Dodds Pennie, Wyse Rebecca, Jones Jannah, Wolfenden Luke, Lecathelinais Christophe, Williams Amanda, Yoong Sze Lin, Finch Meghan, Nathan Nicole, Gillham Karen, Wiggers John
Faculty of Health, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2300, Australia.
BMC Public Health. 2014 Jun 9;14:572. doi: 10.1186/1471-2458-14-572.
Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Few rigorously validated measures exist to measure healthy eating and physical activity policies and practices in this setting, and no such measures exist that are specific to the childcare setting in Australia.
This was a cross sectional study, comparing two measures (pen and paper survey and observation) of healthy eating and physical activity policies and practices in childcare services. Research assistants attended consenting childcare services (n = 42) across the Hunter region of New South Wales, Australia and observed practices for one day. Nominated Supervisors and Room Leaders of the service also completed a pen and paper survey during the day of observation. Kappa statistics and proportion agreement were calculated for a total of 43 items relating to healthy eating and physical activity policies and practices.
Agreement ranged from 38%-100%. Fifty one percent of items showed agreement of greater than or equal to 80%. Items assessing the frequency with which staff joined in active play with children reported the lowest percent agreement, while items assessing availability of beverages such as juice, milk and cordial, as well as the provision of foods such as popcorn, pretzels and sweet biscuits, reported the highest percent agreement. Kappa scores ranged from -0.06 (poor agreement) to 1 (perfect agreement). Of the 43 items assessed, 27 were found to have moderate or greater agreement.
The study found that Nominated Supervisors and Room Leaders were able to accurately report on a number of healthy eating and physical activity policies and practices. Items assessing healthy eating practices tended to have higher kappa scores than those assessing physical activity related policies or practices. The tool represents a useful instrument for public health researchers and policy makers working in this setting.
儿童保育服务是预防肥胖的重要契机，在儿童成长的关键阶段覆盖了很大一部分儿童。在这种环境下，用于衡量健康饮食和体育活动政策及实践的经过严格验证的措施很少，而且在澳大利亚没有专门针对儿童保育环境的此类措施。
这是一项横断面研究，比较了儿童保育服务中健康饮食和体育活动政策及实践的两种测量方法（纸笔调查和观察）。研究助理走访了澳大利亚新南威尔士州猎人地区同意参与研究的儿童保育服务机构（n = 42），并进行了一天的观察。服务机构指定的主管和班级负责人也在观察当天完成了一份纸笔调查。对与健康饮食和体育活动政策及实践相关的总共43项内容计算了卡帕统计量和一致性比例。
一致性范围为38% - 100%。51%的项目显示一致性大于或等于80%。评估工作人员与儿童一起积极玩耍频率的项目一致性百分比最低，而评估果汁、牛奶和甜酒等饮料供应情况以及爆米花、椒盐脆饼和甜饼干等食品供应情况时，一致性百分比最高。卡帕分数范围从 -0.06（一致性差）到1（完全一致）。在评估的43项内容中，有27项显示出中等或更高的一致性。
该研究发现，指定主管和班级负责人能够准确报告许多健康饮食和体育活动政策及实践情况。评估健康饮食实践的项目卡帕分数往往高于评估与体育活动相关政策或实践的项目。该工具对于在此环境下工作的公共卫生研究人员和政策制定者来说是一种有用的工具。
