Food provision and healthy eating environments in before school care: an observational study.

Abstract

Objective: Australian children fall short of national dietary guidelines with only 63% consuming adequate fruit and 10% enough vegetables. Before school care operates as part of Out of School Hours Care (OSHC) services and provides opportunities to address poor dietary habits in children. The aim of this study was to describe the food and beverages provided in before school care and to explore how service-level factors influence food provision.

Design: A cross-sectional study was conducted in OSHC services. Services had their before school care visited twice between March and June 2021. Direct observation was used to capture food and beverage provision, and child and staff behaviour during breakfast. Interviews with staff collected information on service characteristics. Foods were categorised using the Australian Dietary Guidelines, and frequencies calculated. Fishers Exact Test was used to compare food provision with service characteristics.

Setting: The before school care of OSHC services in New South Wales, Australia.

Participants: 25 OSHC services.

Results: Fruit was provided on 22% (n=11) of days and vegetables on 12% (n=6). Services with nutrition policies containing specific language on food provision (i.e. measurable) were more likely to provide fruit compared to those with policies using non-specific language (p = 0.027). Services that reported receiving training in healthy eating provided more vegetables than those who had not received training (p = 0.037).

Conclusions: Before school care can be supported to improve food provision through staff professional development and advocating regulatory bodies for increased specificity requirements in the nutrition policies of service providers.