Validity of a measure to assess healthy eating and physical activity policies and practices in Australian childcare services.

Pennie Dodds,Luke Wolfenden,Nicole Nathan,Rebecca Wyse,John Wiggers,Sze Lin Yoong,Amanda Williams,Karen Gillham,Jannah Jones,Christophe Lecathelinais,Meghan Finch

doi:10.1186/1471-2458-14-572

Abstract

BackgroundChildcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Few rigorously validated measures exist to measure healthy eating and physical activity policies and practices in this setting, and no such measures exist that are specific to the childcare setting in Australia.MethodsThis was a cross sectional study, comparing two measures (pen and paper survey and observation) of healthy eating and physical activity policies and practices in childcare services. Research assistants attended consenting childcare services (n = 42) across the Hunter region of New South Wales, Australia and observed practices for one day. Nominated Supervisors and Room Leaders of the service also completed a pen and paper survey during the day of observation. Kappa statistics and proportion agreement were calculated for a total of 43 items relating to healthy eating and physical activity policies and practices.ResultsAgreement ranged from 38%-100%. Fifty one percent of items showed agreement of greater than or equal to 80%. Items assessing the frequency with which staff joined in active play with children reported the lowest percent agreement, while items assessing availability of beverages such as juice, milk and cordial, as well as the provision of foods such as popcorn, pretzels and sweet biscuits, reported the highest percent agreement. Kappa scores ranged from −0.06 (poor agreement) to 1 (perfect agreement). Of the 43 items assessed, 27 were found to have moderate or greater agreement.ConclusionsThe study found that Nominated Supervisors and Room Leaders were able to accurately report on a number of healthy eating and physical activity policies and practices. Items assessing healthy eating practices tended to have higher kappa scores than those assessing physical activity related policies or practices. The tool represents a useful instrument for public health researchers and policy makers working in this setting.

Highlights

Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development
Childcare services have existing infrastructure to support obesity prevention initiatives and staff are amenable to programs which seek to improve children’s diet and encourage child physical activity [14,15]
Such findings suggest that the tool may provide a valid means of assessing some healthy eating and physical activity practices of services and represent a useful instrument for public health researchers and policy makers working in this setting

Summary

Introduction

Childcare services represent a valuable obesity prevention opportunity, providing access to a large portion of children at a vital point in their development. Centre based childcare services provide a valuable obesity prevention opportunity, given this setting provides education and care to a significant proportion of children aged 3–5 years [8,9] at a vital point in their development [10]. In countries such as Australia, the United States and the United Kingdom, over 50% of children aged under five years attend some form of centre based childcare service, often for prolonged periods of time [11,12,13]. Australian childcare services are required to adhere to licensing and accreditation requirements, a number of which promote the health and physical development of children [7]

Objectives

Methods

Results

Discussion

Conclusion