Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 6, 2020
Date Accepted: Oct 29, 2020
Barriers and enablers to adoption of digital health interventions to support the implementation of dietary guidelines in early childhood education and care: a cross-sectional study
ABSTRACT
Background:
Few Australian childcare centers provide foods consistent with sector dietary guidelines. Digital health technologies are a promising medium to improve the implementation of evidence-based guidelines in the setting. Despite being widely accessible, the population level impact of such technologies has been limited due to the lack of adoption by end-users.
Objective:
The study aimed to assess in a national sample of Australian childcare centers: i) intentions to adopt digital health interventions to support the implementation of dietary guidelines; ii) reported barriers and enablers to the adoption of digital health interventions in the setting; and iii) barriers and enablers associated with high intentions to adopt digital health interventions.
Methods:
A cross-sectional telephone or online survey was undertaken with 407 childcare centers randomly sampled from a publically available national register in 2018. Center intentions to adopt new digital health interventions to support dietary guideline implementation in the sector were assessed in addition to perceived individual, organizational and contextual factors that may influence adoption based on seven sub-domains within the non-adoption, abandonment, scale-up, spread, and sustainability (NASSS) of health and care technologies framework. A multiple variable linear model was used to identify factors associated with high intentions to adopt digital health interventions.
Results:
Findings indicate 58.87% of childcare centers have high intentions to adopt a digital health intervention to support guideline implementation. The ‘changes needed in team interactions’ sub-domain scored lowest (indicative of a potential barrier) (M=3.52), with ‘organization’s capacity to innovate’ scoring highest (indicative of a potential enabler) (M=5.25). The two NASSS sub-domains of ‘ease of adoption decision’ (p<0.001), and ‘identifying work and individuals involved in implementation’ (p=0.01) were significantly associated with high intentions to adopt digital health interventions.
Conclusions:
A substantial proportion of Australian childcare centers have high intentions to adopt new digital health interventions to support dietary guideline implementation. Given evidence of the effectiveness of digital health interventions, these findings suggest that such an intervention may make an important contribution to improving public health nutrition in early childhood.
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.