JMIR Publications

ABSTRACT

Background:

Internationally, the implementation of evidence-based healthy eating policies and practices within Early Childhood Education and Care (ECEC) settings that encourage children’s healthy diets is recommended. Despite the existence of evidence-based healthy eating practices, research indicates that current implementation rates are inadequate. Web-based approaches provide a potentially effective and less costly approach to support ECEC staff with implementing nutrition interventions.

Objective:

The broad aim of this pilot randomized controlled trial was to assess the feasibility of assessing the impact of a web-based program together with health promotion officer support, on ECEC center implementation of healthy eating policies and practices. Specifically, we sought to: (1) Describe the uptake of study evaluation processes (participant consent and data collection rates); (2) Examine ECEC center uptake, acceptability, appropriateness of the intervention and implementation strategies; (3) Understand the potential cost to deliver implementation support strategies; and (4) Describe the potential impact of the web-based intervention on the implementation of targeted healthy eating practices among centers in the intervention group.

Methods:

A 6-month pilot implementation trial employing a cluster-randomized controlled trial design was conducted in 22 ECEC centers within the Hunter New England region of New South Wales, Australia. Potentially eligible centers were distributed a recruitment package then telephoned by the research team to assess eligibility and obtain consent. Centers randomly allocated to the intervention group received access to a web-based program, together with health promotion officer support (e.g., educational outreach visit, ongoing support) to implement five targeted healthy eating practices. The web-based program incorporated audit with feedback, development of action plans and educational materials to facilitate improvement in implementation. Centers allocated to the control group received usual care.

Results:

Of the 47 centers approached for the study, 22 (47%) provided consent to participate. Data collection components were completed by 100% (n=22) of centers. High uptake for implementation strategies provided by health promotion officers (91-100%) and the web-based program (100%) was observed. At follow-up, intervention centers had logged on to the program an average of 5.18 (SD 2.52) times. The web-based program and implementation support strategies were highly acceptable to (91-100%). Implementation of four targeted healthy eating practices improved in the intervention group, ranging from 18.7% to 63.64%.

Conclusions:

This study provides promising pilot data to warrant the conduct of a fully power implementation trial to assess the impact of the program on ECEC implementation. Clinical Trial: Australian New Zealand Clinical Trials Registry (ACTRN12619001158156)