Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia.
Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health & Biosecurity, North Ryde, New South Wales, Australia.
BMJ Open. 2021 Dec 2;11(12):e047618. doi: 10.1136/bmjopen-2020-047618.
INTRODUCTION: Globally, children do not eat enough core foods, with vegetable intakes persistently low. Early life is critical for establishing vegetable acceptance and intake. Increased usage of formal childcare has led to the importance of childcare settings shaping children's food intake. This study will use the multiphase optimisation strategy to develop, optimise and evaluate the effectiveness of a multicomponent initiative package to increase 2-to-5-year-old children's vegetable intake in long day care centres. METHODS AND ANALYSIS: The preparation phase will use existing literature and best practice guidelines to develop three initiatives aiming to: (1) increase vegetable provision at mealtimes, (2) deliver a vegetable-focused sensory curriculum and (3) use supportive mealtime practices encouraging children's tasting of vegetables. The optimisation phase (N=32 centres) will use a 12-week, eight-condition factorial experiment to test main and synergistic effects of the initiatives. The optimum combination of initiatives producing the largest increase in vegetable intake will be identified. The evaluation phase (N=20 centres) will test the effectiveness of the optimised package using a 12-week waitlist randomised controlled trial. Primary outcomes are children's vegetable intake and food group intake at long day care. Secondary outcomes are menu guideline compliance, cook and educator knowledge and skills, and reach. Process evaluation will include fidelity, acceptability, barriers and facilitators, and compatibility with practice. Repeated measures ANOVA with interaction effects (optimisation phase) and linear mixed modelling (evaluation phase) will test effects of the initiatives on vegetable intake. ETHICS AND DISSEMINATION: This study has received ethics approval from the Flinders University Research Ethics Committee (Project No: 1873) for the optimisation phase. Approval for the evaluation phase will be obtained following completion of optimisation phase. Findings will be disseminated to stakeholders, including long day care centres and childcare organisations; and to researchers via peer-reviewed journals and conferences. TRIAL REGISTRATION NUMBERS: ACTRN12620001301954, ACTRN12620001323910p.
简介：在全球范围内，儿童的核心食物摄入量不足，蔬菜摄入量持续偏低。生命早期对于建立对蔬菜的接受度和摄入量至关重要。正规儿童保育的使用增加导致了儿童饮食的重要性，这是由儿童保育机构塑造的。本研究将使用多阶段最优化策略，开发、优化和评估一项多成分干预计划包，以增加 2 至 5 岁儿童在长期日托中心的蔬菜摄入量。 方法和分析：准备阶段将利用现有文献和最佳实践指南，制定三项旨在：（1）增加用餐时蔬菜的供应，（2）提供以蔬菜为重点的感官课程，（3）使用支持性的用餐实践鼓励儿童品尝蔬菜的举措。优化阶段（N=32 个中心）将使用为期 12 周的八项条件析因实验，测试各项举措的主要和协同效应。将确定能使蔬菜摄入量最大增加的最佳举措组合。评估阶段（N=20 个中心）将使用为期 12 周的等待名单随机对照试验测试优化方案的有效性。主要结果是儿童在长期日托中心的蔬菜摄入量和食物组摄入量。次要结果是菜单指南遵守情况、厨师和教育者的知识和技能以及覆盖范围。过程评估将包括保真度、可接受性、障碍和促进因素以及与实践的兼容性。优化阶段采用具有交互效应的重复测量方差分析（ANOVA）和线性混合模型（评估阶段）测试各项举措对蔬菜摄入量的影响。 伦理和传播：本研究已获得弗林德斯大学研究伦理委员会（项目编号：1873）的优化阶段伦理批准。完成优化阶段后，将获得评估阶段的批准。研究结果将分发给利益相关者，包括长期日托中心和儿童保育组织；并通过同行评议期刊和会议分发给研究人员。 试验注册号：ACTRN12620001301954，ACTRN12620001323910p。
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