Childcare service centers' preferences and intentions to use a web-based program to implement healthy eating and physical activity policies and practices: a cross-sectional study.
BACKGROUND
Overweight and obesity is a significant public health problem that impacts a large number of children globally. Supporting childcare centers to deliver healthy eating and physical activity-promoting policies and practices is a recommended strategy for obesity prevention, given that such services provide access to a substantial proportion of children during a key developmental period. Electronic Web-based interventions represent a novel way to support childcare service providers to implement such policies and practices.


OBJECTIVE
This study aimed to assess: (1) childcare centers' current use of technology, (2) factors associated with intention to use electronic Web-based interventions, and (3) Web-based features that managers rated as useful to support staff with implementing healthy eating and physical activity-promoting policies and practices.


METHODS
A computer-assisted telephone interview (CATI) was conducted with service managers from long day care centers and preschools. The CATI assessed the following: (1) childcare center characteristics, (2) childcare centers' use of electronic devices, (3) intention to use a hypothetical electronic Web-based program-assessed using the Technology Acceptance Model (TAM) with ratings between 1 (strongly disagree) and 7 (strongly agree), and (4) features rated as useful to include in a Web-based program.


RESULTS
Overall, 214 service centers out of 277 (77.3%) consented to participate. All service centers except 2 reported using computers (212/214, 99.1%), whereas 40.2% (86/214) used portable tablets. A total of 71.9% (151/210) of childcare service managers reported a score of 6 or more for intention to use a hypothetical electronic Web-based program. In a multivariable logistic regression analysis, intention to use the program was significantly associated with perceived ease of use (P=.002, odds ratio [OR] 3.9, 95% CI 1.6-9.2) and perceived usefulness (P<.001, OR 28,95% CI 8.0-95.2). Features reported by service managers as useful or very useful for a Web-based program included decision-support tools to support staff with menu planning (117/129, 90.7%), links to relevant resources (212/212, 100%), updated information on guidelines (208/212, 98.1%), and feedback regarding childcare center performance in relation to other childcare centers (212/212, 100%).


CONCLUSIONS
Childcare service managers reported high intention to use a Web-based program and identified several useful features to support staff to implement healthy eating and physical activity policies and practices. Further descriptive and intervention research examining the development and use of such a program to support childcare centers with the implementation of healthy eating and physical activity-promoting policies and practices is warranted.
Hunter New England Local Health District, Hunter New England Population Health, Wallsend, Australia. serene.yoong@hnehealth.nsw.gov.au.
Sze Lin
http://orcid.org/0000-0002-0836-017X
SL
Yoong
Christopher Michael
http://orcid.org/0000-0001-8896-0978
CM
Williams
Meghan
http://orcid.org/0000-0002-9828-7868
M
Finch
Rebecca
http://orcid.org/0000-0002-4872-2112
R
Wyse
Jannah
http://orcid.org/0000-0002-9843-352X
J
Jones
Megan
http://orcid.org/0000-0002-6231-0536
M
Freund
John Henry
http://orcid.org/0000-0001-6361-9685
JH
Wiggers
Nicole
http://orcid.org/0000-0002-7726-1714
N
Nathan
Pennie
http://orcid.org/0000-0002-8285-627X
P
Dodds
Luke
http://orcid.org/0000-0002-6178-3868
L
Wolfenden
D002656:Child Day Care Centers / Q000458:organization & administration*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D033182:Intention; D020407:Internet; D008297:Male; D009043:Motor Activity; D009517:New South Wales; D018673:Nutrition Policy; D009765:Obesity / Q000517:prevention & control*; D016134:Organizational Policy; D050177:Overweight / Q000517:prevention & control; D011634:Public Health
childcare centers; guideline adherence; long day care centers; obesity