Implementation of healthy eating and physical activity practices in Australian early childhood education and care services: A cross-sectional study

•Evidence-practice gaps exist for some obesity prevention practices in ECEC services.•Investment is needed to support obesity prevention practices in ECEC services.•Preschools may need additional support to implement healthy eating practices.•Implementation of practices did not differ by service socioeconomic status. The monitoring of healthy eating and physical activity environments is recommended to support population health. Early childhood education and care (ECEC) services are a key setting to deliver obesity prevention strategies as they reach the majority of children aged under five years and have existing supporting infrastructure. The aim of this study was to i) describe the prevalence of implementation of evidence-based healthy eating and physical activity practices in an Australian sample of ECEC services, and ii) examine associations between implementation of practices and service characteristics. A random sample of 2,100 centre-based ECEC services across Australia were invited to participate in a cross-sectional survey online or via telephone (August 2021-April 2022). Service characteristics and implementation of 18 evidence-based healthy eating and physical activity practices were assessed. Descriptive statistics and linear mixed regression analyses were performed. A total of 1,028 (51.8%) eligible services participated. The healthy eating and physical activity practices with the lowest prevalence of implementation were related to encouraging children to consume age-appropriate beverages (17.9%) and providing families with child physical activity education via workshops or meetings (14.6%), respectively. There was a statistically significant difference in the implementation of healthy eating practices by service characteristics, with long day care services implementing significantly more practices than preschools (p