Yoong 2016.
Methods |
Study design: parallel‐group RCT Intervention duration: 6 – 8 weeks Length of follow‐up from baseline: no baseline data collection Differences in baseline characteristics: reported Unit of allocation: Childcare service Unit of analysis: Childcare service |
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Participants |
Service type: Long daycare services Region: NSW, Australia Demographic/socioeconomic characteristics: Not stated Inclusion/exclusion criteria: Long daycare services (centre‐based services typically open ≥ 8 hours/day) located within NSW, Australia, served as the sampling frame. Services were excluded if they did not undertake menu planning on site or where cooks did not understand English sufficiently to complete the survey. Number of services randomised: 77 services Numbers by trial group: n (controls baseline) = n/a n (controls follow‐up) = 39 n (interventions baseline) = n/a n (interventions follow‐up) = 38 Recruitment: Service: 220 services were invited to participate; of these 106 were ineligible to participate, 34 declined to participate and a further 14 could not be contacted. Seventy‐seven consented to participate and were randomly allocated to either the intervention or control condition by a blinded research assistant using a random number function in Microsoft Excel in a 1:1 ratio. Recruitment rate: 68% |
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Interventions |
Number of experimental conditions: 2 (intervention, control) Policies, practices or programmes targeted by the intervention: ‐ Provision of fruit and vegetables on service menu Implementation strategies: Educational materials: Intervention cooks were mailed a two‐page education resource and the menu planning checklist from the Caring for Children resource. Who delivered the intervention: Printed resources were developed by a local health promotion team consisting of dietitians, behavioural scientists and health promotion practitioners. Theoretical underpinning: The content of the material was guided by the theory of planned behaviour (TPB). Description of control: The control group received usual care. All services could access the Caring for Children resource online and may have been offered support from their local health promotion staff. |
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Outcomes |
Outcome relating to the implementation of childcare service policies, practices or programmes: Provision of fruit and vegetables: Data collection method: A one‐item question was used to assess the provision of fruit and vegetables on menus. Validity of measures used: This measure was not validated and is likely to result in an overestimation of effect. Outcome relating to cost: not applicable Outcome relating to adverse consequences: not applicable Outcome relating to child diet, physical activity or weight status: not applicable Outcome relating to implementation strategy acceptability, adoption, penetration, sustainability and appropriateness: Penetration: Data collection method: A telephone interview where participants were asked whether they recalled receiving the educational material and, if so, how long ago they received it Validity of measures used: not reported |
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Notes | The authors acknowledge the funding support of Hunter New England Population Health and Hunter Medical Research Institute. | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Low risk | A random number function in Microsoft Excel was used to generate the random sequence. |
Allocation concealment (selection bias) | Low risk | Microsoft Excel was used to generate a list of random numbers and could forsee assignment. |
Blinding of participants and personnel (performance bias) All outcomes | High risk | Primary outcome of review: Number of fruit and vegetables provided on menu in last week. There was no blinding to group allocation of participants described and this was likely to influence performance. |
Blinding of outcome assessment (detection bias) All outcomes | High risk | Primary outcome: Although CATI interviewers were blinded to group allocation, participant self‐report was used. There was no mention that participants were blinded to group allocation and, therefore, the risk of detection bias was high. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Table 2 outlines that there was missing data for two services (2/77 = 3%) and therefore there was a low risk of attrition bias. |
Selective reporting (reporting bias) | Low risk | The measures reported in the trial registration aligned with those reported in the outcome paper. |
ABC: Activity Begins in Childhood AGHE: Australian Guide to Healthy Eating BMI: Body Mass Index CATCH EC: Coordinated Approach to Child Health Early Childhood CATI: Computer Assisted Telephone Interview CCHP: Child Care Health Program CDC: Centers for Disease Control CHILE: Child Initiative for Lifelong Eating and Exercise CHPHSPC: Californian Childcare Health Programme Health and Safety Checklist CSPlan: Complex Samples Plan DOCC: Diet Observation in Child Care DVD: Digital Versatile Disc ECE: Early Care and Education EPAO: Environment and Policy Assessment and Observation EPAO‐SR: Environment and Policy Assessment and Observation Self Report HAP: Healthy Apple Program HS: Head Start IOM: Institute of Medicine ICC: Intraclass Correlation Coefficient MPL!: Move, Play, Learn! NAPSACC: Nutrition and Physical Activity Self‐Assessment for Child Care NC: North Carolina OSRAP: Observation System for Recording Activity in Preschools PA: Physical Activity RCT: Randomised Controlled Trial SE: Standard Error SFDPH: San Francisco Department of Public Health SNAP: Supplementation Nutrition Assistance Program SOPLAY: System for Observing Play and Leisure in Youth
TA: Technical Assistant TBP:Theory of Planned Behaviour TDF: theoretical domains framework vs: Versus ZBMI: z Body Mass Index