Development of an initiatives package to increase children's vegetable intake in long day care centres using the Multiphase Optimisation Strategy (MOST) randomised factorial experiment

Lucinda K. Bell, Samantha Morgillo, Dorota Zarnowiecki, Claire Gardner, Shalem Leemaqz, Jennifer Arguelles, Astrid A.M. Poelman, Maeva O. Cochet-Broch, David N. Cox, Rebecca K. Golley

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Abstract

Objective: To inform a package of initiatives to increase children's vegetable intake while in long day care (LDC) by evaluating the independent and combined effects of three initiatives targeting food provision, the mealtime environment, and the curriculum. 

Design: Using the Multiphase Optimisation Strategy (MOST) framework, a 12-week, eight-condition (n=7 intervention, n=1 control) randomised factorial experiment was conducted. Children's dietary intake data was measured pre- and post-initiative implementation using the weighed plate waste method (1x meal and 2x between-meal snacks). Vegetable intake (grams/day) was calculated from vegetable provision and waste. The optimal combination of initiatives was determined using a linear mixed-effects model comparing between-group vegetable intake at follow up, while considering initiative fidelity and acceptability. 

Setting: LDC centres in metropolitan Adelaide, South Australia 

Participants: 32 centres, 276 staff, and 1039 children aged 2-5 years 

Results: There were no statistically significant differences between any of the intervention groups and the control group for vegetable intake (all p>0.05). The Curriculum with Mealtime environment group consumed 26.7g more vegetables/child/day than control [GMR (95% CI), 3.29 (0.96, 11.27), p=0.06]. Completion rates for the curriculum (>93%) and mealtime environment (61%) initiatives were high, and acceptability was good (4/5 would recommend), compared to the Food provision initiative (0-50% completed the menu assessment, 3/5 would recommend). 

Conclusion: A program targeting the curriculum and mealtime environment in LDC may be useful to increase children's vegetable intake. Determining the effectiveness of this optimised package in a randomised controlled trial is required, as per the evaluation phase of the MOST framework.

Original languageEnglish
Pages (from-to)3062-3075
Number of pages14
JournalPublic Health Nutrition
Volume26
Issue number12
Early online date25 Aug 2023
DOIs
Publication statusPublished - Dec 2023

Keywords

  • children
  • complex interventions
  • long day care
  • Multiphase Optimization Strategy
  • vegetable intake
  • Long day care
  • Multiphase Optimisation Strategy
  • Complex interventions
  • Vegetable intake
  • Children

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