Alice Grady1, Kirsty Seward2, Meghan Finch3, Alison Fielding2, Fiona Stacey4, Jannah Jones4, Luke Wolfenden4, Sze Lin Yoong4. 1. School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter New England Local Health District, Population Health, New Lambton, New South Wales, Australia; Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, New South Wales, Australia. Electronic address: Alice.Grady@hnehealth.nsw.gov.au. 2. School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter New England Local Health District, Population Health, New Lambton, New South Wales, Australia. 3. School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter New England Local Health District, Population Health, New Lambton, New South Wales, Australia; Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia. 4. School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia; Hunter New England Local Health District, Population Health, New Lambton, New South Wales, Australia; Hunter Medical Research Institute, University of Newcastle, Newcastle, New South Wales, Australia; Priority Research Centre for Health Behaviour, University of Newcastle, Newcastle, New South Wales, Australia.
Abstract
OBJECTIVE: To identify perceived barriers and enablers to implementation of dietary guidelines reported by early childhood education center cooks, and barriers and enablers associated with greater implementation based on assessment of center menu compliance. DESIGN: Cross-sectional telephone interview. SETTING: Early childhood education centers, New South Wales, Australia. PARTICIPANTS: A total of 202 cooks responsible for menu planning; 70 centers provided a menu for review of compliance with dietary guidelines. MAIN OUTCOME MEASURE: Barriers and enablers to dietary guideline implementation were determined using a tool assessing constructs of the Theoretical Domains Framework (TDF). Higher scores (≥6) for each construct indicated enablers to guideline implementation; lower scores (<6) suggested barriers. ANALYSIS: Multivariable linear regression identified TDF constructs associated with greater guideline implementation. RESULTS: Scores were lowest for reinforcement (mean, 5.85) and goals (mean, 5.89) domains, and highest for beliefs about consequences (mean, 6.51) and social/professional role and identity (mean, 6.50). The skills domain was positively associated with greater implementation of guidelines based on menu review (P = .01). CONCLUSIONS AND IMPLICATIONS: Cooks perceived social/professional role and identity, and beliefs about consequences to be enablers to dietary guideline implementation; however, only the skills domain was associated with greater implementation. There are opportunities to target the incongruence in perceptions vs reality of the barriers and enablers to implementation. Future research could examine the utility of the TDF to identify barriers and enablers to implementation to inform intervention development and for evaluating interventions to examine intervention mechanisms.
OBJECTIVE: To identify perceived barriers and enablers to implementation of dietary guidelines reported by early childhood education center cooks, and barriers and enablers associated with greater implementation based on assessment of center menu compliance. DESIGN: Cross-sectional telephone interview. SETTING: Early childhood education centers, New South Wales, Australia. PARTICIPANTS: A total of 202 cooks responsible for menu planning; 70 centers provided a menu for review of compliance with dietary guidelines. MAIN OUTCOME MEASURE: Barriers and enablers to dietary guideline implementation were determined using a tool assessing constructs of the Theoretical Domains Framework (TDF). Higher scores (≥6) for each construct indicated enablers to guideline implementation; lower scores (<6) suggested barriers. ANALYSIS: Multivariable linear regression identified TDF constructs associated with greater guideline implementation. RESULTS: Scores were lowest for reinforcement (mean, 5.85) and goals (mean, 5.89) domains, and highest for beliefs about consequences (mean, 6.51) and social/professional role and identity (mean, 6.50). The skills domain was positively associated with greater implementation of guidelines based on menu review (P = .01). CONCLUSIONS AND IMPLICATIONS: Cooks perceived social/professional role and identity, and beliefs about consequences to be enablers to dietary guideline implementation; however, only the skills domain was associated with greater implementation. There are opportunities to target the incongruence in perceptions vs reality of the barriers and enablers to implementation. Future research could examine the utility of the TDF to identify barriers and enablers to implementation to inform intervention development and for evaluating interventions to examine intervention mechanisms.
Authors: Pippa McKelvie-Sebileau; Erica D'Souza; David Tipene-Leach; Boyd Swinburn; Sarah Gerritsen Journal: Int J Environ Res Public Health Date: 2022-04-13 Impact factor: 4.614
Authors: Alice Grady; Kirsty Seward; Meghan Finch; Luke Wolfenden; Rebecca Wyse; John Wiggers; Christophe Lecathelinais; Sze Lin Yoong Journal: Int J Environ Res Public Health Date: 2020-06-29 Impact factor: 3.390
Authors: Alice Grady; Luke Wolfenden; John Wiggers; Chris Rissel; Meghan Finch; Victoria Flood; David Salajan; Ruby O'Rourke; Fiona Stacey; Rebecca Wyse; Christophe Lecathelinais; Courtney Barnes; Sue Green; Vanessa Herrmann; Sze Lin Yoong Journal: J Med Internet Res Date: 2020-02-04 Impact factor: 5.428
Authors: Shabnam Kashef; Dorota Zarnowiecki; Victoria Brown; Jennifer C Arguelles; David N Cox; Rebecca K Golley Journal: BMJ Open Date: 2021-04-14 Impact factor: 2.692
Authors: Sze Lin Yoong; Alice Grady; John H Wiggers; Fiona G Stacey; Chris Rissel; Victoria Flood; Meghan Finch; Rebecca Wyse; Rachel Sutherland; David Salajan; Ruby O'Rourke; Christophe Lecathelinais; Courtney Barnes; Nicole Pond; Karen Gillham; Sue Green; Luke Wolfenden Journal: Am J Clin Nutr Date: 2020-04-01 Impact factor: 7.045
Authors: Alice Grady; Courtney Barnes; Luke Wolfenden; Christophe Lecathelinais; Sze Lin Yoong Journal: J Med Internet Res Date: 2020-11-20 Impact factor: 5.428