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Campbell JE, McIsaac JLD, Young M, Dickson E, Caldwell S, Barich R, Rossiter M. Advancing assessment of responsive feeding environments and practices in child care. J Nutr Sci 2024; 13:e14. [PMID: 38572372 PMCID: PMC10988165 DOI: 10.1017/jns.2024.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/03/2024] [Accepted: 02/09/2024] [Indexed: 04/05/2024] Open
Abstract
Child care environments offer an ideal setting for feeding interventions. CELEBRATE Feeding is an approach implemented in child care environments in two Maritime Provinces in Canada to support responsive feeding (RF) to foster children's self-efficacy, self-regulation, and healthy relationships with food. This study aimed to describe RF in child care using established and enhanced scoring frameworks. The Environment and Policy Assessment and Observation (EPAO) was modified to reflect RF environments and practices, resulting in our modified EPAO and a CELEBRATE scale. Observations were conducted in 18 child care rooms. Behaviours and environments were scored on both scales, creating 21 RF scores, with a score of '3' indicating the most responsiveness. Descriptive analyses of the scores were conducted. The overall room averages were Mean (M) = 41.00, Standard Deviation (SD) = 7.07 (EPAO), and M = 37.92 SD = 6.50 (CELEBRATE). Most responsive scores among rooms within our EPAO and CELEBRATE scales, respectively, were 'educators not using food to calm or encourage behaviour' (M = 2.94, SD = 0.24; M = 2.98, SD = 0.06) and 'not requiring children to sit at the table until finished' (M = 2.89, SD = 0.47; M = 2.97, SD = 0.12). The least responsive scores within the EPAO were 'educator prompts for children to drink water' (M = 0.78, SD = 0.94) and 'children self-serving' (M = 0.83, SD = 0.38). The least responsive in the CELEBRATE scale were 'enthusiastic role modelling during mealtime' (M = 0.70, SD = 0.68) and 'praise of mealtime behaviour unrelated to food intake' (M = 0.74, SD = 0.55). The CELEBRATE scale captured unique observation information about RF to allow documenting change over time with detailed measurement to inform and support nutrition interventions within child care environments.
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Affiliation(s)
- Julie E. Campbell
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - Jessie-Lee D. McIsaac
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
- Faculty of Education and Department of Child and Youth Study, Mount Saint Vincent University, Halifax, Canada
| | - Margaret Young
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Elizabeth Dickson
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
| | - Sarah Caldwell
- Early Childhood Collaborative Research Centre, Mount Saint Vincent University, Halifax, Canada
| | - Rachel Barich
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| | - Misty Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
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Searle B, Staton S, Littlewood R, Bayliss O, Thorpe K. A Missed Opportunity? Meal Provision in Early Childhood Education and Care Services in the Context of Socioeconomic Disadvantage. Matern Child Health J 2024; 28:362-371. [PMID: 38015389 DOI: 10.1007/s10995-023-03849-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVES Early childhood education and care (ECEC) services are attended by most children before school entry, reaching many living in circumstances of poverty and providing opportunity to support their nutrition. In this study, we examine the extent to which this opportunity is being met, comparing two common types of service provision: centre- versus family- provided food. METHODS Intensive in-situ observations were undertaken across 10 ECEC services in highly disadvantaged Australian communities. All meals provided to children aged 3.5-5 years across an ECEC day (N = 48), of which 11% were experiencing severe food insecurity, were photographed and analysed to assess nutritional adequacy with reference to national dietary standards. RESULTS Meals provided did not meet national dietary recommendations for quality or quantity. Nutrition was least adequate in services with policies of family-provided food. These services were also those that served families experiencing the highest levels of severe food insecurity (29%). CONCLUSIONS In the absence of policies for the provision of food in ECEC, services are not realising their potential to support child nutrition in the context of poverty presenting increased risk to lifetime trajectories of health and wellbeing. System level policy interventions are required to facilitate equitable access to nutritious food and attendant life chances.
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Affiliation(s)
- Bonnie Searle
- Institute for Social Science Research, The University of Queensland, 80 Meier's Rd, Long Pocket, QLD, 4068, Australia.
- Australian Centre of Excellence for Children and Families across the Life Course, The University of Queensland, 80 Meier's Rd, Long Pocket, QLD, 4068, Australia.
| | - Sally Staton
- Institute for Social Science Research, The University of Queensland, 80 Meier's Rd, Long Pocket, QLD, 4068, Australia
| | - Robyn Littlewood
- Health and Wellbeing Queensland, 139 Coronation Drive, Milton, QLD, 4064, Australia
| | - Olivia Bayliss
- Institute for Social Science Research, The University of Queensland, 80 Meier's Rd, Long Pocket, QLD, 4068, Australia
- Australian Centre of Excellence for Children and Families across the Life Course, The University of Queensland, 80 Meier's Rd, Long Pocket, QLD, 4068, Australia
| | - Karen Thorpe
- Australian Centre of Excellence for Children and Families across the Life Course, The University of Queensland, 80 Meier's Rd, Long Pocket, QLD, 4068, Australia
- Queensland Brain Institute, The University of Queensland, 79 Upland Road, St Lucia, QLD, 4067, Australia
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Zhang D, Swindle T, Fletcher JW, Sigman-Grant M, Johnson SL. Remembered childhood mealtime experiences influence on early childcare and education staff. Appetite 2023; 190:107003. [PMID: 37595754 DOI: 10.1016/j.appet.2023.107003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/16/2023] [Accepted: 08/14/2023] [Indexed: 08/20/2023]
Abstract
Parent feeding styles, behaviors, beliefs, and practices are associated with developing children's eating behaviors. However, many children spend considerable time in childcare; thus, are exposed to child-feeding practices of other adults, e.g., early care and education (ECE) staff. Limited research exists on how and whether current classroom feeding practices of ECE staff associate with their own childhood experiences. The About Feeding Children survey, conducted in 2005, examined self-reported feeding practices and beliefs and personal characteristics of ECE staff in Western United States. An exploratory factor analysis of questions related to childhood experiences (N = 1189), revealed two Mealtime Factors: Remembered Adult Control and Remembered Child Autonomy Support. Structural equation modeling was conducted to examine the hypothesis that these remembered experiences would be associated with current feeding practices (Structural Mealtime Strategies, Verbal Mealtime Strategies, and Beliefs about Mealtimes). For each outcome, models had good to moderate fit. Across models, Remembered Autonomy Support was associated with less control, bribing, autonomy undermining, and concern-based control beliefs and greater support at meals and autonomy promoting beliefs in teachers' classroom feeding practices. More research is called for to consider whether reflection on remembered childhood experiences might be beneficial to consider during ECE staff training related to feeding young children.
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Affiliation(s)
- Dong Zhang
- Research and Evaluation Division, Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 521 Jack Stephens Drive #530, Little Rock, AR, 72205, USA.
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 521 Jack Stephens Drive #530, Little Rock, AR, 72205, USA.
| | - Janice Williams Fletcher
- Emerita, Child, Family, and Consumer Studies, University of Idaho, 1003 Colt Road, Moscow, ID, 83843Do, USA.
| | - Madeleine Sigman-Grant
- Maternal and Child Health Specialist, University of Nevada, Reno, 2558 S Elizabeth Street, #5, Salt Lake City, UT, 84106, USA.
| | - Susan L Johnson
- Section of Nutrition, Department of Pediatrics, CU Anschutz Medical Campus, Children's Eating Laboratory, 12631 E 17th Ave, Rm #2609, Aurora, CO, 80045, USA.
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Searle B, Staton S, Littlewood R, Thorpe K. Mealtimes in the context of poverty: Comparison of ECEC services providing food and those requiring food provided from home. Child Care Health Dev 2023; 49:995-1005. [PMID: 36843189 DOI: 10.1111/cch.13109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/10/2023] [Accepted: 02/17/2023] [Indexed: 02/28/2023]
Abstract
BACKGROUND In developed economies, most children attend Early Childhood Education and Care (ECEC) services before school entry, many from early life and across long days. For this reason, ECEC services present significant potential to provide food environments that positively influence eating behaviours and food preferences with attendant effect on life course trajectories of health and wellbeing. Yet there is evidence that feeding practices that limit optimal ongoing nutrition, such as pressure and restriction, are amplified in ECEC services serving disadvantaged communities. We sought to identify underlying explanatory mechanisms through observation of children's feeding experiences and educator explanations comparing, family-provided and service-provided meals. METHOD This study used qualitative analyses of educator interviews and observation records from 55 mealtimes in 10 ECEC services: 5 providing food and 5 requiring family food provision. RESULTS High levels of concern drove educator's controlling feeding practices at mealtimes but presented differently across meal provision modes. In centres that provided food, educators' concern focused on food variety, manifesting in pressure to 'try' foods. In centres requiring family-provided food, concern focused on nutrition quantity and quality and manifested as control of order of food consumption and pacing of intake to ensure food lasted across the day. Interview data suggested that conflict aversion limited optimal nutrition. In centres providing food, this was seen in menus that prioritized child food preferences. In centres requiring family meal provision, conflict aversion was seen as reticence to discuss lunchbox contents with families. CONCLUSION The findings direct attention to public health intervention. Currently, ECEC face significant barriers to realizing their potential to support child nutrition and establish positive life course trajectories of nutrition. To do so requires targeted supports that enable sufficient supply and quality of food in the context of poverty.
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Affiliation(s)
- Bonnie Searle
- Australian Centre of Excellence for Children and Families across the Life Course, Brisbane, Queensland, Australia
- Institute for Social Science Research, University of Queensland, Brisbane, Queensland, Australia
| | - Sally Staton
- Australian Centre of Excellence for Children and Families across the Life Course, Brisbane, Queensland, Australia
| | - Robyn Littlewood
- Health and Wellbeing Queensland, Brisbane, Queensland, Australia
| | - Karen Thorpe
- Australian Centre of Excellence for Children and Families across the Life Course, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
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Mixed-method assessment of caregiver feeding practices in early care and education centres during COVID-19. Public Health Nutr 2022; 26:12-22. [PMID: 36345562 PMCID: PMC9744446 DOI: 10.1017/s1368980022002452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The COVID-19 pandemic changed early care and education (ECE) mealtimes. Feeding practices that support children's emerging autonomy may support children's healthy eating, but it is unknown whether and how COVID-19 changed feeding practices. This paper describes caregiver feeding practices in ECE centres in Florida during COVID-19. DESIGN A mixed-methods design was used to understand mealtime feeding practices. Survey and interview questions were developed based on the Trust Model. More than 7000 surveys were sent to ECE centres. Analysis included descriptive statistics for survey data and thematic analysis for interview data. SETTING This statewide study included teachers in all licensed and license-exempt ECE centres. PARTICIPANTS Four hundred and thirty-one teachers completed a survey, and twenty-nine participated in follow-up interviews. RESULTS Surveys showed most teachers engaged in autonomy-supportive behaviours, such as letting children eat until they were finished (90 %). The most common controlling behaviour was praising children for cleaning their plates (70 %). The most common responses about changes to mealtimes were keeping physical distance and serving healthy food. Interview themes were Autonomy Support, Controlling Feeding Practices, Interactions are the Same, Interactions are Different, Physical Distancing and Healthy Eating. CONCLUSIONS Mealtimes are a central part of the day for young children and teachers in ECE environments. COVID-19 continues to influence ECE routines as behaviour change remains the primary method of reducing the risk of COVID-19 in the absence of a vaccine for young children. Understanding teachers' practices and perspectives is important for reducing the risk of COVID-19 and supporting children's autonomy and healthy eating.
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Farrer Mackie J, Marshall J, Alkon A, Gray H, Himmelgreen D, Kirby RS. Mealtime best practices and infection control in early care and education centres during COVID-19. Child Care Health Dev 2022; 48:990-1000. [PMID: 35102591 DOI: 10.1111/cch.12979] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Most young children in the United States attend early care and education (ECE) programmes, where they consume the majority of daily calories. Best practices to support children's healthy eating include teachers sitting together with children, eating the same food, and appropriately supporting children in serving and feeding themselves. To understand how the COVID-19 pandemic changed mealtime practices in ECE, this study (1) describes what adaptations ECE directors and teachers made to mealtimes to include best practices, and (2) identifies common adaptations made to comply with COVID-19 infection control guidelines. METHODS This cross-sectional, mixed-methods study utilized survey and interview questions based on the trust model and social cognitive theory. More than 7000 surveys were distributed to ECE directors and teachers in Florida. Surveys were completed by 759 directors and 431 teachers. Also, 29 follow-up interviews with teachers were completed. Participants were asked to describe their mealtimes before and during COVID-19. Descriptive statistics and frequencies were used to analyse survey data, and thematic analysis was applied to interview data. RESULTS Less than 5% of survey respondents reported children serving themselves, a pre-COVID best practice. Interviews identified three common adaptations: (1) modification-best practices were incorporated into new routines, such as eating together but sitting farther away, (2) elimination-routines changed so that best practices were no longer possible, such as teachers wearing masks and standing during meals, and (3) minimal change-minimal changes due to COVID-19 occurred and consequently mealtime practices did not change. CONCLUSIONS Current recommendations do not allow children to self-serve, which previously was a key best practice. ECE centres that have successfully integrated COVID-19 modifications and maintained mealtime best practices-perhaps in a new form-can serve as examples for others. These findings are generalizable to ECE centres in Florida and could be compared with other states.
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Affiliation(s)
- Joanna Farrer Mackie
- Health Sciences Research Institute, University of California, Merced, California, USA
| | - Jennifer Marshall
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Abbey Alkon
- School of Nursing, University of California San Francisco, San Francisco, California, USA
| | - Heewon Gray
- College of Public Health, University of South Florida, Tampa, Florida, USA
| | - David Himmelgreen
- Department of Anthropology, University of South Florida, Tampa, Florida, USA
| | - Russell S Kirby
- College of Public Health, University of South Florida, Tampa, Florida, USA
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Swindle T, Phelps J, Schrick B, Johnson SL. Hungry is not safe: A mixed methods study to explore food insecurity in early care and education. Appetite 2021; 167:105626. [PMID: 34389375 DOI: 10.1016/j.appet.2021.105626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 06/09/2021] [Accepted: 08/04/2021] [Indexed: 11/25/2022]
Abstract
The early care and education (ECE) environment has the potential to affect both children and their families. Food insecurity in ECE and its management may be an important influence. Objectives of this mixed methods study were to (1) elicit prominent themes relating to teacher experiences with food insecurity (in the classroom) through qualitative interviews; (2) translate interview themes into survey items and analyze survey data to explore generalizability of the qualitative findings; and (3) provide preliminary data on properties of a new tool to study the influence of food insecurity in the ECE setting. An exploratory sequential mixed methods design (QUAL → quant) was used. Twenty-eight interviews about teacher experiences with food insecurity were followed by 781 surveys to assess generalizability of interview findings. Qualitative themes highlighted that ECE teachers are concerned about children's food insecurity in their classroom; ECE teachers have developed their own set of strategies to manage their concern; and teachers often struggle with what to do. Quantitative results demonstrated many teachers had the same concerns and used the strategies described in the interviews. Further, in exploratory analyses, ECE teachers with Food Insecurity scored significantly higher on all scales (e.g., Food Insecurity Concerns, Struggle with Addressing Food Security) in both adjusted and unadjusted analyses. ECE teachers with Food Acquisition Stress had higher scores on Strategies to Address Food Insecurity with Families in adjusted analyses.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199, USA.
| | - Joshua Phelps
- Cooperative Extension, Division of Agriculture, University of Arkansas, 2301 S University Ave, Little Rock, AR, 72204, USA
| | - Britney Schrick
- Cooperative Extension, Division of Agriculture, University of Arkansas, 2301 S University Ave, Little Rock, AR, 72204, USA
| | - Susan L Johnson
- Department of Pediatrics, University of Colorado, 12631 East 17th Avenue, Mail Stop F-561 Academic Office Building, Aurora, CO, 80045, USA
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Abobakar L, Engler-Stringer R, Leis A, Vatanparast H. Evaluation of the impact of the Healthy Start/Départ Santé intervention on improving menu planning practices and improving the congruence between planned menus and actual food served in Saskatchewan childcare centres. Prev Med Rep 2021; 23:101403. [PMID: 34136337 PMCID: PMC8181209 DOI: 10.1016/j.pmedr.2021.101403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/04/2022] Open
Abstract
The majority of centres did not comply with the recommended nutrition guidelines. More than 50% of centres listed processed foods in amounts exceeding recommendations. The interventions may effectively improve the accuracy and reliability of menus.
The objective of this study was to evaluate the impact of the Healthy Start/Départ Santé (HS/DS) intervention program on improving menu planning practices and improving the congruence between planned menus and actual food served in licensed childcare centres in Saskatchewan. Overall, 39 licensed childcare centres in the province of Saskatchewan, Canada, were selected through a cluster randomized control trial to evaluate the impact of the HS/DS intervention. The pre and post intervention food menus of these centres were analyzed and compared to the Saskatchewan Childcare Nutrition Guidelines (SCNG). The food and beverages served at lunch were observed and digitally recorded using digital plate-waste measures. The congruence between the planned menus and the actual food served was assessed. Descriptive analyses and non-parametric tests were performed to determine the impact of the intervention. The results of this study indicated that there was no significant difference between the groups regarding the distribution and proportion of centres that adhered to the SCNG. The centres that received the intervention demonstrated significant improvements in adherence to their written menus, with the proportions of match between the items that served and listed (p-value = 0.029), and additional items served (p-value = 0.014). Within each group, intervention and usual practice, there were significant differences in centres that met the foods to limit guideline among the usual practice centres (p-value = 0.035). Findings from this study indicated that the HS/DS intervention had a positive impact on improving the adherence of the participating centres to the centres’ planned menus. HS/DS trial registration number: NCT02375490.
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Affiliation(s)
- Lila Abobakar
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Rachel Engler-Stringer
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Anne Leis
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada
- Corresponding author at: College of Pharmacy and Nutrition and School of Public Health, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada.
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Yoong SL, Jones J, Pearson N, Swindle T, Barnes C, Delaney T, Lum M, Golley R, Matwiejczyk L, Kelly B, Kerr E, Love P, Esdaile E, Ward D, Grady A. An Overview of Research Opportunities to Increase the Impact of Nutrition Intervention Research in Early Childhood and Education Care Settings According to the RE-AIM Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2745. [PMID: 33800463 PMCID: PMC7967470 DOI: 10.3390/ijerph18052745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/18/2021] [Accepted: 02/24/2021] [Indexed: 12/26/2022]
Abstract
Objective: To highlight opportunities for future nutrition intervention research within early childhood and education care (ECEC) settings, with a focus on generating evidence that has applicability to real-world policy and practice. Methods: An overview of opportunities to progress the field was developed by the authors using a collaborative writing approach and informed by recent research in the field. The group developed a list of recommendations aligned with the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework. Pairs of authors drafted individual sections of the manuscript, which were then reviewed by a separate pair. The first and senior author consolidated all sections of the manuscript and sought critical input on the draft iterations of the manuscript. Results: Interventions that employ digital platforms (reach) in ECEC settings, as well as research in the family day care setting (effectiveness) were identified as areas of opportunities. Research understanding the determinants of and effective strategies for dissemination (adoption), the implementation of nutrition programs, in addition to de-implementation (implementation) of inappropriate nutrition practices, is warranted. For maintenance, there is a need to better understand sustainability and the sustainment of interventions, in addition to undertaking policy-relevant research. Conclusions: The ECEC setting is prime for innovative and practical nutrition intervention research.
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Affiliation(s)
- Sze Lin Yoong
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- School of Health Science, Swinburne University of Technology, Melbourne, VIC 3122, Australia
| | - Jannah Jones
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Nicole Pearson
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | - Courtney Barnes
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Tessa Delaney
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Melanie Lum
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Rebecca Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia; (R.G.); (L.M.)
| | - Louisa Matwiejczyk
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia; (R.G.); (L.M.)
| | - Bridget Kelly
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia; (B.K.); (E.K.)
| | - Erin Kerr
- Early Start, School of Health and Society, University of Wollongong, Wollongong, NSW 2522, Australia; (B.K.); (E.K.)
| | - Penelope Love
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3217, Australia;
| | - Emma Esdaile
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW 2006, Australia;
| | - Dianne Ward
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, CA 27516, USA;
- Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, CA 27514, USA
| | - Alice Grady
- Hunter New England Population Health, Wallsend, NSW 2287, Australia; (J.J.); (N.P.); (C.B.); (T.D.); (M.L.); (A.G.)
- Priority Research Centre for Health Behaviour, The University of Newcastle, Callaghan, NSW 2308, Australia
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Swindle T, Rutledge J. Measuring feeding practices among early care and education teachers and examining relations with food insecurity. Appetite 2020; 155:104806. [PMID: 32735955 DOI: 10.1016/j.appet.2020.104806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 10/23/2022]
Abstract
Early care and education teachers' (ECETs) dietary and feeding behaviors have the potential to influence children's health outcomes. This study sought to: (1) gather data on the properties and performance of the CFQ and CFSQ in an ECET sample and compare properties to published parent samples and (2) examine relations between FI experiences by ECETs and reported feeding practices, and (3) examine relations between FI experiences by ECETs and reported feeding practices. ECETs completed 506 cross-sectional surveys. Mean patterns, ranges, and internal consistency values on the adapted instruments for ECETs were consistent with those published for parents. Significant mean differences between parents and ECETs on established scales using one-sample t-tests were prevalent with medium to large effect sizes despite small, relative differences. The majority of ECETs were authoritarian (35.6%), followed by indulgent (29.2%), authoritative (17.9%), and uninvolved (17.3%). T-tests indicated that ECETs who were currently food insecure were significantly higher than teachers who were currently food secure on scales of perceived responsibility, concern about child weight, restriction, pressure to eat, monitoring, demandingness, and responsiveness (all p < .001). Chi-square tests found that food insecurity was not independent from ECET feeding style, with a greater occurrence of authoritarian and less of indulgent feeding styles for ECETs who were food insecure. Overall, analyses support that two popular measures of feeding practices function similarly in ECETs as they do in parents. Additionally, results demonstrate associations between food insecurity and ECETs' feeding practices.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR, 72205-7199; USA.
| | - Julie Rutledge
- School of Human Ecology; Louisiana Tech University, P.O. Box 3167, Ruston, LA, 71272, USA
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Swindle T, Rutledge JM, Johnson SL, Selig JP, Curran GM. De-implementation of detrimental feeding practices: a pilot protocol. Pilot Feasibility Stud 2020; 6:181. [PMID: 33292711 PMCID: PMC7678218 DOI: 10.1186/s40814-020-00720-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early childhood educators (ECEs) often use detrimental feeding practices and are slow to implement positive feeding practices. Nevertheless, few studies have aimed to understand and change ECEs' feeding practices. This gap needs to be addressed because implementation (i.e., adding new, evidence-based practices) and de-implementation (i.e., stopping low-value or harmful practices) are distinct processes that require unique strategies. METHODS We will develop a de-implementation strategy for detrimental feeding practices using evidence-based quality improvement (EBQI) sessions to engage stakeholders and draw on the Niven process model for de-implementation. Then, we will investigate the effects of the de-implementation strategy in a proof-of-principle study. The de-implementation strategy will be evaluated in 2 partnering childcare agencies using a pre-post, within-site design. For our primary outcome, we will interview educators throughout the school year to assess the feasibility and acceptability of the intervention and survey them with standard measures for assessing feasibility and acceptability. For secondary outcomes, we will investigate its effects on the use of detrimental and evidence-based feeding practices by teachers and impacts on child BMI and diet. DISCUSSION The current study will establish the feasibility and acceptability of our de-implementation approach and will provide preliminary data toward 3 predicted secondary outcomes: (1) decreased detrimental feeding practices by ECEs, (2) increased adoption of and fidelity to nutrition promotion practices, and (3) improved child dietary outcomes. These results are expected to contribute to the uptake and sustainability of mealtime interventions to improve the diets of young children. Results will also apply to the field of implementation science by informing processes for developing de-implementation approaches in a community setting.
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Affiliation(s)
- Taren Swindle
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, 4301 W. Markham St, #530, Little Rock, AR 72205-7199 USA
| | - Julie M. Rutledge
- College of Applied and Natural Sciences, Louisiana Tech University, Ruston, USA
| | - Susan L. Johnson
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, USA
| | - James P. Selig
- College of Public Health, Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Geoff M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Central Arkansas Veterans Healthcare System, Little Rock, USA
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Love P, Walsh M, Campbell KJ. Knowledge, Attitudes and Practices of Australian Trainee Childcare Educators Regarding Their Role in the Feeding Behaviours of Young Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103712. [PMID: 32466111 PMCID: PMC7277710 DOI: 10.3390/ijerph17103712] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/19/2020] [Accepted: 05/22/2020] [Indexed: 02/08/2023]
Abstract
Background: Early childhood (2-5 years) is acknowledged as a critical time for the establishment of healthy behaviours. The increasing number of children and amount of time spent in childcare provides strong rationale to explore the important role that childcare services and childcare educators play in influencing healthy eating behaviours of young children in their care. Methods: This study used a qualitative exploratory approach to describe the knowledge, attitudes and practices of Australian childcare trainee educators' regarding their role in the feeding of young children. Results: All participants agreed that feeding of young children was an important part of their role, but described challenges to the promotion of healthy eating and the adoption of responsive child feeding practices. These included personal beliefs and experiences with food, the bi-directional nature of child feeding, conflicting parental requests and/or unsupportive centre-based policies and procedures. Conclusion: Training about responsive child feeding practices within the childcare sector should include all childcare staff; aim to enhance relational efficacy and communication skills with parents; and empower childcare staff to lead organisational change. To support this, childcare centres need to provide coherent centre-based healthy eating policies inclusive of healthy food provision and desirable feeding practices.
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Affiliation(s)
- Penelope Love
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3216, Australia;
- Centre of Research Excellence, Early Prevention of Obesity in Childhood (EPOCH), Sydney 2007, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia;
- Correspondence:
| | - Melissa Walsh
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia;
| | - Karen J. Campbell
- Institute for Physical Activity and Nutrition, Deakin University, Geelong 3216, Australia;
- Centre of Research Excellence, Early Prevention of Obesity in Childhood (EPOCH), Sydney 2007, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia;
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