Date of Award

2016

Document Type

Thesis

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Medical and Health Sciences

First Supervisor

Associate Professor Amanda Devine

Second Supervisor

Dr Leesa Costello

Third Supervisor

Dr Johnny Lo

Abstract

The provision of a nutritious diet in a child’s early years can have an immense effect on their future health and wellbeing. Due to the increasing number of children attending child care, this setting is strategically placed for teaching children important food literacy skills and establishing positive eating habits, which remain through to adulthood. However, food served in child care facilities is often not of the best nutritional quality (Zuercher, Grace, & Kranz, 2011) and there is lack of positive role modelling among staff. Both of these factors pose obstacles to a health-promoting environment for the children who attend.

The nutritional needs of young children are well known. This research sought to identify the child care specific nutrition education resources currently available, and to understand the broader needs of Australian child care staff that would enable them to provide a healthy eating environment. The findings of this research phase informed the design and development of a website to increase child care staff nutrition knowledge and confidence in providing a healthy eating environment, facilitating ongoing continuous improvement in their professional development. Discussion boards to promote a sense of community and provide ‘information wrapped in support’ were a key website feature.

Qualitative interviews were conducted with child care facility staff and key industry stakeholders. Although positive attitudes towards promoting healthy eating were demonstrated, data revealed that recommended nutrition resources were not well known or utilised by the childcare sector and staff reported a lack of confidence and workplace support. Guided by the Spiral Technology Action Research model (H. Skinner, Maley, & Norman, 2006), a health promotion project management tool, these findings informed the development of the website, “Supporting Nutrition in Australian Childcare” (SNAC), containing a range of resources, recipes, discussion boards and links.

Use of the website, staff nutrition knowledge, attitudes, confidence and sense of community were evaluated using a qualitative, netnographic approach, through conversation threads, interviews and observations. Quantitative data collection methods including pre- and post-intervention surveys and web analytics were utilised to triangulate these findings.

Despite the “netnographic slog”, that is, the persistence and continued attempts to recruit educators and encourage them to engage with the website, findings suggest that the SNAC website was well utilised and valued by more than 1200 SNAC members, attracting over 90,000 page views and 600 posts/comments. Educators valued the ‘information wrapped in support’ offered by the website, and a sense of community developed, particularly around shared emotional connection. Educators reported positive attitudes and high self-efficacy towards providing a healthy eating environment. However, evaluation results demonstrated disparity between reported knowledge and behaviours, such as high self-efficacy, and those observed, such as poor quality menu plans.

This research has shown the need for changes in public health policy to reprioritise a healthy eating environment in Australian childcare facilities; changes that foreground optimal nutrition in the early years as vital for future health and wellbeing. However, given that high-level policy change is often difficult and time consuming, the demonstrated disparity between reported and observed knowledge and behaviours highlights the need for shorter term strategies that address the support so badly needed, to ensure the long-term sustainability of these changes.

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