"First Bite": An intervention to increase children's vegetable consumption in Early Childhood Education and Care (ECEC) services in areas of high socioeconomic disadvantage - a cluster randomized controlled trial protocol.

Abstract

BackgroundOnly 2% of 4-8-year-old Australian children consume the daily recommended vegetable serves, with implications on the development of lifelong dietary behaviors. Evidence suggests that enhancing children's access, exposure and familiarity with vegetables can help increase their vegetable intake. Most children attend Early Childhood Education and Care (ECEC) services, which are well placed to increase vegetable consumption through curriculum change, play-based learning and parental education.AimWe aim to determine the efficacy of the 'First Bite-Get it Right' (First Bite) intervention to improve the vegetable intake of 3-5-year-old children in ECEC services compared to a control group.MethodThis 8-week cluster-randomized controlled trial involves ECEC services (n = 30) and children (n∼300) from socioeconomically disadvantaged areas in two local health districts in New South Wales, Australia and includes an intervention and wait-list control group. The First Bite program comprises: 1) Educator professional development; 2) Child daily "Veggie Break"; 3) Child experiential learning activities; and 4) Parent resources. Baseline and post-intervention measures include skin carotenoid scanning, vegetable serves plate waste, lunch box audits, child-reported vegetable preferences, and child parent-reported vegetable intake. Group-by-time interactions will be analyzed by linear mixed model regression, accounting for ECEC clustering.SummaryThis study will evaluate whether a comprehensive ECEC-based intervention can improve children's vegetable consumption in socioeconomically disadvantaged areas. The findings will inform recommendations for ECEC policies, educator training programs, and parent engagement strategies to promote healthy eating in early childhood.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN: 12624000249550 (Date: 14/03/2024). https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=387095.