Child-level evaluation of a web-based intervention to improve dietary guideline implementation in childcare centers: a cluster-randomized controlled trial
Although it is recommended that childcare centers provide foods consistent with dietary guidelines, the impact of implementing sector-specific guidelines on child outcomes is largely unknown. This study aims to examine the impact of a web-based program and support to implement dietary guidelines in...
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| Veröffentlicht in: | The American journal of clinical nutrition 2020-04, Vol.111 (4), p.854-863 |
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| creator | Yoong, Sze Lin Grady, Alice Wiggers, John H Stacey, Fiona G Rissel, Chris Flood, Victoria Finch, Meghan Wyse, Rebecca Sutherland, Rachel Salajan, David O’Rourke, Ruby Lecathelinais, Christophe Barnes, Courtney Pond, Nicole Gillham, Karen Green, Sue Wolfenden, Luke |
| description | Although it is recommended that childcare centers provide foods consistent with dietary guidelines, the impact of implementing sector-specific guidelines on child outcomes is largely unknown.
This study aims to examine the impact of a web-based program and support to implement dietary guidelines in childcare centers on children’s 1) diet; 2) BMI z scores; and 3) child health-related quality of life (HRQoL).
This study was a cluster-randomized controlled trial utilizing a Type-3 Hybrid implementation-effectiveness design conducted between October 2016 and March 2018. This study reports on child outcomes. Fifty-four childcare centers in New South Wales, Australia were randomly assigned to the intervention (a web-based menu-planning tool and support) or control group (usual care). The intervention was designed to address barriers and enablers to dietary guideline implementation according to the Theoretical Domains Framework. A quota of 35 consenting childcare centers undertook child-level evaluation of dietary intake where 522 parents consented to completing ≥1 component of data collection for their child. Child consumption of core and discretionary (unhealthy) foods while in care was assessed via dietary observations by blinded research assistants, childcare diet quality was assessed via educator-completed questionnaires, BMI z scores were assessed via measured weight and height, and child HRQoL was assessed via parent report at baseline and 12-mo follow-up.
There was a significant increase in mean child consumption of fruit (0.39 servings; 95% CI: 0.12, 0.65 servings) and dairy foods (0.38 servings; 95% CI: 0.19, 0.57 servings) and a significant reduction in consumption of discretionary foods (−0.40 servings; 95% CI: −0.64, −0.16 servings) in care in the intervention group, relative to control at 12-mo follow-up. No significant differences were observed in diet quality, BMI z scores, or HRQoL.
A web-based intervention to support planning of childcare menus consistent with dietary guidelines can improve child consumption of healthier foods in daycare. This trial was registered at www.anzctr.org.au as ACTRN12616000974404. |
| doi_str_mv | 10.1093/ajcn/nqaa025 |
| format | Article |
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This study aims to examine the impact of a web-based program and support to implement dietary guidelines in childcare centers on children’s 1) diet; 2) BMI z scores; and 3) child health-related quality of life (HRQoL).
This study was a cluster-randomized controlled trial utilizing a Type-3 Hybrid implementation-effectiveness design conducted between October 2016 and March 2018. This study reports on child outcomes. Fifty-four childcare centers in New South Wales, Australia were randomly assigned to the intervention (a web-based menu-planning tool and support) or control group (usual care). The intervention was designed to address barriers and enablers to dietary guideline implementation according to the Theoretical Domains Framework. A quota of 35 consenting childcare centers undertook child-level evaluation of dietary intake where 522 parents consented to completing ≥1 component of data collection for their child. Child consumption of core and discretionary (unhealthy) foods while in care was assessed via dietary observations by blinded research assistants, childcare diet quality was assessed via educator-completed questionnaires, BMI z scores were assessed via measured weight and height, and child HRQoL was assessed via parent report at baseline and 12-mo follow-up.
There was a significant increase in mean child consumption of fruit (0.39 servings; 95% CI: 0.12, 0.65 servings) and dairy foods (0.38 servings; 95% CI: 0.19, 0.57 servings) and a significant reduction in consumption of discretionary foods (−0.40 servings; 95% CI: −0.64, −0.16 servings) in care in the intervention group, relative to control at 12-mo follow-up. No significant differences were observed in diet quality, BMI z scores, or HRQoL.
A web-based intervention to support planning of childcare menus consistent with dietary guidelines can improve child consumption of healthier foods in daycare. This trial was registered at www.anzctr.org.au as ACTRN12616000974404.</description><identifier>ISSN: 0002-9165</identifier><identifier>EISSN: 1938-3207</identifier><identifier>DOI: 10.1093/ajcn/nqaa025</identifier><identifier>PMID: 32091593</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Australia ; Body height ; Child ; Child care ; Child Day Care Centers - standards ; child diet ; Child Health - standards ; Child, Preschool ; childcare centers ; Children ; Clinical trials ; Clusters ; Consumption ; Dairy products ; Data collection ; Daycare ; Diet ; Diet - standards ; dietary guidelines ; Dietary intake ; Evaluation ; Female ; Food ; Food consumption ; Food intake ; Guidelines ; Health Promotion ; Humans ; Internet-Based Intervention ; Intervention ; Male ; Meals ; Menu Planning - standards ; Nutrition Policy ; obesity ; Original Research Communications ; Parents ; public health nutrition ; Quality assessment ; Quality of Life ; Randomization</subject><ispartof>The American journal of clinical nutrition, 2020-04, Vol.111 (4), p.854-863</ispartof><rights>2020 American Society for Nutrition.</rights><rights>Copyright © The Author(s) 2020. 2020</rights><rights>Copyright © The Author(s) 2020.</rights><rights>Copyright American Society for Clinical Nutrition, Inc. Apr 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c491t-db9d6731e28b9fa3e2b71a9d930b857083905515865c954118586df7d649e27a3</citedby><cites>FETCH-LOGICAL-c491t-db9d6731e28b9fa3e2b71a9d930b857083905515865c954118586df7d649e27a3</cites><orcidid>0000-0003-3379-5340</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32091593$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoong, Sze Lin</creatorcontrib><creatorcontrib>Grady, Alice</creatorcontrib><creatorcontrib>Wiggers, John H</creatorcontrib><creatorcontrib>Stacey, Fiona G</creatorcontrib><creatorcontrib>Rissel, Chris</creatorcontrib><creatorcontrib>Flood, Victoria</creatorcontrib><creatorcontrib>Finch, Meghan</creatorcontrib><creatorcontrib>Wyse, Rebecca</creatorcontrib><creatorcontrib>Sutherland, Rachel</creatorcontrib><creatorcontrib>Salajan, David</creatorcontrib><creatorcontrib>O’Rourke, Ruby</creatorcontrib><creatorcontrib>Lecathelinais, Christophe</creatorcontrib><creatorcontrib>Barnes, Courtney</creatorcontrib><creatorcontrib>Pond, Nicole</creatorcontrib><creatorcontrib>Gillham, Karen</creatorcontrib><creatorcontrib>Green, Sue</creatorcontrib><creatorcontrib>Wolfenden, Luke</creatorcontrib><title>Child-level evaluation of a web-based intervention to improve dietary guideline implementation in childcare centers: a cluster-randomized controlled trial</title><title>The American journal of clinical nutrition</title><addtitle>Am J Clin Nutr</addtitle><description>Although it is recommended that childcare centers provide foods consistent with dietary guidelines, the impact of implementing sector-specific guidelines on child outcomes is largely unknown.
This study aims to examine the impact of a web-based program and support to implement dietary guidelines in childcare centers on children’s 1) diet; 2) BMI z scores; and 3) child health-related quality of life (HRQoL).
This study was a cluster-randomized controlled trial utilizing a Type-3 Hybrid implementation-effectiveness design conducted between October 2016 and March 2018. This study reports on child outcomes. Fifty-four childcare centers in New South Wales, Australia were randomly assigned to the intervention (a web-based menu-planning tool and support) or control group (usual care). The intervention was designed to address barriers and enablers to dietary guideline implementation according to the Theoretical Domains Framework. A quota of 35 consenting childcare centers undertook child-level evaluation of dietary intake where 522 parents consented to completing ≥1 component of data collection for their child. Child consumption of core and discretionary (unhealthy) foods while in care was assessed via dietary observations by blinded research assistants, childcare diet quality was assessed via educator-completed questionnaires, BMI z scores were assessed via measured weight and height, and child HRQoL was assessed via parent report at baseline and 12-mo follow-up.
There was a significant increase in mean child consumption of fruit (0.39 servings; 95% CI: 0.12, 0.65 servings) and dairy foods (0.38 servings; 95% CI: 0.19, 0.57 servings) and a significant reduction in consumption of discretionary foods (−0.40 servings; 95% CI: −0.64, −0.16 servings) in care in the intervention group, relative to control at 12-mo follow-up. No significant differences were observed in diet quality, BMI z scores, or HRQoL.
A web-based intervention to support planning of childcare menus consistent with dietary guidelines can improve child consumption of healthier foods in daycare. This trial was registered at www.anzctr.org.au as ACTRN12616000974404.</description><subject>Australia</subject><subject>Body height</subject><subject>Child</subject><subject>Child care</subject><subject>Child Day Care Centers - standards</subject><subject>child diet</subject><subject>Child Health - standards</subject><subject>Child, Preschool</subject><subject>childcare centers</subject><subject>Children</subject><subject>Clinical trials</subject><subject>Clusters</subject><subject>Consumption</subject><subject>Dairy products</subject><subject>Data collection</subject><subject>Daycare</subject><subject>Diet</subject><subject>Diet - standards</subject><subject>dietary guidelines</subject><subject>Dietary intake</subject><subject>Evaluation</subject><subject>Female</subject><subject>Food</subject><subject>Food consumption</subject><subject>Food intake</subject><subject>Guidelines</subject><subject>Health Promotion</subject><subject>Humans</subject><subject>Internet-Based Intervention</subject><subject>Intervention</subject><subject>Male</subject><subject>Meals</subject><subject>Menu Planning - standards</subject><subject>Nutrition Policy</subject><subject>obesity</subject><subject>Original Research Communications</subject><subject>Parents</subject><subject>public health nutrition</subject><subject>Quality assessment</subject><subject>Quality of Life</subject><subject>Randomization</subject><issn>0002-9165</issn><issn>1938-3207</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNqFkUtv1DAUhS1ERYfCjjWyxKIsCLXjOIm7QKpGvKRKbGBtOfZN65FjT-0kqP0p_FqcZqgAIbHylc7ncx8HoReUvKVEsDO10_7M3yhFSv4IbahgbcFK0jxGG0JIWQha82P0NKUdIbSs2voJOs66oFywDfqxvbbOFA5mcBhm5SY12uBx6LHC36ErOpXAYOtHiDP4e20M2A77GGbAxsKo4i2-mqwBZz0sioMhk6uP9VgvHbSKgDUsNuk8W2s3pVwXUXkTBnuXe-jgxxicy-UYrXLP0FGvXILnh_cEffvw_uv2U3H55ePn7cVloStBx8J0wtQNo1C2negVg7JrqBJGMNK1vCEtE4Rzytuaa8ErSttcmr4xdSWgbBQ7Qe9W3_3UDWCWIaNych_tkFeTQVn5p-LttbwKs2woa-umzgavDwYx3EyQRjnYpME55SFMSZasZoQTKqqMvvoL3YUp-rxeplrRVBWhNFNvVkrHkFKE_mEYSuQSulxCl4fQM_7y9wUe4F8pZ-B0BcK0_59VvZKQDz5biDJpC16DsRH0KE2w__74E1CpzcM</recordid><startdate>20200401</startdate><enddate>20200401</enddate><creator>Yoong, Sze Lin</creator><creator>Grady, Alice</creator><creator>Wiggers, John H</creator><creator>Stacey, Fiona G</creator><creator>Rissel, Chris</creator><creator>Flood, Victoria</creator><creator>Finch, Meghan</creator><creator>Wyse, Rebecca</creator><creator>Sutherland, Rachel</creator><creator>Salajan, David</creator><creator>O’Rourke, Ruby</creator><creator>Lecathelinais, Christophe</creator><creator>Barnes, Courtney</creator><creator>Pond, Nicole</creator><creator>Gillham, Karen</creator><creator>Green, Sue</creator><creator>Wolfenden, Luke</creator><general>Elsevier Inc</general><general>Oxford University Press</general><general>American Society for Clinical Nutrition, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T7</scope><scope>7TS</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3379-5340</orcidid></search><sort><creationdate>20200401</creationdate><title>Child-level evaluation of a web-based intervention to improve dietary guideline implementation in childcare centers: a cluster-randomized controlled trial</title><author>Yoong, Sze Lin ; Grady, Alice ; Wiggers, John H ; Stacey, Fiona G ; Rissel, Chris ; Flood, Victoria ; Finch, Meghan ; Wyse, Rebecca ; Sutherland, Rachel ; Salajan, David ; O’Rourke, Ruby ; Lecathelinais, Christophe ; Barnes, Courtney ; Pond, Nicole ; Gillham, Karen ; Green, Sue ; Wolfenden, Luke</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c491t-db9d6731e28b9fa3e2b71a9d930b857083905515865c954118586df7d649e27a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Australia</topic><topic>Body height</topic><topic>Child</topic><topic>Child care</topic><topic>Child Day Care Centers - standards</topic><topic>child diet</topic><topic>Child Health - standards</topic><topic>Child, Preschool</topic><topic>childcare centers</topic><topic>Children</topic><topic>Clinical trials</topic><topic>Clusters</topic><topic>Consumption</topic><topic>Dairy products</topic><topic>Data collection</topic><topic>Daycare</topic><topic>Diet</topic><topic>Diet - standards</topic><topic>dietary guidelines</topic><topic>Dietary intake</topic><topic>Evaluation</topic><topic>Female</topic><topic>Food</topic><topic>Food consumption</topic><topic>Food intake</topic><topic>Guidelines</topic><topic>Health Promotion</topic><topic>Humans</topic><topic>Internet-Based Intervention</topic><topic>Intervention</topic><topic>Male</topic><topic>Meals</topic><topic>Menu Planning - standards</topic><topic>Nutrition Policy</topic><topic>obesity</topic><topic>Original Research Communications</topic><topic>Parents</topic><topic>public health nutrition</topic><topic>Quality assessment</topic><topic>Quality of Life</topic><topic>Randomization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoong, Sze Lin</creatorcontrib><creatorcontrib>Grady, Alice</creatorcontrib><creatorcontrib>Wiggers, John H</creatorcontrib><creatorcontrib>Stacey, Fiona G</creatorcontrib><creatorcontrib>Rissel, Chris</creatorcontrib><creatorcontrib>Flood, Victoria</creatorcontrib><creatorcontrib>Finch, Meghan</creatorcontrib><creatorcontrib>Wyse, Rebecca</creatorcontrib><creatorcontrib>Sutherland, Rachel</creatorcontrib><creatorcontrib>Salajan, David</creatorcontrib><creatorcontrib>O’Rourke, Ruby</creatorcontrib><creatorcontrib>Lecathelinais, Christophe</creatorcontrib><creatorcontrib>Barnes, Courtney</creatorcontrib><creatorcontrib>Pond, Nicole</creatorcontrib><creatorcontrib>Gillham, Karen</creatorcontrib><creatorcontrib>Green, Sue</creatorcontrib><creatorcontrib>Wolfenden, Luke</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of clinical nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoong, Sze Lin</au><au>Grady, Alice</au><au>Wiggers, John H</au><au>Stacey, Fiona G</au><au>Rissel, Chris</au><au>Flood, Victoria</au><au>Finch, Meghan</au><au>Wyse, Rebecca</au><au>Sutherland, Rachel</au><au>Salajan, David</au><au>O’Rourke, Ruby</au><au>Lecathelinais, Christophe</au><au>Barnes, Courtney</au><au>Pond, Nicole</au><au>Gillham, Karen</au><au>Green, Sue</au><au>Wolfenden, Luke</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Child-level evaluation of a web-based intervention to improve dietary guideline implementation in childcare centers: a cluster-randomized controlled trial</atitle><jtitle>The American journal of clinical nutrition</jtitle><addtitle>Am J Clin Nutr</addtitle><date>2020-04-01</date><risdate>2020</risdate><volume>111</volume><issue>4</issue><spage>854</spage><epage>863</epage><pages>854-863</pages><issn>0002-9165</issn><eissn>1938-3207</eissn><abstract>Although it is recommended that childcare centers provide foods consistent with dietary guidelines, the impact of implementing sector-specific guidelines on child outcomes is largely unknown.
This study aims to examine the impact of a web-based program and support to implement dietary guidelines in childcare centers on children’s 1) diet; 2) BMI z scores; and 3) child health-related quality of life (HRQoL).
This study was a cluster-randomized controlled trial utilizing a Type-3 Hybrid implementation-effectiveness design conducted between October 2016 and March 2018. This study reports on child outcomes. Fifty-four childcare centers in New South Wales, Australia were randomly assigned to the intervention (a web-based menu-planning tool and support) or control group (usual care). The intervention was designed to address barriers and enablers to dietary guideline implementation according to the Theoretical Domains Framework. A quota of 35 consenting childcare centers undertook child-level evaluation of dietary intake where 522 parents consented to completing ≥1 component of data collection for their child. Child consumption of core and discretionary (unhealthy) foods while in care was assessed via dietary observations by blinded research assistants, childcare diet quality was assessed via educator-completed questionnaires, BMI z scores were assessed via measured weight and height, and child HRQoL was assessed via parent report at baseline and 12-mo follow-up.
There was a significant increase in mean child consumption of fruit (0.39 servings; 95% CI: 0.12, 0.65 servings) and dairy foods (0.38 servings; 95% CI: 0.19, 0.57 servings) and a significant reduction in consumption of discretionary foods (−0.40 servings; 95% CI: −0.64, −0.16 servings) in care in the intervention group, relative to control at 12-mo follow-up. No significant differences were observed in diet quality, BMI z scores, or HRQoL.
A web-based intervention to support planning of childcare menus consistent with dietary guidelines can improve child consumption of healthier foods in daycare. This trial was registered at www.anzctr.org.au as ACTRN12616000974404.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>32091593</pmid><doi>10.1093/ajcn/nqaa025</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-3379-5340</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The American journal of clinical nutrition, 2020-04, Vol.111 (4), p.854-863 |
| issn | 0002-9165 1938-3207 |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Australia Body height Child Child care Child Day Care Centers - standards child diet Child Health - standards Child, Preschool childcare centers Children Clinical trials Clusters Consumption Dairy products Data collection Daycare Diet Diet - standards dietary guidelines Dietary intake Evaluation Female Food Food consumption Food intake Guidelines Health Promotion Humans Internet-Based Intervention Intervention Male Meals Menu Planning - standards Nutrition Policy obesity Original Research Communications Parents public health nutrition Quality assessment Quality of Life Randomization |
| title | Child-level evaluation of a web-based intervention to improve dietary guideline implementation in childcare centers: a cluster-randomized controlled trial |
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