None listed
Conditions
Brief summary
This study seeks to assess the effectiveness of an 18-month digital health intervention (Tiny Bites) targeting infant feeding practices, delivered to ECEC educators and primary caregivers of children aged between 4-12 months (inclusive) relative to a usual care control group. We hypothesise that children in the intervention group will have a 0.26 lower BMI zscore compared to those in the control group. We will recruit 60 early childhood education and care services and 540 carer/child dyads. Services will be randomly assigned to intervention or control in a 1:1 ratio. To improve infant feeding practices, services allocated to the intervention group will receive access to an online portal (which includes a self-assessment and webinars around infant nutrition) and support from health service staff. Parents in the intervention group will receive text messages tailored to their child's age around infant feeding. After delivering the intervention for 18 months, we will compare the BMI zscores of children in the intervention group to the control.
Interventions
The Tiny Bites program is a primarily digital intervention that supports early childhood education and care (ECEC) services and primary caregivers of children aged <2 years with improving child nutrition, Tiny Bites will be delivered across approximately 18 months.
Strategies for ECEC services include:
-Participate in an initial educational outreach visit and support calls from a Health Promotion Officer throughout the duration of the intervention (educational outreach and facilitation). A heal
The Tiny Bites program is a primarily digital intervention that supports early childhood education and care (ECEC) services and primary caregivers of children aged <2 years with improving child nutrition, Tiny Bites will be delivered across approximately 18 months. Strategies for ECEC services include: -Participate in an initial educational outreach visit and support calls from a Health Promotion Officer throughout the duration of the intervention (educational outreach and facilitation). A health promotion officer located with the Local Health District will reach out via telephone to schedule the initial visit and any follow up calls at a time that is convenient to the service. These contacts could be conducted face to face, online or via the phone. - The service supervisor will complete the web-based Tiny Bites self-assessment (approximately 15 minutes) and this will automatically generate a suggested action plan for implementation (self-assessment and action planning) -Educators will be invited to participate in free training which will be delivered through pre-recorded (and live) 6 x 15-minute self-paced webinar modules covering infant feeding and responsive feeding practices and 1 x 20-minute self-paced webinar module covering nutrition conversations with primary caregivers, professionally presented by experts in the field of infant nutrition and communication (online professional development) -Services will be asked to appoint an Infant Nutrition Champion (an educator in the infant room) The strategies will support ECECs with: - Updating policy and procedures around responsive feeding practices and infant feeding, including ongoing breastfeeding (where appropriate) - Distributing bi-monthly online or paper communication to primary caregivers (approximately 9 over 18 months) using provided templates, which reinforce key themes from text messages and how the service supports these behaviours through their primary caregiver communication system - Displaying physical resources including posters, stickers and flipcharts designed to remind educators about implementing best practice infant feeding and responsive feeding practices and to act as prompts to facilitate nutrition conversations with primary caregivers. To assess adherence, the health promotion team will track number of contacts and what was delivered in each session. To maximise adherence, multiple contacts and flexible delivery modalities will be offered to ECECs. We will gather online analytics to monitor completion of webinars and use of the online elements.. Primary caregivers will receive: -Regular text messages (approximately weekly to fortnightly throughout the 18-month period). These messages will be broadly tailored to child developmental milestones and will be one-way messages. - Monthly/bi-monthly digital newsletters summarising resources and text messages (these newsletters will also be delivered to nominated individuals who may be involved in feeding children, such as grandparents/extended family members). - A number of communications from the ECEC service will be distributed to primary caregivers which reinforce key themes from text messages and describes how the service is supporting these behaviours. These may vary from centre to centre. - Access to a webpage with a collection of infant feeding and responsive feeding digital resources. Some text messages and digital newsletters will include links that direct parents to this webpage and/or specific resources. - Access to infant feeding and responsive feeding webinars developed by experts via links in the text messages. This will be recorded versions hosted on the Tiny Bites program. This will be similar to that accessed by the childcare providers in terms of length and duration. We will collect data related to parent opening of text messages and accessing links using online analytics. We are not able to access individual parents accessing of the webinars however will monitor the number clicking on the link to the online recording.
Sponsors
Deakin University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
4 Months to 65 Years
Healthy volunteers
Yes
Inclusion criteria
ECEC services will be eligible if: i) they enrol at least 5 children aged 4-12 months (inclusive) ii) have internet access and iii) are located in areas where an existing text messaging service has not been rolled out (Healthy Beginnings for HNE Kids). Children will be eligible if they: i) are aged 4- 12 months (inclusive) at recruitment; ii) are present at the ECEC services during the week of recruitment and, iii) have primary caregiver consent. Families with more than one child of the same age (i.e. twins, triplets) will be included if they meet the eligibility criteria. Primary caregivers of eligible children will be eligible to participate if i) they have a mobile phone with web capabilities (e.g. 4G/5G) and ii) can understand English sufficiently to engage with the intervention.
Exclusion criteria
Mobile services, family-based day care, occasional care services, Department of Education services and services who cater exclusively for children requiring specialist care will be excluded, as will services involved in trials conducted by the research team in the past two years. Children with diagnosed medical conditions that influence their ability to consume foods in line with the Australian Dietary Guidelines will be excluded.
Outcome results
None listed