Confident and understanding parents: Child nutrition and active play intervention among highly disadvantaged families attending Supported Playgroups

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The trial is the third phase of a complex intervention that by definition, involves large variability in a target population and is a placed-based initiative for highly vulnerable families. Our research is informed by a needs assessment (Phase 1) and feasibility study (Phase 2). We will assess the impact of child nutrition and active play advice delivered in community-based early childhood settings to vulnerable families. We will train Supported Playgroup facilitators and bicultural workers to will deliver six key messages (chosen from 10) about child health and development issues. Building on established relationships between facilitators, bicultural workers and their families, the program is delivered by facilitators in their existing Supported Playgroups using place-based resources, during one school term. We previously found that children attending Supported Playgroups were over-represented among those consuming sweet drinks and ‘packaged’ foods, and viewing excessive hours of television. Parents reported concerns about the safety of their children during active play and some powerlessness in providing healthy food. Supported Playgroup parents also described greater difficulties accessing, understanding, and using health information than other families in the same locations of social disadvantage. Our subsequent feasibility study co-designed by stakeholders demonstrated effective communication about key messages in child nutrition and active play by Supported Playgroup facilitators. More specifically, it resulted in improved knowledge and confidence of SP facilitators and parents, and changes in parenting behaviours. Although key messages in child nutrition and active play have been successfully used in early childhood interventions in Australia, culturally and linguistically diverse and significantly disadvantaged families have not participated. Innovation in effective delivery of child nutrition and active play messages is urgently required for high needs families. Research questions Can early childhood settings be used as a platform to convey key child health and developmental messages to parents of young children living with significant social and economic disadvantage? Can Supported Playgroup facilitators effectively communicate key messages about child nutrition and active play? How can the evidence-based knowledge be best disseminated for specific family and playgroup contexts? What knowledge will families recall away from Supported Playgroups and will it translate into child-health practices and better connections to existing services? To this end, the general hypothesis is that when well-considered and sensitively delivered messages about child nutrition and active play are embedded into Supported Playgroups, parental knowledge will increase and child-health practices will improve. This experience will also increase the social connectedness and ultimately the self-efficacy in parenting of highly disadvantaged parents. Specific Hypotheses 1. That increased parental knowledge and self-efficacy about child nutrition and active play will promote improved child health-related behaviours. 2. That Supported Playgroups are an effective place-based setting to convey child health and development information to vulnerable families. Aim Our overall research goal is to address health and social inequalities among vulnerable families with young children. Specifically this project aims to 1. Improve child nutrition and active play-related behaviours in vulnerable families. 2. Advance knowledge about effective strategies for achieving translation of the research findings into policy in early childhood settings. The trial has not been previously registered. Relevant citations arising from Phase 1 are: Myers, J., K. Gibbons, G. Naughton, et al. (2015). "Early childhood nutrition, active outdoor play and sources of information for families living in highly socially disadvantaged locations." Journal of Paediatrics and Child Health 51(3): 287-293. Myers, J., S. Thorpe, et al. (2014). "Early childhood nutrition concerns, resources and services for Aboriginal families in Victoria." Australian and New Zealand Journal of Public Health 38(4): 370-376.

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