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Issue Addressed: Dietary intake and physical activity behaviours of many Australian children are not meeting recommendations, particularly for those living in socioeconomically disadvantaged circumstances. This study aimed to design and assess the feasibility and acceptability of a suite of narrative videos and text messages focused on healthy eating and physical activity behaviours appropriate for parents of young children from socioeconomically disadvantaged backgrounds. Methods: Parents of 1–5‐year‐old children (n = 6) were recruited to develop a suite of 12 narrative videos on healthy eating and physical activity behaviours, underpinned by theory. Twelve complementary text messages were subsequently developed. A different group of parents (n = 16) recruited from socioeconomically disadvantaged areas reviewed the videos and text messages over 6 weeks and provided feedback via surveys and qualitative interviews (n = 13). Results: There was a high level of engagement with and acceptability of the videos and text message content. Participants found the videos easy to access and they liked the narrative style. Screen time videos and text messages relating to screen time, play and physical activity, role modelling and fussy eating were most useful. Conclusions: Narrative style healthy eating, physical activity and screen time videos and complementary text messages were highly acceptable to the sample of parents of 1–5‐year‐old children from socioeconomically disadvantaged areas recruited from the Illawarra Shoalhaven region of NSW, Australia. So What?: Short narrative style videos and text messages are an easy to process and acceptable method of delivering healthy lifestyle promotion content to parents. [ABSTRACT FROM AUTHOR]

Issue Addressed Methods Results Conclusion So What? Out of School Hours Care (OSHC) is an important setting to promote healthy eating and physical activity. Between 2017 and 2018, The Eat Smart Play Smart (ESPS) resources were disseminated to OSHC services across New South Wales (NSW), Australia. The aim of this study was to evaluate the awareness and usability of ESPS to support OSHC healthy eating and physical activity practices.All NSW OSHC services (approximately 1700) were invited to complete an online survey to assess awareness and use of the ESPS resources (manual and online modules). Data were analysed using SPSS (Version 29).A total of 393 OSHC staff responded to the survey. Most (75%) had used the ESPS resources. Of the 25% who had not used the resources, 63% indicated it was because they did not receive the manual and 52% were not aware of the resources. Of the OSHC services that knew about the resources, 69% indicated that ESPS contributed to their service's ability to meet the Australian National Quality Standards. Respondents identified additional support was required regarding physical activity educational materials and professional learning. Suggestions for improvements included offering content in different formats (e.g., digital).This evaluation identified factors influencing the uptake of the ESPS resources and will inform future interventions for OSHC staff to improve knowledge and practices in healthy eating and physical activity promotion.Our findings will support the optimisation of ESPS resources and inform future development of future healthy eating and physical activity interventions in the OSHC setting. [ABSTRACT FROM AUTHOR]

This study aimed to examine associations between gross motor skills and executive functions (EF) in a large sample of Australian preschool-aged children. Of 566 children (mean age = 3.2 ± 0.4 years, 51.2% girls), locomotor, object control, and total skill competence were significantly associated with visual spatial working memory and inhibition (p < 0.05). Total skill competence was associated with shifting and locomotor skills were significantly associated with self-regulation (p < 0.05). Static balance was significantly associated with inhibition and shifting (p < 0.05). In boys, an association between object control skills and visual spatial working memory was observed. In girls, an association between static balance and visual spatial working memory, phonological working memory, and shifting was observed. The identification of significant associations between gross motor skills and different EFs is an important contribution to the growing evidence on the relationship between motor skills and EFs in early childhood. [ABSTRACT FROM AUTHOR]

This study explored parental engagement, child BMI and secondary outcomes from the social media component of an online healthy lifestyle program for parents of preschool-aged children. Intervention group participants received access to an online program and Facebook group. Data were collected at baseline and 3- and 6-months follow-up. Facebook usage data on comments and posts were used to determine total active engagement. There was a high level of Facebook group membership and most parents actively engaged at least once. Although there were varying levels of engagement between modules and cohorts, it was modest overall. User acceptability of the Facebook group was lower than expected. Children of parents in the intervention who engaged more in the Facebook group (by posting and commenting) demonstrated greater sleep duration over time (estimate 1.79, 95% CI 0.42 to 3.17, p =.01) Children of parents who engaged more in the Facebook group also participated in less moderate- to vigorous-intensity physical activity (estimate −0.14, 95% CI −0.26 to −0.01, p =.03). This study is one of the first parent-focussed healthy lifestyle interventions to include a social media component. Further research is recommended with larger sample sizes and longer duration to further explore the potential of social media in childhood obesity interventions. [ABSTRACT FROM AUTHOR]

Background The use of parent-focused internet-based programs for the prevention and treatment of childhood obesity has shown promise but there is an acknowledged gap in parent-focused interventions which target the early childhood stage. Methods The aim of this study is to determine the efficacy of Time2bHealthy - an online healthy lifestyle program for parents of preschool-aged children. The program will be evaluated using a two-arm, parallel, randomised controlled design. The 11-week program is underpinned by Social Cognitive Theory and consists of interactive modules on healthy eating, physical activity, screen-time and sleep. The intervention also involves elements of social media, where participants share discuss ideas and experiences and they can interact and obtain information with experts. Time2bHealthy is being compared to a comparison condition. Outcomes include change in BMI (primary outcome), dietary intake, physical activity, sleep, child feeding, parental role-modelling and parent self-efficacy. Process evaluation data, such as adherence and engagement with the online forums, will also be collected. Discussion Time2bHealthy is the first randomised controlled trial to our knowledge to assess the efficacy of an online parent-focussed healthy lifestyle program for preschool-aged children in changing body mass index. Early childhood is a crucial time for establishing healthy lifestyle behaviours and parents play an important role. This study therefore fills an important gap in the literature. If found to be efficacious, Time2bHealthy has potential for broad-reach access and translation into primary health care services. Trial Registration The study is registered with the Australian and New Zealand Clinical Trials Registry (12616000119493). [ABSTRACT FROM AUTHOR]

Aim: Telephone health behaviour change interventions have shown potential as a medium for change. The aim of the present study was to evaluate the effectiveness of a telephone behaviour change program on weight and physical activity. It was hypothesised that participants would achieve significant improvements in body mass index (BMI) and physical activity at the completion of the program and at follow up. Methods: A six‐month health telephone behaviour change program was delivered by health professionals trained in health coaching methodology. Participants (n = 250) had two or more chronic disease risks, received five calls during the program and a follow up call 12–18 months after completion of the program. Results: The average participant age was 70, 72% were female and mean BMI was 28.90 kg/m2. Significant improvements in BMI were reported from baseline to post‐intervention (−1.70% change) and from baseline to follow up (−1.21% change). Changes in weight were significant from baseline to post‐intervention (−1.67% change) and not significant from baseline to follow up (−1.25% change). Significant changes in the average number of minutes spent in moderate to vigorous intensity physical activity (MVPA) per week were reported between baseline and post‐intervention and post‐intervention and follow up. From baseline to follow up, the average time spent in MVPA per week increased by 157 minutes. At follow up, 86% of participants maintained or further improved their health behaviour. Conclusions: The present study demonstrated the potential effectiveness of a low‐dose telephone health behaviour change program in assisting participants to change and maintain their health behaviour. [ABSTRACT FROM AUTHOR]

Background: Parents are key decision makers and role models in establishing and maintaining healthy behaviours in their children. Interventions involving parents have been shown to be more effective than those that do not, but there are barriers to participation. Efficacy trials have previously been conducted on two such parent-focussed healthy eating and active living interventions with the potential to overcome these barriers - Healthy Habits (telephone-based) and Time2bHealthy (online) with promising results. Further research is now required to determine the effectiveness of these interventions in a real-world context. The Time for Healthy Habits study is a 3-arm partially randomised preference trial which aims to evaluate the effectiveness and cost-effectiveness of two theory-based programs to promote healthy eating and appropriate levels of movement behaviours (physical activity, sedentary behaviour and sleep) for parents of 2- to 6-year-old children (Healthy Habits Plus telephone-based program and Time2bHealthy online program), when compared to a comparison group receiving written materials.Methods: Participants will be recruited across five Local Health Districts in New South Wales, Australia. The partially randomised preference design initially allows for participants to decide if they wish to be randomised or opt to select their preferred intervention and has been recommended for use to test effectiveness in a real-world setting. Both interventions incorporate multiple behaviour change techniques and support parents to improve their children's healthy eating, and movement behaviours (physical activity, sedentary behaviour and sleep) and run for 12 weeks, followed by a 3-month and 9-month post-baseline follow-up. Participants will also be asked to complete a process evaluation questionnaire at the completion of the intervention (3-months post-baseline). Outcomes include fruit and vegetable intake (primary outcome), non-core food intake, weight status, physical activity, sedentary behaviour, and sleep habits.Discussion: To our knowledge, this is the first translational research trial evaluating the effectiveness and cost-effectiveness of a healthy eating and active living intervention in the 2- to 6-years age group. The results will build the evidence base in regard to translation of effective childhood obesity prevention interventions and inform the implementation and delivery of community based childhood obesity prevention programs.Trial Registration: UTN: U1111-1228-9748, ACTRN: 12619000396123p. [ABSTRACT FROM AUTHOR]

Assess educators' feeding practices and mealtime environments in family daycare services and examine the factors associated with educators' feeding practices and mealtime environments. Cross-sectional observational study of family daycare services (n = 33) in Australia. Best practices for mealtime environments and educator feeding practices were assessed during each mealtime using the Environment Policy Assessment and Observation instrument. Correlates assessed via survey included: socioeconomic status, main language spoken at home, early childhood career experience, and nutrition professional development. Descriptive statistics and independent t tests were calculated. Educators typically had higher scores, indicating better practices, for (the absence of) negative practices compared with positive practices. The only positive practice meeting best-practice standards was educators sitting with children during the meal. There were no significant correlations for educators' feeding practices or mealtime environment. Educators may benefit from professional development targeting positive feeding practices and supportive mealtime environments. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality and quantity of foods and beverages provided to children aged 0-5 years in family day care and identify structural and sociodemographic factors associated with the nutritional quality of food provided.Design: A cross-sectional study measured the food and beverages provided to children using weighed food records. The number of serves from different food groups was calculated according to the Australian Guide to Healthy Eating, and a healthy food provision index score was created. Associations between structural and sociodemographic factors and healthy food provision index scores were analysed using linear mixed models.Setting: Family day care services in two large geographic areas in New South Wales, Australia.Participants: One hundred and four children in thirty-three family day care services.Results: During attendance at childcare, most children met recommended servings of fruit but not dairy, vegetables, lean meat and meat alternatives and wholegrains. Discretionary foods exceeded recommendations. Children's age, socio-economic status and the type of main meal provided were significantly associated with the healthy food provision index score.Conclusions: Foods provided to children in family day care are aligned with dietary recommendations for fruit but not vegetables, dairy, lean meat and meat alternatives, wholegrains or discretionary foods. Interventions to promote healthy eating are needed to support families and educators to improve the nutritional quality of food provided to children. [ABSTRACT FROM AUTHOR]

Background: This systematic review examined the effectiveness of experiential learning interventions for improving children's physical activity knowledge, attitudes, and behaviours. It also aimed to identify intervention characteristics that resulted in the greatest impact. Methods: Four databases: Education Research Complete, Scopus, Web of Science and PsychINFO were searched from database inception to January 2023. Eligible studies: (1) included children 0–12 years; (2) assessed the effect of physical activity outcomes on children's physical activity knowledge, attitudes or behaviour and (3) were randomised controlled trials conducted in any setting. Study risk of bias was assessed by two independent reviewers using the Cochrane risk of bias tool. Intervention approaches were categorised, and effect sizes were compared across studies for each outcome. Results: Twelve studies were included in the review: ten in school age and two in below five years. For behavioural outcomes, six of eight studies showed medium to large effects (effects size (ES) range: 0.3–0.9), two of the three studies that assessed attitudinal outcomes displayed medium effects (ES range: 0.4–0.5) and both studies that assessed knowledge outcomes displayed medium to large effects (ES range: 0.4–1.3). The two experiential learning interventions among children < 5 years demonstrated small to medium effects on behaviour change (ES range: 0.2–0.5). Effective interventions combined enjoyable practical activities (fitness activities, games and challenges), with behaviour change techniques (goal setting, and self-monitoring), were underpinned by a behaviour change theory, and were often of short duration (< 4 months) but intense (several sessions/week). Moderate to high statistical heterogeneity was observed for behaviour outcomes and risk of bias across studies was generally high. Conclusions: This review provides some evidence supporting the effectiveness of experiential learning interventions in improving physical activity outcomes in school-aged children. Additional evidence is needed in children <5 years old. Future experiential learning interventions need to strengthen the evidence with rigorous methodological quality and clear reporting of the experiential learning components. [ABSTRACT FROM AUTHOR]

Background: Opportunities for physical activity within out of school hours care (OSHC) are not well documented in Australia. This study explored factors associated with children (5–12 years) meeting 30 min of moderate to vigorous physical activity (MVPA) while attending OSHC in the afternoon period. Methods: A cross-sectional study, conducted in 89 OSHC services in New South Wales, Australia, serving 4,408 children. Each service was visited twice between 2018–2019. Physical activity promotion practices were captured via short interviews and System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN). Physical activity spaces was measured (m2) and physical activity of 3,614 child days (42% girls), were collected using Acti-Graph accelerometers. Association between program practices and children accumulation of MVPA was tested using mixed effects logistic regression, adjusted by OSHC service and child. Results: Twenty-six percent of children (n = 925) accumulated 30 min or more of MVPA. Factors associated with children reaching MVPA recommendations included: services scheduling greater amounts of child-led free play, both 30–59 min (OR 2.6, 95%CI 1.70, 3.98) and ≥ 60 min (OR 6.4, 95%CI 3.90, 10.49); opportunities for staff-led organised play of ≥ 30 min (OR 2.3, 95%CI 1.47, 3.83); and active games that engaged the majority of children (OR 1.7, 95%CI 1.11, 2.61). Children were less likely to meet MVPA recommendations if services played games with elimination components (OR 0.56, 95%CI 0.37, 0.86). Conclusion: Improvements to service-level physical activity promotion practices, specifically the type of physical activity scheduled and the structure of games, may be an effective strategy to increase MVPA of children attending OSHC afterschool in NSW, Australia. [ABSTRACT FROM AUTHOR]

In Australia, less than one quarter of children aged 5–12 years meet national physical activity (PA) guidelines. Before school care operates as part of Out of School Hours Care (OSHC) services and provide opportunities for children to meet their daily PA recommendations. The aim of this study was to explore factors associated with children meeting 15 min of moderate-to-vigorous-intensity physical activity (MVPA) while attending before school care. A cross-sectional study was conducted in 25 services in New South Wales, Australia. Each service was visited twice between March and June 2021. Staff behaviours and PA type and context were captured using staff interviews and the validated System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN) time sampling tool. Child PA data were collected using Actigraph accelerometers and associations between program practices and child MVPA analysed. PA data were analysed for 654 children who spent an average of 39.2% (±17.6) of their time sedentary; 45.4% (±11.4) in light PA; and 14.9% (±11.7) in MVPA. Only 17% of children (n = 112) reached ≥15 min MVPA, with boys more likely to achieve this. Children were more likely to meet this recommendation in services where staff promoted and engaged in PA; PA equipment was available; children were observed in child-led free play; and a written PA policy existed. Before school care should be supported to improve physical activity promotion practices by offering staff professional development and guidance on PA policy development and implementation practices. • Before school care can promote increased child physical activity. • Less than one in five children are sufficiently active while attending. • Children are more active when staff promote and participate in the activity. • Services may benefit from a physical activity policy and active equipment. • Staff professional development around physical activity is encouraged. [ABSTRACT FROM AUTHOR]