Summary of findings for the main comparison.

Strategies to improve the implementation of healthy eating, physical activity and obesity prevention policies, practices or programmes within childcare services
Patient or population: children up to the age of 6 years Settings: centre‐based childcare services that cater for children prior to compulsory schooling Intervention: any strategy (including educational materials, educational meetings, audit and feedback, opinion leaders, small incentives or grants, educational outreach visits or academic detailing) with the primary intent of improving the implementation (by usual service staff) of policies, practices or programmes in centre‐based childcare services to promote healthy eating, physical activity or prevent unhealthy weight gain Comparison: no intervention (8 studies) or alternate intervention (2 studies)
Outcomes	Impact	No of participants (studies)	Quality of the evidence (GRADE)
Implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention	We are uncertain whether strategies improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention	1053 participants (childcare services), 10 studies	⊕⊝⊝⊝ very lowa
Childcare service staff knowledge, skills or attitudes related to the implementation of policies, practices or programmes that promote child healthy eating, physical activity	We are uncertain whether strategies to improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention improve childcare service staff knowledge, skills or attitudes	457 participants (childcare service staff), 2 studies	⊕⊝⊝⊝ very lowa
Cost or cost‐effectiveness of strategies to improve the implementation of policies, practices or programmes in childcare services	No studies were found that looked at the cost or cost‐effectiveness of strategies to improve the implementation of policies, practices or programmes in childcare services	Nil	N/A
Adverse consequences of strategies to improve the implementation of policies, practices or programmes in childcare services	We are uncertain whether strategies to improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention impact on adverse consequences	20 participants (childcare services), 1 study	⊕⊝⊝⊝ very lowb
Measures of child diet, physical activity or weight status	We are uncertain whether strategies to improve the implementation of policies, practices or programmes that promote child healthy eating, physical activity and/or obesity prevention improve child diet, physical activity or weight status	2829 participants (children), 3 studies	⊕⊝⊝⊝ very lowa
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

^aTriple downgraded due to limitations in the design, imprecision of evidence and unexplained heterogeneity. ^bTriple downgraded due to indirectness, inconsistency and imprecision of evidence.