title: Obesity prevention in the family day care setting: impact of the Romp & Chomp intervention on opportunities for children's physical activity and healthy eating.
abstract: BACKGROUND
  The Romp & Chomp intervention reduced the prevalence of overweight/obesity in pre-school children in Geelong, Victoria, Australia through an intervention promoting healthy eating and active play in early childhood settings. This study aims to determine if the intervention successfully created more health promoting family day care (FDC) environments.
  
  
  METHODS
  The evaluation had a cross-sectional, quasi-experimental design with the intervention FDC service in Geelong and a comparison sample from 17 FDC services across Victoria. A 45-item questionnaire capturing nutrition- and physical activity-related aspects of the policy, socio-cultural and physical environments of the FDC service was completed by FDC care providers (in 2008) in the intervention (n= 28) and comparison (n= 223) samples.
  
  
  RESULTS
  Select results showed intervention children spent less time in screen-based activities (P= 0.03), organized active play (P < 0.001) and free inside play (P= 0.03) than comparison children. There were more rules related to healthy eating (P < 0.001), more care provider practices that supported children's positive meal experiences (P < 0.001), fewer unhealthy food items allowed (P= 0.05), higher odds of staff being trained in nutrition (P= 0.04) and physical activity (P < 0.001), lower odds of having set minimum times for outside (P < 0.001) and organized (P= 0.01) active play, and of rewarding children with food (P < 0.001).
  
  
  CONCLUSIONS
  Romp & Chomp improved the FDC service to one that discourages sedentary behaviours and promotes opportunities for children to eat nutritious foods. Ongoing investment to increase children's physical activity within the setting and improving the capacity and health literacy of care providers is required to extend and sustain the improvements.
authors.affiliation: WHO Collaborating Centre for Obesity Prevention, Deakin University and McCaughey Centre and Melbourne School of Population Health, The University of Melbourne, Melbourne, Vic. Australia. andreams@unimelb.edu.au
authors.forename: A
authors.initials: A
authors.lastname: de Silva-Sanigorski
authors.forename: D
authors.initials: D
authors.lastname: Elea
authors.forename: C
authors.initials: C
authors.lastname: Bell
authors.forename: P
authors.initials: P
authors.lastname: Kremer
authors.forename: L
authors.initials: L
authors.lastname: Carpenter
authors.forename: M
authors.initials: M
authors.lastname: Nichols
authors.forename: M
authors.initials: M
authors.lastname: Smith
authors.forename: S
authors.initials: S
authors.lastname: Sharp
authors.forename: R
authors.initials: R
authors.lastname: Boak
authors.forename: B
authors.initials: B
authors.lastname: Swinburn
mesh_terms: D001315:Australia; D057191:Capacity Building; D002654:Child Care; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D015397:Program Evaluation; D012931:Social Environment; D014739:Victoria