Evaluation of an multi-component initiative package to promote children’s vegetable intake in child care

The overall project will undertake the three phases of the Multiphase Optimisation Strategy (MOST) study design to develop and evaluate a multicomponent initiative package to increase children’s vegetable intake in long day care. The Preparation and Optimisation phases will develop and evaluate the initiative components. This trial registration describes the final Evaluation Phase study which will test the effectiveness of the multicomponent initiative package for increasing children’s vegetable intake in care. The initiative package will comprise initiatives supporting cooks to increase vegetable provision on the menu, and educators to deliver a vegetable-focused curriculum and use of supportive feeding practices at mealtimes for increasing vegetable intake. Centres will use the initiative package for the 12-week intervention period. FOOD PROVISION: The food provision initiative will support cooks to increase the provision of vegetables on the menu across all eating occasions. Cooks will complete an online training module, use an online menu planning tool to review their menu and implement the revised menu. The training will take approximately 45-55 minutes to complete and covers menu planning, importance of healthy eating, implementing menu guidelines and overcoming common barriers. Cooks will use an automated online menu assessment tool to assess compliance of their menu with guidelines. Cooks will enter their current menu, recipes, and number of children for whom their menu caters and will receive an overview of compliance of the menu with guidelines for each food group. Recommendations by food group will be provided, identifying meal occasions (morning snack, lunch, and afternoon snack) and days where the menu needs to be revised the menu to meet guidelines. Cooks will be asked to complete the training, menu assessment, revise their menu according to provided recommendations within the first 4 weeks of the intervention period and then implement their revised menu. Completion of the online training and menu assessment will be monitored using website analytics at 12-week follow up. MEALTIME ENVIRONMENT: The mealtime environment initiative will provide training to increase educator’s knowledge and skills for using practices at mealtimes that promote children’s vegetable acceptance and intake. Educators will complete an interactive online training module (~45-55 minutes) which includes topics about the role of the educator in fostering children’s vegetable knowledge and acceptance, how to create a supportive meal time environment, use of feeding practices, overcoming barriers related to food rejection and how to plan, implement and monitor a strategy to within their centre. The training module will promote strategies to increasing vegetable acceptance and intake within the context of creating a mealtime environment which is supportive for increasing overall healthy eating. Completion of the online training will be monitored using website analytics at 12-week follow-up. CURRICULUM: The curriculum initiative will consist of a lesson package for educators that aims to provide opportunities for children to learn about, try and enjoy vegetables by increasing their exposure to a variety of familiar and unfamiliar vegetables. The initiative is based on experiential learning, sensory education, and insights on vegetable preference development in children. The curriculum will be adapted from the evidence-based Taste & Learn vegetable education curriculum for primary school children (aged 5-12 years) to be suitable for younger children and align with The Early Years Learning Framework. The curriculum will consist of a series of 16 short (~10-20min) lessons and hands-on activities delivered during intentional teaching time, a series of 16 snack time occasions where vegetables will be tasted, supporting resources and activities (e.g. reading corner, songs) and a group reward chart to track progress of vegetables tasted. Educators will be provided with written background information and lesson plans. Delivery of the curriculum will be evaluated via a detailed checklist at 12-week follow-up.