Bell A Colin, Davies Lynda, Finch Meghan, Wolfenden Luke, Francis J Lynn, Sutherland Rachel, Wiggers John
1School of Medicine and Public Health,University of Newcastle,University Drive,Callaghan,NSW 2308,Australia.
2Hunter New England Population Health,Wallsend,New South Wales,Australia.
Public Health Nutr. 2015 Jun;18(9):1610-9. doi: 10.1017/S1368980013003364. Epub 2014 Jan 9.
To determine the impact of an implementation intervention designed to introduce policies and practices supportive of healthy eating in centre-based child-care services. Intervention strategies included staff training, resources, incentives, follow-up support, and performance monitoring and feedback.
A quasi-experimental design was used to assess change over 20 months in healthy eating policy and practice in intervention and comparison child-care services.
The Hunter New England (HNE) region of New South Wales (NSW), Australia.
All centre-based child-care services (n 287) in the intervention region (HNE) were invited and 240 (91% response rate) participated. Two hundred and ninety-six services in the rest of NSW were randomly selected as a comparison region and 191 participated (76% response rate). A sub-analysis was conducted on those services that provided children food (n 196 at baseline and n 190 at follow-up). Ninety-six provided menus for analysis at baseline (HNE, n 36; NSW, n 50) and 102 provided menus at follow-up (HNE, n 50; NSW, n 52).
Services in the intervention region were significantly more likely to provide only plain milk and water for children (P = 0.018) and to engage parents in nutrition policy or programmes (P = 0.002). They were also more likely (P = 0.056) to have nutrition policy on home packed food. In addition, menus of services that provided lunch were significantly more likely to comply with healthy eating guidelines for sweetened drinks (P < 0.001), fruit (P < 0.001) and vegetables (P = 0.01).
An implementation intervention was able to modify policy and practice in a large number of child-care services so that they were more supportive of healthy eating.
确定一项实施干预措施的影响，该措施旨在引入支持中心式儿童保育服务中健康饮食的政策和做法。干预策略包括员工培训、资源、激励措施、后续支持以及绩效监测和反馈。
采用准实验设计来评估干预组和对照组儿童保育服务机构在20个月内健康饮食政策和做法的变化。
澳大利亚新南威尔士州（NSW）的亨特新英格兰（HNE）地区。
干预地区（HNE）的所有中心式儿童保育服务机构（n = 287）均被邀请，240家机构（回复率91%）参与。新南威尔士州其他地区的296家服务机构被随机选为对照组，191家机构参与（回复率76%）。对那些为儿童提供食物的服务机构进行了亚组分析（基线时n = 196，随访时n = 190）。96家机构在基线时提供菜单用于分析（HNE地区，n = 36；新南威尔士州，n = 50），102家机构在随访时提供菜单（HNE地区，n = 50；新南威尔士州，n = 52）。
干预地区的服务机构更有可能只为儿童提供纯牛奶和水（P = 0.018），并让家长参与营养政策或项目（P = 0.002）。它们也更有可能（P = 0.056）制定关于家庭自带食物的营养政策。此外，提供午餐的服务机构的菜单更有可能符合关于含糖饮料（P < 0.001）、水果（P < 0.001）和蔬菜（P = 0.01）的健康饮食指南。
一项实施干预措施能够改变大量儿童保育服务机构的政策和做法，使其更支持健康饮食。
