Abstract
Food and physical activity environments in family day care can be improved to better support healthy behaviors. A 6-month two-arm parallel randomized controlled trial evaluated the effectiveness of a web-based tool to promote healthier practices through quality improvement planning among Australian service providers and their educators. Service providers were randomized 1:1 into the intervention group (using the tool for a minimum of 1 month alongside regular quality improvement plan processes) and control group (regular quality improvement plan processes). The primary outcome of change in the quality of the improvement plan (in relation to the incorporation of healthy practices) was assessed using a checklist designed specifically for the study. Secondary outcomes were self-ratings of awareness and knowledge of various topics assessed using a 5-point Likert-type scale. Eight service providers and 22 educators participated (four service providers and 10 educators in the intervention group; four service providers and 12 educators in the control group). Intention-to-treat analyses found significant change in quality of the revised improvement plan for the intervention group. The intervention group showed an increase in self-rated awareness and knowledge on healthy practices and National Quality Standards, and confidence in identifying priority areas. This is the first-known web-based tool designed specifically for family day care to promote healthier practices. There are several opportunities for the tool to be embedded in practice, including delivery of the tool as part of support programs or training. This trial is registered with Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623000369628.