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Open Access Research article

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

Pennie Dodds13, Rebecca Wyse1234, Jannah Jones1234*, Luke Wolfenden1234, Christophe Lecathelinais2, Amanda Williams1, Sze Lin Yoong134, Meghan Finch1234, Nicole Nathan1234, Karen Gillham2 and John Wiggers1234

Author Affiliations

1 Faculty of Health, School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW 2300, Australia

2 Hunter New England Population Health, Hunter New England Local Health District, Locked Bag No. 10, Newcastle, Wallsend NSW 2287, Australia

3 Priority Research Centre for Health Behaviour, The University of Newcastle, Newcastle, NSW 2308, Australia

4 Hunter Medical Research Institute, Newcastle, NSW 2300, Australia

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BMC Public Health 2014, 14:572  doi:10.1186/1471-2458-14-572

Published: 9 June 2014

Abstract

Background

Childcare 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.

Methods

This 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 (nā€‰=ā€‰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.

Results

Agreement 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 āˆ’0.06 (poor agreement) to 1 (perfect agreement). Of the 43 items assessed, 27 were found to have moderate or greater agreement.

Conclusions

The 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.

Keywords:
Healthy eating; Physical activity; Obesity prevention; Childcare; Nursery; Preschool; Measurement tool