An implementation intervention to encourage healthy eating in centre-based child-care services: impact of the Good for Kids Good for Life programme

Abstract

Objective: To determine the impact of an implementation intervention designed to introduce policies and practices supportive of healthy eating in centre-based child-care services. Intervention strategies included staff training, resources, incentives, follow-up support, and performance monitoring and feedback.

Design: A quasi-experimental design was used to assess change over 20 months in healthy eating policy and practice in intervention and comparison child-care services.

Setting: The Hunter New England (HNE) region of New South Wales (NSW), Australia.

Subjects: All centre-based child-care services (n 287) in the intervention region (HNE) were invited and 240 (91% response rate) participated. Two hundred and ninety-six services in the rest of NSW were randomly selected as a comparison region and 191 participated (76% response rate). A sub-analysis was conducted on those services that provided children food (n 196 at baseline and n 190 at follow-up). Ninety-six provided menus for analysis at baseline (HNE, n 36; NSW, n 50) and 102 provided menus at follow-up (HNE, n 50; NSW, n 52).

Results: Services in the intervention region were significantly more likely to provide only plain milk and water for children (P = 0.018) and to engage parents in nutrition policy or programmes (P = 0.002). They were also more likely (P = 0.056) to have nutrition policy on home packed food. In addition, menus of services that provided lunch were significantly more likely to comply with healthy eating guidelines for sweetened drinks (P < 0.001), fruit (P < 0.001) and vegetables (P = 0.01).

Conclusions: An implementation intervention was able to modify policy and practice in a large number of child-care services so that they were more supportive of healthy eating.

Keywords: Child-care services; Healthy eating; Implementation intervention.