Green Amanda M, Mihrshahi Seema, Innes-Hughes Christine, O'Hara Blythe J, McGill Bronwyn, Rissel Chris
NSW Office of Preventive Health, Liverpool, NSW, Australia.
Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Front Public Health. 2020 Feb 21;8:34. doi: 10.3389/fpubh.2020.00034. eCollection 2020.
Childhood obesity is an important public health issue. Approximately 20% of 2-4 year olds are overweight or obese, meaning 1 in 5 Australian children start school above a healthy weight. In the state of New South Wales (NSW) the combined prevalence of childhood overweight and obesity is significantly higher among children from low socioeconomic status backgrounds and children from regional, rural and remote areas. This paper describes implementation of a healthy eating and active play program () for center-based early childhood education and care (ECEC) services aimed at influencing healthy behaviors in young children in NSW, Australia. It shows changes over time including a focus on disadvantaged, Aboriginal and remote communities. It also discusses the challenges and future opportunities for the program. Routine data in relation to service delivery (reach) and implementation indicators are collected by Local Health District staff. Fifteen implementation indicators (known as practices) were introduced to monitor the implementation of (six related to promoting and encouraging healthy eating, four related to improving physical activity, two related to small screen recreation; and three related to quality of service delivery). As of 30 June 2017, 88.4% of ECEC services have staff trained in . Of the 15 practices related to promoting and encouraging healthy eating, increasing physical activity and improving the quality of service delivery 13 practices saw significant improvements between 2012 and 2017. This was consistent for services with a high proportion of Aboriginal children and for services in disadvantaged and remote communities. There has been a statistically significant increase in the proportion (37.6-81.0%, < 0.0001) and type of ECEC services (preschools 36.1-81.3%, < 0.0001, long day care 38.6-81.0%, < 0.0001, and occasional care 34.0-74.6%, < 0.0001) that have implemented the program since 2012 as well as in services with a high proportion of Aboriginal children (33.6-85.2% < 0.0001), services in disadvantaged communities (37.4-83.3% < 0.001), and services in remote communities (27.8-59.4% < 0.0139). This paper demonstrates that has seen large improvements in the delivery of training, practice achievements and program adoption in ECEC services across NSW including services in disadvantaged and remote communities and that have a higher proportion of Aboriginal children.
儿童肥胖是一个重要的公共卫生问题。大约20%的2至4岁儿童超重或肥胖，这意味着五分之一的澳大利亚儿童入学时体重就超过了健康水平。在新南威尔士州（NSW），社会经济地位较低背景的儿童以及来自地区、农村和偏远地区的儿童中，儿童超重和肥胖的综合患病率显著更高。本文描述了一项针对基于中心的幼儿教育与保育（ECEC）服务的健康饮食与积极玩耍项目（）的实施情况，该项目旨在影响澳大利亚新南威尔士州幼儿的健康行为。它展示了随着时间的变化，包括对弱势、原住民和偏远社区的关注。它还讨论了该项目面临的挑战和未来机遇。地方卫生区工作人员收集与服务提供（覆盖范围）和实施指标相关的常规数据。引入了15项实施指标（称为实践）来监测（）的实施情况（六项与促进和鼓励健康饮食相关，四项与增加身体活动相关，两项与小屏幕娱乐相关；三项与服务提供质量相关）。截至2017年6月30日，88.4%的ECEC服务机构有接受过（）培训的工作人员。在与促进和鼓励健康饮食、增加身体活动以及提高服务提供质量相关的15项实践中，有13项实践在2012年至2017年间有显著改善。这在原住民儿童比例较高的服务机构以及弱势和偏远社区的服务机构中都是一致的。自2012年以来实施该项目的ECEC服务机构的比例（37.6 - 81.0%，<0.0001）和类型（幼儿园36.1 - 81.3%，<0.0001，长期日托38.6 - 81.0%，<0.0001，临时保育34.0 - 74.6%，<0.0001）以及原住民儿童比例较高的服务机构（33.6 - 85.2% <0.0001）、弱势社区的服务机构（37.4 - 83.3% <0.001）和偏远社区的服务机构（27.8 - 59.4% <0.0139）都有统计学上的显著增加。本文表明，（）在新南威尔士州的ECEC服务机构，包括弱势和偏远社区以及原住民儿童比例较高的服务机构的培训提供、实践成果和项目采用方面都有了很大改进。
