Determining educators needs to support healthy eating

environments in early childhood settings

http://dx.doi.org/10.23965/AJEC.42.2.03

Ruth Wallace
Amanda Devine
Leesa Costello
Edith Cowan University
School of Medical and Health Sciences (SMHS)
Systems and Intervention Research Centre for Health (SIRCH)

THE PROVISION OF A nutritious diet early in life can have an immense effect on future
health and wellbeing. The number of children attending child care is increasing, thus this
setting is strategically placed to establish positive eating habits. This qualitative study
sought to understand the needs of Australian early childhood education and care staff
in relation to the provision of a healthy eating environment. Key stakeholders formed a
consultancy group to provide feedback and advice. The study was underpinned by the
Spiral Action Research model. Analysis of 48 in-depth interviews identified the following
themes: healthy eating activities, resources, nutrition training, attitudes towards healthy
eating and the proposed intervention, and barriers to healthy eating. Participants were
open to using an online repository of nutrition resources and information wrapped in
support. This formative data informed the development of a best practice website
including discussion boards intended to foster an online community of practice.

Introduction
Long Day Care Centres (LDCCs) play a significant role in
the wellbeing of families and the communities in which
they live. This role includes the provision of important
opportunities for child development, enabling parental
workforce participation and contributing to the building
of stronger family units (Baxter & Hand, 2013). In 2015,
there were > 675 000 Australian children aged birthfour
years attending LDCC for an average of 28.4 hours per
week (DET, 2016), although some children may attend up
to 45 hours per week (ABS, 2012). Many LDCCs provide
food and drinks therefore food choices are predetermined
and for some children this provision may form a major
contribution to their overall daily intake of food (Bell,
Hendrie, Hartley & Golley, 2015).
The National Quality Standard (NQS) forms part of the
national legislative framework governing the provision of
long day care (LDC) in Australia, and under these auspices,
there are a number of stipulations pertaining to food and
nutrition. Food must be nutritious and varied and meet
specific dietary needs, drinking water should be readily
accessible and the menu prominently displayed (ACECQA,
2012). Mandatory training for food preparation staff includes
one module of the Certificate III in Child Care Services,
providing basic information about nutrition, menu planning
and food hygiene. The Certificate III is also the minimum
qualification for other LDCC staff, while more senior staff
such as directors would typically hold a Diploma in Child
Care Services, and early years teachers are required to
achieve a tertiary degree in early education (ACECQA, 2012).
Despite these regulations, studies have identified the food
provided at some LDCCs was of poor nutritional quality (Bell
et al., 2015; Sambell, Devine & Lo, 2014), suggesting that
the mandatory training may not have provided the necessary
skills to prepare nutritionally adequate food, or was not
recent enough for staff to recall the content. Moreover, staff
may view this mandatory training as a matter of regulatory
compliance rather than a learning opportunity. The provision
of food at an LDCC is assessed under Quality Area 2.2 of the
NQS, and refers to food being provided that is consistent
with the Get Up & Grow guidelines and/or the Australian
Dietary Guidelines (ACECQA, 2013). However, there is
no accompanying training to guide the implementation
of these resources in an LDCC, thus the translation of
evidence-based information into practice is thought to be
underutilised (Geoffroy et al., 2013).
This has led to concerns about the nutritional welfare
of young children, as both Australian and international
researchers have reported the food offered at LDCCs
may lack important nutrients vital for optimal child growth
and development (e.g. Jennings, McEvoy & Corish, 2011;

20 Australasian Journal of Early Childhood

Sambell et al., 2014). LDC is a critical, but untapped
environment where young children can develop positive,
lifelong food habits (Briley & McAllaster, 2011). There is
potential to teach food literacy skills and promote the
consumption of healthy foods (Parletta, 2014), however,
the role modelling of unhealthy eating behaviours by staff
has been reported (Erinosho, Hales, McWilliams, Emunah
& Ward, 2012; Gubbels, Gerards & Kremers, 2015) and
initiating nutrition curriculum and opportunities to teach
children about healthy eating is limited (Kim, Shim, Wiley,
Kim & McBride, 2011). It is acknowledged that other
factors might also affect the environment experienced
by children attending LDC, such as limited food budgets,
the quality of lunchbox food and limited physical activity
opportunities; however, the focus of this study was LDCCs
who provide all food and drinks for children.
There are concerns that overweight, obesity, macro and
micronutrient deficiencies are increasing, which may, in
part, be related to an increased reliance on LDC (AIHW,
2011). For example, overweight or obesity conditions
were more frequently observed in children receiving care
at an LDCC (Geoffroy et al., 2013), although this could also
be influenced by other factors such as level of parental
education and socioeconomic status (Alberdi et al., 2016).
In 20112012, almost 23 per cent of Australian children
aged twofour years were reported as overweight or
obese (ABS, 2014), increasing their risk of developing
chronic diseases such as asthma and Type 2 diabetes, and
leading to poor general health and reduced psychological
wellbeing (AIHW, 2009). Moreover, children who are
overweight or obese have a higher risk of continuing
this trend into adulthood (Guo, Wu, Chumlea & Roche,
2002). Micronutrients play a critical role in brain function
and development, and sub-optimal intakes can contribute
to learning difficulties and behavioural problems (Parletta,
2014). In particular, low intakes of dietary iron in children
aged onefour years increases the risk of permanent
neurobehavioral impairments, such as lower attention span,
intelligence quotas and academic performance (Georgieff,
2011; Roberts & Heyman, 2000). Furthermore, the overall
quality of childrens diets can affect academic performance
and intelligence quotas. For example, Northstone, Joinson,
Emmett, Ness and Paus (2012) reported children aged
three years old (n = 3966) with a junk food dietary pattern
demonstrated increased hyperactivity, lower academic
performance and reduced IQ scores at eight years old,
compared to children consuming a healthy diet who
increased their IQ scores at the same age.
Historically, many nutrition and healthy eating resources
have been available for use in LDCCs and research has
indicated in particular, the benefit of accreditation or award
schemes in improving food and nutrition practices, food
hygiene and adherence to state and national guidelines
(Bell et al., 2015; Matwiejczyk, Colmer & McWhinnie,
2007). However, key components of such schemes
were typically face-to-face training and site assessments,
viewed by some as onerous and reported as barriers to
participation (Matwiejczyk et al., 2007). Moreover, some
nutrition education programs, such as Start Right-Eat Right,
have lost funding or government support (Bell et al., 2015)
and in some Australian states and territories, limited or no
programs are in place.
Many health promotion programs use specifically designed
websites to deliver health messages and resources to
participants (Webb, Joseph, Yardley & Michie, 2010).
Furthermore, the advancement of technology and internet
accessibility supported the use of a website as a vehicle
to reach rural and remote LDCCs, improving the longer
term sustainability of potential projects. It was, therefore,
surmised that the development of a food and nutrition
specific website (the focus of this study) could increase
staff contact with appropriate nutrition education resources
and provide support in an easily accessible and time
efficient format. Through formative research, the aim
of this study was to understand the broader needs of
Australian LDCC staff in relation to providing and promoting
a healthy eating environment for the children in their care.
The findings from this study phase informed the design
and development of a website to increase LDCC staff
nutrition knowledge and confidence in providing a healthy
eating environment, while facilitating ongoing continuous
improvement in their professional development.
Methods
A qualitative approach was adopted as it allowed both
the researcher and the participants to articulate the
meanings of their social realities (Liamputtong, 2010, p.
12) and suited the aim, which sought to identify variables
to be examined in later stages of the study (Creswell,
2009). A qualitative methodology also supported a fluid and
flexible approach to understand the subjective experiences
(Liamputtong, 2010) of LDCC staff.
A research framework was implemented, and used as
a project management tool to ensure methodological
rigour, acknowledging the multiple levels of influence on
LDCC staff and settings. The Spiral Technology Action
Research (STAR) model (Skinner, Maley & Norman,
2006) was adopted (Figure 1), as it suited the qualitative
action research approach, allowing active participation
and the deep investigation required. Moreover, given the
importance of identifying participants needs, the STAR
model provided a constant reminder of the importance
of involving community in the developmental process
(Skinner et al., 2006); especially as individual and
organisational issues could potentially thwart the success
of the proposed website. Elements of this model were
used to manage the research process as it interweaved
technological design with community involvement, through
a series of developmental cycleslisten, plan, do, study,
act; and the first two steps; listen and plan, were at the
forefront of this study phase.
Vo l u m e 4 2 N u m b e r 2 J u n e 2 0 1 7 21
 formed. This group provided guidance on issues such
as the use of appropriate terminology and feedback on
suitable resources for the proposed intervention. No formal
data collection took place with this group.
Data was uploaded to NVivo for organisation and
analysis. The main question guide headings were used
to descriptively code emerging themes. Data was
recontextualised by examining categories rather than
sources, moving from simple document analysis to
deeper interpretive analysis (Bazeley & Jackson, 2013).
This method allowed an unexpected theme to emerge
barriers to providing a healthy eating environment, thus
acknowledging differing perspectives of the participants.

Findings
Semi-structured interviews (n = 48) were conducted
with staff from 13 LDCCs across a wide range of roles.
Two centres were located in WA regional cities and 11
in the Perth metropolitan area. Sixteen interviews were
conducted by telephone and the remainder face-to-face.

forefront of this study phase. Demographic data

The participants interviewed were representative of
the LDC sector (ABS, 2011) in terms of gender, age,
Figure 1. Spiral Technology Action Research (STAR) model qualifications and experience (Table 1).

Table 1. Participant's demographic data

A sampling frame of all LDCCs in Western Australia
(WA) was developed, and an invitation to participate in Variable Result n %
an interview emailed to the director of each centre for Gender Female 48 100
distribution among the staff. Fifteen LDCCs responded Age (years) < 18 2 4
to the invitation, and subsequently, individual staff
1925 17 36
members who agreed to an interview completed a brief
online survey, including informed consent, demographic 2635 9 19
and use of information technology questions. A question 3645 11 23
plan guided the semi-structured interviews around topics 4655 4 8
such as nutrition resources accessed, attitudes towards
56+ 5 10
healthy eating, confidence about nutrition knowledge and
participants perceptions of the proposed website. Allowing TOTAL 48 100
the conversation to flow naturally ensured any interesting or Role in Owner/director 11 23
unexpected data was captured (OLeary, 2010). Interviews early years Early years teacher 1 2
continued until saturation was reached, that is, when the centre
2IC/group leader 18 37
researcher had engaged with 48 staff from 13 LDCCs, no
new themes were emerging and no new insights were Food coordinator 9 19
offered. Interviews were audio-recorded with participant Certificate III/trainee 9 19
consent and transcribed verbatim. Purposive sampling
TOTAL 48 100
ensured transferability as participants represented the
context of the research (LDC staff), and a broad range Type of None 6 12.5
of staff across all roles were recruited (Jensen, 2008). qualification Certificate III 14 29
Ethics approval was granted by the Edith Cowan University held
Certificate IV 1 2
Ethics Committee (# 8727), and pseudonyms were
Diploma 27 56
used to protect participant confidentiality. Additionally,
a consultancy group, including representatives from key Early years teaching degree 3 6
stakeholders and early childhood organisations (such as Other teaching degree 3 6
Ngala, Child Australia and Early Childhood Australia) was

22 Australasian Journal of Early Childhood

Experience in the early years sector ranged between four
months to 35 years, with a mean of nine years. Many
participants had dual/multiple roles; for example, a food
coordinator may also work on the floor, that is, caring for
children, when meal times are complete, or a second-in-
charge (2IC) may also work on the floor as well as having
supervisory responsibilities.
Twelve per cent of participants had obtained a teaching
or other university degree and six participants reported
no relevant childcare qualification (Table 1). These were
food coordinators who, under previous legislation, were
only required to complete the food hygiene and safety
components of a Certificate III in Child Care Services
(Government of Western Australia, 2007).
Roles explored
An LDCC typically provides care for children aged between
six weeks and five years old. The role of directors and 2IC
generally involves managing the centre and overseeing
operations. The food coordinators role focuses on food
preparation, although some work on the floor is also
required. Children are grouped according to their ages, and
although this varies between each LDCC, typically these
groups are babies (birthtwo years), toddlers (twothree
years) and preschool (threefive years). Given the dual/
multiple roles that many staff hold, only 21 participants
(44 per cent) cared solely for children in a specific age
group, and the greatest proportion (57 per cent) of this
group cared for two and three-year-old children (Table 2).
Table 2. Age range of children cared for
Age n %
Babies (6 weeks2 years) 6 28.5
Toddler (23 years) 12 57
Preschool (35 years) 3 14.5
TOTAL 21 100
Engagement with information technology
All centres had a computer and internet connection and
92 per cent of participants (n = 44) confirmed access
to these facilities while at work. Approximately half the
participants reported using the internet for work related
purposes weekly or more. However, five participants
reported never using the internet for work related purposes
(across all age ranges), and only one reported no access to
a computer and/or internet connection at home.
The majority of participants (n = 35, 73 per cent) across
all age ranges accessed the internet daily for personal
reasons, reflective of the internet usage among the
wider Australian population (ABS, 2011) and comparable
to United States (US) research about LDC staff as internet
consumers (Weigel, Weiser, Bales & Moyses, 2012). This
sample was also indicative of women who are increasingly
using the internet as a means of education (Donelle &
Hoffman-Goetz, 2008). Moreover, 40 per cent (n = 19)
were aged between 1925 yearsan age demographic
who prefer to receive health and education materials via
the internet (Colby, Johnson, Eickhoff & Johnson, 2011).
It was important to establish the types of internet platforms
participants accessed regularly, given the intention to
provide an online resource32 participants (66 per cent)
reported accessing social media sites on a daily basis
(aged < 35 years), compared to US data where 50 per cent
(n = 408) of LDCC staff reported using social media
regularly (Weigel et al., 2012). Across all age ranges, the
reported use of discussion boards was more limited.
Approximately half the participants reported never using
discussion boards, although 10 (21 per cent) did report
using them on a regular basis.
FindingsInterview data
Data was organised into categories according to the main
topic headings from the question guide. The findings are
presented under the same headings, namely healthy
eating activities, resources used, nutrition training,
attitudes towards healthy eating, and attitudes towards the
proposed intervention, together with barriers to healthy
eatingan unexpected theme to emerge from the data.
Healthy eating activities
Active role modelling at meal times was reported as a
common practicethat is, sitting with children as they ate
and demonstrating positive mealtime behaviours, such as
encouraging children to try new foods and eating the same
foods. This was an encouraging finding, given that children
who observe a significant adult enjoying healthy food
may have their own preferences profoundly influenced
(Benton, 2004). In contrast, research by Erinosho and
colleagues (2012) found that 20 per cent (n = 22) of their
participants working in LDCCs who reported modelling
healthy behaviours were actually observed engaging in less
positive behaviours. Teaching children about the nutrients
in their food may increase their consumption of healthy
foods (Gripshover & Markman, 2013); however, evidence
of planned learning experiences incorporating healthy
eating topics was less apparent and participants could not
provide examples of when this had occurred. The NQS
stipulates planned learning experiences that incorporate
discussions and activities about healthy eating and caring
for their bodies into childrens everyday experiences
(ACECQA, 2012, p. 61) should be provided. These findings
suggest that these experiences are less prioritised and as
such, health promoting opportunities are missed.
Resources
Participants were asked to recall specific resources they
used to support the provision of nutritious food and the
promotion of healthy eating within the early childhood
Vo l u m e 4 2 N u m b e r 2 J u n e 2 0 1 7 23
education and care (ECEC) setting. More than half
(n = 25) stated they simply searched the internet while
acknowledging the information validity or reliability could
not be assured. Similarly, a study by Gibbons, Graham,
Marraffa and Henry (2000), found most LDCC staff relied
on newspapers, magazines or food company brochures for
nutrition information, and few considered approaching a
reliable source such as a dietitian or nutritionist.
Participants were asked specifically about the Get up
& Grow manuals and the Australian Dietary Guidelines
(NHMRC, 2013), the resources prescribed by the NQS to
guide the provision of nutritious and varied food. However,
as reported elsewhere broad recommendations, such as
government guidelines, may be difficult to implement
and thus underutilised (Geoffroy et al., 2013, p. 757),
as reflected in the responses from these respondents.
Thirty participants (63 per cent) reported having never
heard of Get Up & Grow and only six participants
(12 per cent) actually reported using the resources. Similarly,
25 participants (54 per cent) were aware of the Australian
Dietary Guidelines, but only five (10 per cent) reported
actual use, and few were aware of a major review to
include specific recommendations for children aged
twofour years (NHMRC, 2013).
Qualifications
Participants were asked specifically if any basic nutrition
concepts were taught in their mandatory training and
whether they believed this training equipped them with
sufficient nutrition knowledge and confidence to promote
a healthy eating environment in LDC.
When asked to what extent food and nutrition concepts
were included in the Certificate III, one director, with more
than 20 years experience in the early years sector, had a
strong opinion about the value of this mandatory training:
I think the Cert III is pretty valueless. Its been watered
down so much along the way so that they could get
staff through it now, its all stuff they could learn by
being here [at the centre]. I dont think it gives them
any good background stuff (Katie).
Although Katie was the only participant to voice this opinion
so strongly, almost all of the other participants (n = 46),
while being able to recall the menu planning and food safety
components of their mandatory training, reported that there
was little, if any coverage of basic nutrient concepts, positive
role modelling or dealing with fussy eaters. Several noted
their training was so long ago they could not recall the
specific content. Participants who had completed higher
level training, such as a diploma or teaching degree, also
reported no nutrition units were included.
Two food coordinators reported they did not hold the
mandatory qualifications, which may be due to previous
legislation that only required completion of the menu
planning and food safety components of the Certificate III.
24 Australasian Journal of Early Childhood
However, Gibbons et al. (2000) commented that food
coordinators should actually have a higher level of nutrition
training and knowledge to enable them to effectively
develop a nutritionally adequate menu. Pollard, Lewis
and Millers (1999) study of food and nutrition in the WA
ECEC sector, 18 years ago, found food coordinators had
limited nutrition training and subsequently, recommended
legislative changes to ensure statutory nutrition and food
hygiene training. However, little has changed. These
findings suggest that the training mandated as a result of
Pollard and colleagues (1999) research has been watered
down over the years and does not equip trainees with
the necessary skills, illustrating the need for ongoing
training. This was suggested as a potential inclusion in the
proposed website, and participants welcomed the concept
of nutrition training on an ongoing basis; consistent with
US research where staff requested improved resources
and more specific child nutrition training (Romaine, Mann,
Kienapple & Conrad, 2007).
Confidence
Some participants expressed a lack of confidence that
prevented their approaching parents about nutrition and
healthy feeding practices. For example, an educator
described how a three-year-old child was arriving at the
centre each morning with a bottle of milk, having not been
provided with breakfast. The educator understood this was
an inappropriate practice for a child of this age, but lacked
the confidence to discuss this with the parents for fear of
stepping on their toes. Lynch and Batal (2011) corroborate
these concerns, noting that staff often felt uncomfortable
discussing nutrition issues with parents and tended only to
discuss more general issues, such as overall food intake,
rather than specific nutritional concerns.
Although acknowledging that their statutory training
lacked nutrition content, several participants (across a
range of roles) stated they were confident about their
nutrition knowledge. It is possible this confidence was
overstated, especially given the reliability or accuracy of
nutrition resources utilised appears unclear. These findings
reinforced the need to increase staff nutrition knowledge
so they can confidently broach sensitive topics with parents
and thus contribute to a healthy eating environment.
Attitudes
Attitudes towards providing a healthy eating environment in
the LDC setting were overwhelmingly positive, and many
participants (n = 30; 62 per cent) explained this was because
they believed the food provided in the home environment was
not nutritious. These beliefs stemmed from their observations
of children arriving at the centre with unhealthy foods and drinks,
and by recalling stories children had shared about the food
they have at home. Although these attitudes could have been
influenced by social desirability, specifically the desire to present
oneself in a socially conventional way (Fisher & Katz, 2000,
p. 107), healthy eating is a contemporary topic and these
positive attitudes were perceived as genuine. Participants
acknowledged the important role the centre had to play in
providing an appropriate environment to support childrens
health. For example:
 our service is located in a low socioeconomic area
where nutritious meals for a lot of families come low
on the list of priorities. However, we know that whilst
the children are attending preschool they are being
provided with nutritious food (Layla).
In contrast, Lynch and Batal (2011) reported staff believed
it was difficult to create a healthy eating environment at the
centre if parents allowed their children to eat unhealthily at
home, but only one participant in our study agreed: Surely
its all down to the parents, if they dont care, what does
it matter what we do? (Olga).
However, most participants in this study reported that because
they believed some parents might allow their children to eat
unhealthily at home, it was increasingly important to create
a healthy eating environment at the centre:
 e like the fact that children have a wholesome meal at
W
lunch time so the parents dont have to stress too much
for dinner, they can pick their battles a little bit (Tabitha).
Parental employment is cited as the main reason for children
attending LDCCs in Australia (Baxter & Hand, 2013), and
these participants explained that hours of work and limited
time for shopping and cooking were the reasons they
believed families made poor food choices. However, despite
these positive attitudes and good intentions, recent research
indicates that the food provided at LDCCs may not be of
the best nutritional quality (Sambell et al., 2014), further
highlighting the need for a nutrition education website.
Barriers to providing a healthy eating environment
A theme emerging from the interviews was the barriers
encountered by staff in response to promoting or
providing a healthy eating environment, namely; childrens
preferences, parental influence and staff behaviours.
Childrens preferences
It was reported that childrens preferences for the same food
on different occasions often fluctuated, thus influencing
food provision. For example, a food coordinator, referring
to the same dish offered on different days, complained
that: One day the children wont eat something like that
and another day they cant get enough of something [the
same dish] (Rosie).
Another food coordinator explained that when she tried
to provide a healthier option, such as wholemeal pizza
bases, the children refused the food due to the unfamiliar
taste and consistency, and subsequently this food was
not offered again. US research suggests that repeatedly
offering new or rejected foods between five and 15 times
may promote eventual acceptance (Caton et al., 2014).
Moreover, the Get Up & Grow resources also state that
new foods should continue to be offered, even if initially
rejected (DoHA, 2013); however, it has been established
that this resource is neither well-known nor well-utilised.
Therefore, the lack of persistence demonstrated by these
food coordinators in relation to repeatedly offering healthier
foods is not surprising, especially in light of their limited
nutrition training.
Another commonly reported issue was food neophobia
(food refusal), commonly peaking in children aged between
two and six years (Dovey, Staples, Gibson & Halford, 2008),
resulting in staff making decisions about the alternative
food choices to be offered. A director reported:
 I just increase the amount of fruit that child has if
they havent eaten their meal rather than make them
something completely different. I feel like there isn't
really info there on how to handle that in a centre
situation (Audrey).
The number of children in a room at meal times could
influence the ability of staff to focus on one or two fussy
eaters, as the child:staff ratio for children older than three
years is 11:1. The Get Up & Grow guidelines state that food
should not be used as a punishment or reward, and while
encouraging persistence, do not make recommendations
about alternatives when a meal is refused (DoHA, 2013).
This further demonstrates the need for comprehensive
guidelines on effective management of food refusal in
this setting, while maintaining the nutritional quality of
the alternative foods offered.
Parental influence
The influence of parents on their childrens eating habits
was also reported as a barrier to providing a healthy eating
environment. Participants reported that some parents were
not necessarily concerned about what their children had eaten
over the course of a day, but how much or if they had eaten.
Participants also reported a number of parents who
requested specific dietary requirements for their children,
not necessarily for medical reasons. For example, an
educator discussed an infant who had been placed on the
Paleolithic diet by her parents. Such requests can lead to
concern among staff as they may not have the expertise to
adequately assess the suitability of the diet, cannot be sure
if the child is receiving a nutritionally balanced diet and may
lack the confidence to approach the parents with these
concerns. Thus, the proposed website, and in particular a
forum where there is access to a nutrition expert, could
provide credible information and support on similar issues.
Staff behaviours
There was an apparent lack of nutrition knowledge
among some participants, especially food coordinators.
For example, a food coordinator described providing fish
Vo l u m e 4 2 N u m b e r 2 J u n e 2 0 1 7 25
fingers because fresh fish was unavailable. Fish fingers
are considered a discretionary food item that should be
avoided in LDC settings (Healthy Eating Advisory Service,
2014) as healthier alternatives such as canned fish could
be utilised. This lack of nutrition knowledge was reinforced
by a director who described her former food coordinators
viewpoint: that it was more important the children ate
something rather than nothing, regardless of the nutritional
quality. This viewpoint demonstrates a limited knowledge
of important nutrition concepts among some staff, which
could restrict their ability to effectively model healthy food
choices, or provide a healthy eating environment. Evaluation
of the now defunct Start Right-Eat Right program, revealed
that participants (n = 87) who attended nutrition workshops
reported increased nutrition knowledge and the ability to
develop appropriate menu plans (Bell et al., 2015), thus
reinforcing the need for such support to be provided.
Proposed intervention
Participants were introduced to the concept of a website
hosting a depository of evidence-based resources, online
activities and discussion boards, to support the provision
of a healthy eating environment in the LDC setting. The
actual preference for a website was not questioned, as
this was not the aim of the research, but the researcher
sought to understand the content required in order that a
best practice model could be developed. A wide range of
topics were suggested, with most participants expressing
a desire to increase nutrition knowledge and learn
strategies to better cope with food refusal. Participants
welcomed the notion of a one-stop-shop for accurate,
current and reliable nutrition resources and advice from
qualified nutrition experts. This was a reassuring finding
as it had been established that many staff freely used the
internet to search for information without any assurance
of accuracy, validity or reliability, as found in other LDCC
communities (Weigel et al., 2012).
Apart from the few participants who indicated that they
would not use internet-based computer training, all
other staff welcomed online activities, intended to offer
information wrapped in support, to refresh their current
nutrition knowledge and add value to the existing statutory
training. Colby et al. (2011) claimed that internet-based
training is the preferred method of delivery for younger
adults of interest given that almost 60 per cent of these
participants were aged < 35 years old. Participants
indicated they would find the discussion boards a useful
tool to seek information and support, although reported
they might not necessarily contribute, as confirmed by
the demographic data where 50 per cent of participants
(n = 24) reported not using discussion boards.
Conclusions and recommendations
The main limitation of this study was the representativeness
of the study sample, as 60 per cent (n = 29) of the
26 Australasian Journal of Early Childhood
participants held senior roles, such as director or 2IC. Only
19 per cent (n = 9) of participants were food coordinators,
thus the perspectives of these important staff members
may not have been adequately represented. Furthermore,
the focus of this study was around nutrition education and
although it is acknowledged that physical activity is an
important factor in optimal child health, this was beyond
the scope of the current study.
Analysis of the qualitative interviews and discussions
with consultancy group members provided a preliminary
understanding of LDCC sector needs in relation to
providing a healthy eating environment, and informed
the development of the proposed website. Participants
reported positive role modelling regularly, but there was
little evidence of planned learning experiences in practice
to teach children nutrition concepts. The recommended
nutrition resources (Australian Dietary Guidelines and
Get Up & Grow manuals) were not well-known or well-
utilised, and participants readily acknowledged using the
internet to search for nutrition information, uncertain of the
quality. Participants reported that mandatory qualifications
provided little, if any, nutrition training. Although there was
a lack of confidence around discussing nutrition issues
with parents, positive attitudes towards providing a
healthy eating environment were apparent, even though
participants may not have sufficient skills or confidence to
achieve this. A number of barriers to providing a healthy
eating plan were reported, including food refusal, parental
influence and a lack of nutrition knowledge among staff.
Most participants had access to a computer and internet
connection and were comfortable using the internet for
work and personal purposes; many used social media
regularly, but discussion boards less so. However,
despite the reported low levels of discussion board use,
participants were open to the concept of a web-based
one-stop-shop to provide reliable and accurate nutrition
resources, together with discussion boards, where an
online community of practice could be fostered and
access to nutrition experts provided. The concept of a
website to assist staff to provide and promote a healthy
eating environment was well received by participants and
consultancy group members, thus the Supporting Nutrition
for Australian Childcare (SNAC) website www.snacwa.
com.au was developed and launched in 2013.
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