Efficacy and feasibility of enabling healthy, affordable, environmentally sustainable childcare food provision at scale.

The project will utilise a randomised control trial (RCT) design to explore the impact of two food waste reduction strategies, individually and in combination, namely, a purpose-designed food waste audit and whole-of-centre resources, including classroom activities. Both strategies were co-designed using the IDEAS Framework, between the research team (research nutritionists and dietitians), childcare centre staff (cooks, educators and directors) and the Healthy Eating Advisory Service, a Victorian Government funded program delivered by Nutrition Australia (publication under review). This process involved participation in semi-structured interviews to understand the barriers and enablers to the provision of healthy, sustainable food, followed by two video-conference focus groups with interviewees to explore support options to address these needs. Childcare services will be recruited from the national Australian Children’s Education & Care Quality Authority (ACECQA) registry, Recruitment strategy and sample size estimations are based on studies undertaken by the researchers and others. Recruited childcare centres (n=~30) will be stratified by locality (regional/metropolitan), and socioeconomic position using the Australian Socio-Economic Indexes for Area (SEIFA), then randomized into 3 groups. Group 1 will be exposed to a self-report 1-day food waste audit, Group 2 will be exposed to whole-of-centre resources, and Group 3 will be exposed to both the food waste audit and resources. Exposure to each intervention condition will be an 8-week period to allow sufficient time to detect practice change. After the 8-week period, a self-report 1-day food waste audit will be conducted across all Groups as post-intervention data collection. For the purpose-designed food waste resource: This self-report audit tool has been utilised by the research team previously (Elford A, Spence AC, Wakem A, Rozman M, Campbell KJ, Love P. Environmental sustainability and food provision in the early childhood and education setting. Public Health Nutrition. 2023;26(11):2200-2210. doi:10.1017/S1368980023001908), and provides a non-invasive approach. A paper copy of the audit protocol, audit record and a calibrated commercial scale will be couriered to each childcare service ahead of the audit. A member of the research team will then contact the service by telephone to confirm receipt and understanding of the protocol. Service staff responsible for food provision are required to weigh all foods/beverages consumed during 1-day. The audit diary is used to record weights and photographs (using mobile phones or other eg: tablets) are taken of all foods/beverages being weighed. Weights are recorded/photographed at food preparation stage for the entire childcare service. One 2- to 5-year-old room is selected at random to collect weights and photographs of a) all food prepared; b) food prepared but not served (serving waste); c) food plated and served but not eaten (plate waste). The completed audit diary and all photographs are to be emailed to the research team, where verification checks of recorded weights on protocol templates will be made against photographs of weighed items. A member of the research team will be available by phone throughout the self-report audit as needed. The research team member will also arrange for the calibrated scale to be couriered back to the University. For the whole-of-centre resources, including classroom activities: This resource features a 'toolkit' with tips and links to resources for each staff member (manager, educator, cook). The links to resources are Australia-specific examples, to enable implementation of the Sustainable Healthy Diets guiding principles. It will be recommended that the childcare service designate 1-week within the intervention period as "Food Waste Awareness Week" and use the 'toolkit' during this time to identify and implement relevant sustainable healthy food provision practices, and to deliver a 10-15min classroom activity. The classroom activity will involve children scraping their left-over food from the main meal into buckets and measuring this food waste using a ruler. During usual group 'circle' time, the educator will talk with the children about the food waste, engaging with them through drawings. The research team will be available to the childcare service for any questions regarding the use of the toolkit in the setting up the "Food Waste Awareness Week". Post-intervention surveys will be used to monitor uptake, acceptability, appropriateness and feasibility of the resources. Drawings made by children (regarding their understanding of "food waste") during the classroom activity will also be collected.