- Title
- Improving the dietary intake of children attending centre-based childcare in NSW, Australia
- Creator
- Barnes, Courtney Jayne
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Introduction and aims: Poor dietary behaviours are leading modifiable risk factors of overweight and obesity in childhood. The Early Childhood Education and Care (ECEC) setting provides a unique opportunity to influence the development of children’s dietary behaviours, with several components of ECEC centre nutrition environments associated with improved child dietary intake. In response to this, evidence-based policies and practices have been developed, which acknowledge the potential for the ECEC setting to influence child dietary intake. However, current implementation of such policies and practices within the ECEC setting is poor. In order for interventions to improve implementation of healthy eating policies and practices to result in population-wide health improvements, they must be both effective and also scalable. Research suggests, however, that current interventions are not designed and delivered in ways that are amenable to scale up. As such, this thesis sought to address the identified limitations of the current evidence base by describing the development, and investigating the potential impact, of a web-based implementation intervention to improve ECEC centre nutrition environments and child dietary intake at scale. Specifically, the objectives of this thesis were to: 1. Examine the association between ECEC centre healthy eating practices in influencing children’s healthy eating behaviours (Chapter Two); 2. Assess the impact and scalability of a web-based implementation intervention aiming to increase child intake of fruit and vegetables within ECEC centres (Chapter Three and Four); 3. Systematically review strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices and programmes within ECEC centres (Chapter Five); and 4. Summarise implications for future policy, practice and research (Chapter Six). Results: of the identified centre healthy eating practices. The trial found that the web-based intervention together with health promotion officer support was highly feasible, acceptable to centre staff, can be delivered at low-cost, and is potentially effective in improving centre implementation of healthy eating practices. A scalability assessment also found that this implementation intervention may potentially be amenable to delivery to a large number of ECEC centres. Such findings indicate that the web-based intervention is a potentially effective and scalable approach to providing support to ECEC centres to improve the implementation of healthy eating practices. Finally, the systematic review consisting of 21 studies provides evidence of the effectiveness of strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices and programmes within ECEC centres. Conclusion: This thesis provides a compilation of implementation-focused research on improving the implementation of evidence-based healthy eating policies and practices within ECEC centres. Additionally, it provides considerable guidance for the development of future implementation interventions to improve child dietary intake in care at scale. A cross-sectional study in 22 ECEC centres in the Hunter New England (HNE) region of New South Wales (NSW), determined that the availability of foods within children’s lunchboxes was associated with children’s intake of such foods (P < 0.01). Additionally, this study demonstrated that several other healthy eating practices, including centre provision of intentional healthy eating learning experiences (estimate −0.56; P = 0.01) and the use of feeding practices that support children’s healthy eating (estimate −2.02; P = 0.04) were associated with reduced child intake of saturated fat in care. Findings of this study provided considerable guidance for the development of a pilot implementation trial within 22 ECEC centres in the HNE region of NSW, which aimed to improve the implementation of the identified centre healthy eating practices. The trial found that the web-based intervention together with health promotion officer support was highly feasible, acceptable to centre staff, can be delivered at low-cost, and is potentially effective in improving centre implementation of healthy eating practices. A scalability assessment also found that this implementation intervention may potentially be amenable to delivery to a large number of ECEC centres. Such findings indicate that the web-based intervention is a potentially effective and scalable approach to providing support to ECEC centres to improve the implementation of healthy eating practices. Finally, the systematic review consisting of 21 studies provides evidence of the effectiveness of strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices and programmes within ECEC centres. Conclusion: This thesis provides a compilation of implementation-focused research on improving the implementation of evidence-based healthy eating policies and practices within ECEC centres. Additionally, it provides considerable guidance for the development of future implementation interventions to improve child dietary intake in care at scale.
- Subject
- dietary intake; children; centre-based childcare; NSW, Australia; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1496502
- Identifier
- uon:54168
- Rights
- Copyright 2021 Courtney Jayne Barnes
- Language
- eng
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 11 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 504 KB | Adobe Acrobat PDF | View Details Download |