Hunter New England Population Health, Wallsend, NSW, 2287, Australia.
School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.
Implement Sci. 2019 Feb 18;14(1):17. doi: 10.1186/s13012-019-0865-7.
While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation of healthy eating and physical activity-promoting policies and practices in childcare services.
The study was conducted with childcare services in the Hunter New England region of New South Wales, Australia. Eligible services were randomised to a wait-list control group or to receive the implementation strategy. The strategy targeted the implementation of written nutrition, physical activity, and small screen recreation policies; providing information to families regarding healthy eating, physical activity, and small screen time; providing twice weekly healthy eating learning experiences to children; providing water and plain milk only to children; providing fundamental movement skills activities for children every day; and limiting the use of electronic screen time for educational purposes and learning experiences. Intervention services received a performance review and facilitated feedback process five times over the 10 months that included an assessment of current practices, goal setting, identification of barriers to implementation, problem-solving, and resource provision. The primary outcome was the proportion of services implementing all six policies and practices, assessed by nominated supervisor completion of a computer-assisted telephone interview at baseline and 12-month follow-up.
One hundred and eight services took part. There were no significant differences in the proportion of services implementing all six practices at 12 months (mean difference 0.51; 95% CI 0.16 to 1.58; p = 0.24). There were also no differences between groups in the mean number of policies and practices implemented (mean difference 0.1; 95% CI - 0.4 to 0.6; p = 0.71), or the proportion implementing each of the six individual policies and practices at 12 months (OR range 0.57 to 1.85; p > 0.05).
Further support may be required to assist childcare services to make recommended changes to their policies and practices.
The trial was registered retrospectively on 10 September 2014 with the Australian New Zealand Clinical Trials Registry ACTRN12614000972628 .
虽然建议儿童保育服务机构制定政策和实践，以支持肥胖预防，但为了制定政策和实践，仍然需要有限的证据。本研究的目的是检验绩效审查和促进反馈在增加儿童保育服务机构实施健康饮食和促进身体活动政策和实践方面的效果。
本研究在澳大利亚新南威尔士州亨特新英格兰地区的儿童保育服务机构进行。符合条件的服务机构被随机分配到等待名单对照组或接受实施策略组。该策略针对书面营养、身体活动和小屏幕娱乐政策的实施；向家庭提供关于健康饮食、身体活动和小屏幕时间的信息；每周为儿童提供两次健康饮食学习体验；仅向儿童提供水和纯牛奶；每天为儿童提供基本运动技能活动；并限制电子屏幕时间用于教育目的和学习体验。干预服务机构在 10 个月内接受了五次绩效审查和促进反馈过程，其中包括对当前实践进行评估、设定目标、确定实施障碍、解决问题和提供资源。主要结果是通过指定主管人员在基线和 12 个月随访时完成计算机辅助电话访谈，评估服务机构实施所有六项政策和实践的比例。
共有 108 家服务机构参与。在 12 个月时，实施所有六项实践的服务机构比例没有显著差异（平均差异 0.51；95%CI 0.16 至 1.58；p=0.24）。两组在实施政策和实践的平均数量（平均差异 0.1；95%CI -0.4 至 0.6；p=0.71）或在 12 个月时实施六项单独政策和实践的比例（OR 范围 0.57 至 1.85；p>0.05）方面也没有差异。
可能需要进一步的支持，以帮助儿童保育服务机构对其政策和实践进行建议的更改。
该试验于 2014 年 9 月 10 日在澳大利亚新西兰临床试验注册中心进行了回顾性注册，注册号为 ACTRN12614000972628。
