impact of the intervention on: the proportion of service menus compliant with recommendations for i) all food groups; ii) individual food groups; and iii) mean servings of individual food groups. Childcare service use and acceptability of the web-based program were also assessed.

Methods:

A single-blinded parallel group randomised controlled trial was undertaken with 54 childcare services in New South Wales, Australia. Services were randomised to a 12 month intervention or usual care control. Intervention services received access to an online menu planning program linked to their usual child care management software system. Childcare service compliance with dietary guidelines, and servings of food groups was assessed at baseline, 3 and 12 months follow-up.

Results:

No significant differences in the mean number of food groups compliant with dietary guidelines, the proportion of service menus compliant with recommendations for all food groups, or for individual food groups, were found at 3 or 12 months follow-up between the intervention and control group. Intervention service menus provided significantly more servings of fruit (P<.001), vegetables (P=.03), dairy (P=.03) and meat (P=.003), and reduced their servings of discretionary foods (P=.02) compared to control group at 3 months. This difference was maintained for fruit (P=.03) and discretionary foods (P=.003) at 12 months. Intervention childcare service staff logged into the web-based program an average of 40.4 (SD 31.8) times, and rated the program as highly acceptable.

Conclusions:

Whilst improvements in childcare service overall menu and individual food group compliance with dietary guidelines were not statistically significant, findings indicate a web-based menu planning intervention can improve the servings for some healthy food groups, and reduce the provision of discretionary foods. Future research exploring the effectiveness of differing strategies in improving the implementation of dietary guidelines in child care services is warranted. Clinical Trial: Prospectively registered 25 July 2016 with Australian New Zealand Clinical Trial Registry (ANZCTR) ACTRN12616000974404. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368647&isReview=true