Factors associated with early childhood education and care service implementation of healthy eating and physical activity policies and practices in Australia: a cross-sectional study

Abstract

Many early childhood education and care (ECEC) services fail to implement recommended policies and practices supportive of healthy eating and physical activity. The purpose of this study was to assess whether certain theoretically-based factors are associated with implementation of healthy eating and physical activity policies and practices in a sample of ECEC services. A crosssectional survey was conducted with Service Managers of ECEC services. The survey assessed the operational characteristics, policy, and practice implementation, and 13 factors were suggested by Damschroder's Consolidated Framework for Implementation Research to impede or promote implementation. Logistic regression analyses found a significant association between implementation factor score and full implementation (OR 1.38; 95% CI 1.18-1.61; p=<0.01), indicating that for every one point increase in implementation score, ECEC services were 38 % more likely to be fully implementing the policies and practices. The findings highlight the opportunities for improving implementation of obesity prevention interventions in this setting by developing interventions that address such factors.

Effectiveness of an intervention to facilitate the implementation of healthy eating and physical activity policies and practices in childcare services: a randomised controlled trial

“…Given the high acceptability of the intervention strategies, prospective interventions may consider utilising strategies that best address the reported barriers to policy and practice implementation. For example, the addition of intervention strategies to garner the support for healthy eating and physical activity policies and practices by parents and carers may improve the effectiveness of future interventions, given their influence on service operation and activities [ 67 ]. Finally, the intervention did improve some policies and practices, including the implementation of adult-guided activities to develop fundamental movement skills in children.…”

Improving the impact of obesity prevention interventions in the childcare setting: The need for a systematic application of implementation science

“…Importantly tools have also been developed to assist researchers and practitioners using the framework to select the most appropriate strategies to address these . While such frameworks have typically been used to assess factors that may impede recommended professional practice in clinical settings, their application in childcare settings is increasing . Systematic review protocols, recently registered with PROSPERO, also suggest that an up‐to‐date systematic synthesis of barriers and facilitators of fruit and vegetable consumption in pre‐school‐aged children, together with factors that influence the implementation of dietary guidelines in childcare serviceswill soon be available.…”

Time to focus on implementation: the need to re‐orient research on physical activity in childcare services

“…One impediment to the implementation of physical activity interventions may be the lack of research to inform the development of evidence‐based implementation strategies. Research describing strategies to enhance implementation represent less than 5% of all physical activity intervention research, 9 and few studies have sought to identify the range of potential barriers to the implementation of physical activity policies and practices in settings such as childcare that would be hypothesised by comprehensive theoretical frameworks 10,11 . A recent update of an Agency for Healthcare Research and Quality systematic review found that policy makers and practitioners are largely bereft of an evidence base to guide the development of population‐wide implementation interventions in community settings more generally, and in childcare settings specifically 12 …”