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Randomized Controlled Trial
. 2019 Feb 18;14(1):17.
doi: 10.1186/s13012-019-0865-7.

A randomised controlled trial of performance review and facilitated feedback to increase implementation of healthy eating and physical activity-promoting policies and practices in centre-based childcare

Meghan Finch  1   2   3   4 , Fiona Stacey  5   6   7 , Jannah Jones  8   6   7 , Sze Lin Yoong  5   6   7 , Alice Grady  5   6   7 , Luke Wolfenden  5   6   7
Affiliations
Randomized Controlled Trial

A randomised controlled trial of performance review and facilitated feedback to increase implementation of healthy eating and physical activity-promoting policies and practices in centre-based childcare

Meghan Finch et al. Implement Sci. .

Abstract

Background: While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation of healthy eating and physical activity-promoting policies and practices in childcare services.

Methods: The study was conducted with childcare services in the Hunter New England region of New South Wales, Australia. Eligible services were randomised to a wait-list control group or to receive the implementation strategy. The strategy targeted the implementation of written nutrition, physical activity, and small screen recreation policies; providing information to families regarding healthy eating, physical activity, and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and plain milk only to children; providing fundamental movement skills activities for children every day; and limiting the use of electronic screen time for educational purposes and learning experiences. Intervention services received a performance review and facilitated feedback process five times over the 10 months that included an assessment of current practices, goal setting, identification of barriers to implementation, problem-solving, and resource provision. The primary outcome was the proportion of services implementing all six policies and practices, assessed by nominated supervisor completion of a computer-assisted telephone interview at baseline and 12-month follow-up.

Results: One hundred and eight services took part. There were no significant differences in the proportion of services implementing all six practices at 12 months (mean difference 0.51; 95% CI 0.16 to 1.58; p = 0.24). There were also no differences between groups in the mean number of policies and practices implemented (mean difference 0.1; 95% CI - 0.4 to 0.6; p = 0.71), or the proportion implementing each of the six individual policies and practices at 12 months (OR range 0.57 to 1.85; p > 0.05).

Conclusions: Further support may be required to assist childcare services to make recommended changes to their policies and practices.

Trial registration: The trial was registered retrospectively on 10 September 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614000972628 .

Keywords: Childcare; Children; Implementation; Nutrition; Obesity prevention; Physical activity.

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Conflict of interest statement

Ethics approval and consent to participate

The trial was approved by the Hunter New England Human Research Ethics Committee (06/07/26/4.04) and the University of Newcastle Human Research Ethics Committee (H-2008-0343). Informed consent was gained from all study participants.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Participant flow chart
See this image and copyright information in PMC

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