None listed
Conditions
Brief summary
Early Education and care childcare services are an important setting for interventions to improve child diet as they provide access to large number of children at a critical period in the development of dietary habits. For the majority of childcare centres (approximately 70%), food consumed by children is provided by parents. However research suggests that lunchboxes often contain excessive quantities of “non-core foods” (or energy dense, nutrient poor foods) and inadequate amounts of core foods such as vegetables contributing to poor health outcomes and increasing children’s risk of excessive weight gain which track into adulthood and increase risk of chronic diseases. To date, there has been few studies aiming to improve the nutritional content of lunchbox foods packed in the childcare setting, most reporting limited effect on improving lunchbox contents or improving child nutritional intake. This study explores the use of an app on changing the types of foods packed in young children’s (3-6 years old) lunchboxes while attending childcare service. It aims to measure the impact of the intervention on reducing non-core foods packed and consumed via lunchboxes
Interventions
An intervention to decrease the packing of non-core foods (i.e. energy dense, nutrient poor foods) in lunchboxes will be delivered to eligible children attending early education and care long day care centres.
The intervention will primarily target parents of children aged 3-6 years attending a selected sample of early education and care services (Long Day Care and Preschools services). Strategy selection will be guided by the Behaviour Change Wheel (BCW) and primarily be delivered via a commu
An intervention to decrease the packing of non-core foods (i.e. energy dense, nutrient poor foods) in lunchboxes will be delivered to eligible children attending early education and care long day care centres. The intervention will primarily target parents of children aged 3-6 years attending a selected sample of early education and care services (Long Day Care and Preschools services). Strategy selection will be guided by the Behaviour Change Wheel (BCW) and primarily be delivered via a communication app that is currently used by childcare services to provide information to parents. The intervention components will be delivered over a 16 week period. The components of the intervention are as below: 1. Provision of regular prompts and reminders to parents Regular messages (developed by Public Health Nutritionists) sent via push notifications will be provided to parents. Messages addressing parent reported barriers to packing healthier food in lunchboxes will be delivered via push notifications for 10 weeks (one per week) to support parents with packing healthier lunchboxes for the child . The push notifications will consist of a brief written message designed to influence parent behaviour related to packing of lunchboxes. Message content will be enhanced by the use of relevant graphics, text and/or embedded video links. Specifically each message will encourage parents to swap non-core foods for core foods in the lunchbox as well as provide advice, information or ideas for overcoming an identified barrier to packing healthy lunchboxes. Implementation fidelity (ie delivery of messages) will be ascertained by accessing app analytics, as well as measure parent access of the messages. 2. Providing suggestions on types of food to pack in lunchboxes To address a key barrier to packing healthier lunchboxes (i.e. parents not knowing what particular foods to pack), parents will be given access, and encouraged to use, a list of recommended and not recommended foods for their child lunchbox. The list will be referred to regularly as part of the weekly push messages as well as be statically accessible content on the app 3. Childcare service lunchbox guidelines Nominated supervisors will receive support to ensure consistency between any current service lunchbox guidelines and the lunchbox recommendations within the app. The guidelines will outline the recommended foods as well as highlight non -core foods not recommended for inclusion in lunchboxes. Nominated supervisors will be asked to communicate any changes to existing guidelines to educators and parents via the app and/or newsletters or verbally. 4. Childcare services endorsement of the intervention To support use of the app by parents and ensure consistency in nutrition message promoted, research staff will meet with the service Nominated supervisor of each intervention service to orientate them to the intervention, secure managerial endorsement and seek a commitment from service managers to communicate the initiative to Educators and parents. Nominated Supervisors will also distribute a printed resource pack to Educators containing the all the intervention content available via the app, including the push notification messages and the decision making tool containing the list of recommended and non-recommended foods for the lunchbox. Nominated supervisors will also be asked to communicate endorsement of the initiative to parents via the app and/ or other preferred communication method. They will also be asked to send a second parent message or other communication item mid-way through the intervention will the purpose of encouraging continued participation and providing non-contingent praise and positive feedback. Nominated supervisors will be asked to complete a record of implementation in order to assess compliance with these requests.
Sponsors
Hunter New England Local Health District Population Health
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
3 Years to 6 Years
Healthy volunteers
Yes
Inclusion criteria
Early Education and Care Services (Long Day Care Services and Preschools): For a service to be eligible, it will be located within the Hunter New England region of NSW Australia, cater for children 3-6 years of age, be a “lunchbox service” (ie requires parents to provide all food), be open for at least 8 hours per day, be using or willing to commence using the parent communication app used to deliver the intervention. Parents: For parents to be eligible they must have a child aged 3-6 years attending the “lunchbox” service on the days of designated data collection, have access or be willing to access the app. Children: For children within the service to be eligible to participate they will be aged 3-6 years, have parental consent and attend care during any of the days of designated data collection.
Exclusion criteria
Early Education and Care Services (Long Day Care Services and Preschools): Services will be excluded if they are participating in any trial related to improving child nutrition, are a Department and Education community run service or cater exclusively for children with special needs. Parents: Parents will be excluded if are participating in any trial related to improving child nutrition. Children: Children will be excluded from the trial if they have special dietary requirements or allergies that would necessitate specialised tailoring of their diet such that it may be adversely affected by the intervention.
Outcome results
None listed