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      A randomised controlled trial of an online menu planning intervention to improve childcare service adherence to dietary guidelines: a study protocol

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          Abstract

          Introduction

          The implementation of dietary guidelines in childcare settings is recommended to improve child public health nutrition. However, foods provided in childcare services are not consistent with guidelines. The primary aim of the trial is to assess the effectiveness of a web-based menu planning intervention in increasing the mean number of food groups on childcare service menus that comply with dietary guidelines regarding food provision to children in care.

          Methods and analysis

          A parallel group randomised controlled trial will be undertaken with 54 childcare services that provide food to children within New South Wales, Australia. Services will be randomised to a 12-month intervention or usual care. The experimental group will receive access to a web-based menu planning and decision support tool and online resources. To support uptake of the web program, services will be provided with training and follow-up support. The primary outcome will be the number of food groups, out of 6 (vegetables, fruit, breads and cereals, meat, dairy and ‘discretionary’), on the menu that meet dietary guidelines (Caring for Children) across a 1-week menu at 12-month follow-up, assessed via menu review by dietitians or nutritionists blinded to group allocation. A nested evaluation of child dietary intake in care and child body mass index will be undertaken in up to 35 randomly selected childcare services and up to 420 children aged approximately 3–6 years.

          Ethics and dissemination

          Ethical approval has been provided by Hunter New England and University of Newcastle Human Research Ethics Committees. This research will provide high-quality evidence regarding the impact of a web-based menu planning intervention in facilitating the translation of dietary guidelines into childcare services. Trial findings will be disseminated widely through national and international peer-reviewed publications and conference presentations.

          Trial registration

          Prospectively registered with Australian New Zealand Clinical Trial Registry (ANZCTR) ACTRN12616000974404.

          Related collections

          Most cited references39

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          The Lancet, 380(9859), 2224-2260
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            Effects of computerized clinical decision support systems on practitioner performance and patient outcomes: a systematic review.

            Developers of health care software have attributed improvements in patient care to these applications. As with any health care intervention, such claims require confirmation in clinical trials. To review controlled trials assessing the effects of computerized clinical decision support systems (CDSSs) and to identify study characteristics predicting benefit. We updated our earlier reviews by searching the MEDLINE, EMBASE, Cochrane Library, Inspec, and ISI databases and consulting reference lists through September 2004. Authors of 64 primary studies confirmed data or provided additional information. We included randomized and nonrandomized controlled trials that evaluated the effect of a CDSS compared with care provided without a CDSS on practitioner performance or patient outcomes. Teams of 2 reviewers independently abstracted data on methods, setting, CDSS and patient characteristics, and outcomes. One hundred studies met our inclusion criteria. The number and methodologic quality of studies improved over time. The CDSS improved practitioner performance in 62 (64%) of the 97 studies assessing this outcome, including 4 (40%) of 10 diagnostic systems, 16 (76%) of 21 reminder systems, 23 (62%) of 37 disease management systems, and 19 (66%) of 29 drug-dosing or prescribing systems. Fifty-two trials assessed 1 or more patient outcomes, of which 7 trials (13%) reported improvements. Improved practitioner performance was associated with CDSSs that automatically prompted users compared with requiring users to activate the system (success in 73% of trials vs 47%; P = .02) and studies in which the authors also developed the CDSS software compared with studies in which the authors were not the developers (74% success vs 28%; respectively, P = .001). Many CDSSs improve practitioner performance. To date, the effects on patient outcomes remain understudied and, when studied, inconsistent.
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              Childhood obesity: public-health crisis, common sense cure

              The Lancet, 360(9331), 473-482
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2017
                11 September 2017
                : 7
                : 9
                : e017498
                Affiliations
                [1 ]departmentSchool of Medicine and Public Health , University of Newcastle , Callaghan, Australia
                [2 ]Hunter New England Local Health District, Population Health , Wallsend, Australia
                [3 ]Hunter Medical Research Institute , New Lambton Heights, Australia
                [4 ]departmentPriority Research Centre for Health Behaviour , University of Newcastle , Callaghan, Australia
                [5 ]departmentWestmead Hospital , Western Sydney Local Health District , Westmead, Australia
                [6 ]departmentFaculty of Health Sciences and Charles Perkins Centre , The University of Sydney , Sydney, Australia
                [7 ]The University of Sydney, School of Public Health , Camperdown, Australia
                [8 ]departmentNSW Office of Preventive Health , South Western Sydney Local Health District , Liverpool, Australia
                [9 ]Healthy Australia Ltd, St Kilda South , Victoria, Australia
                Author notes
                [Correspondence to ] Dr Alice Grady; alice.grady@ 123456hnehealth.nsw.gov.au
                Article
                bmjopen-2017-017498
                10.1136/bmjopen-2017-017498
                5595182
                28893755
                b2070dd5-50dd-42f3-a50d-18023218f5e2
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 27 April 2017
                : 04 July 2017
                : 27 July 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;
                Categories
                Nutrition and Metabolism
                Protocol
                1506
                1714
                Custom metadata
                unlocked

                Medicine
                child care,child preschool,menu planning,nutrition policy,practice guidelines,randomized controlled trial,online systems

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