Evaluation of a Long Day Care Intervention Targeting the Mealtime Environment and Curriculum to Increase Children's Vegetable Intake: a Cluster Randomised Controlled Trial Using the Multiphase Optimisation Strategy Framework

Overview

Journal Public Health Nutr

Publisher Cambridge University Press

Date 2024 Feb 26

PMID 38404253

Authors

Samantha Morgillo

Lucinda K Bell

Claire Gardner

Shabnam Kashef

Karen Stafford

Dorota Zarnowiecki

Astrid Am Poelman

Maeva O Cochet-Broch

Brittany J Johnson

Aarti Gulyani

David N Cox

Rebecca K Golley

Affiliations

Soon will be listed here.

Abstract

Objective: To determine the reach, adoption, implementation and effectiveness of an intervention to increase children's vegetable intake in long day care (LDC).

Design: A 12-week pragmatic cluster randomised controlled trial, informed by the multiphase optimisation strategy (MOST), targeting the mealtime environment and curriculum. Children's vegetable intake and variety was measured at follow-up using a modified Short Food Survey for early childhood education and care and analysed using a two-part mixed model for non-vegetable and vegetable consumers. Outcome measures were based on the RE-AIM framework.

Setting: Australian LDC centres.

Participants: Thirty-nine centres, 120 educators and 719 children at follow-up.

Results: There was no difference between intervention and waitlist control groups in the likelihood of consuming any vegetables when compared with non-vegetable consumers for intake (OR = 0·70, (95 % CI 0·34-1·43), = 0·32) or variety (OR = 0·73 (95 % CI 0·40-1·32), = 0·29). Among vegetable consumers ( 652), there was no difference between groups in vegetable variety (exp(b): 1·07 (95 % CI:0·88-1·32, = 0·49) or vegetable intake (exp(b): 1·06 (95 % CI: 0·78, 1·43)), = 0·71) with an average of 1·51 (95 % CI 1·20-1·82) and 1·40 (95 % CI 1·08-1·72) serves of vegetables per day in the intervention and control group, respectively. Intervention educators reported higher skills for promoting vegetables at mealtimes, and knowledge and skills for teaching the curriculum, than control (all < 0·001). Intervention fidelity was moderate ( 16/20 and 15/16 centres used the Mealtime environment and Curriculum, respectively) with good acceptability among educators. The intervention reached 307/8556 centres nationally and was adopted by 22 % eligible centres.

Conclusions: The pragmatic self-delivered online intervention positively impacted educator's knowledge and skills and was considered acceptable and feasible. Intervention adaptations, using the MOST cyclic approach, could improve intervention impact on children' vegetable intake.

Citing Articles

Interventions for increasing fruit and vegetable consumption in children aged five years and under.

Hodder R, OBrien K, Wyse R, Tzelepis F, Yoong S, Stacey F Cochrane Database Syst Rev. 2024; 9:CD008552.

PMID: 39312396 PMC: 11418976. DOI: 10.1002/14651858.CD008552.pub8.

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