Heather OhlyRegistered Nutritionist

IntroductionIntroduction• Food Standards Agency funded (now DH)

• Exploratory and developmental trial of a family-centred nutrition intervention delivered in children’s centres

• Rural/urban settings – Cornwall and Islington

• Collaboration with UCL

Study designStudy design

Exploratory phaseExploratory phase• Consultations with parents and children’s

centre staff

• Focus groups (39 parents; 24 staff)

• Individual interviews (6 parents)

• Questionnaire surveys (261 parents; 31 centre managers)

Summary of findingsSummary of findings• Nutrition intervention is needed

• Short.....flexible.....community outreach

• Emphasis on practical skills – cooking, recipe ideas, food shopping, budgeting, overcoming fussy eating

• Staff capacity and training needs

Development phaseDevelopment phase• Literature review of nutrition interventions

targeting under fives (UK & Worldwide)

• Review of resources available

• Consultations with local steering groups in both locations

Cherry courseCherry course• Four week course (2 hours per week)

• Free crèche provided

• Parent and child involvement

• Interactive and practical sessions

• Recruited and trained of tutors (FL)

Overview of sessionsOverview of sessions• Week 1: Family friendly foods• Week 2: Introducing new foods• Week 3: Healthy snacks and drinks• Week 4: Healthy eating on a budget

• Food preparation and tasting each week

• Cherry at home

RCT study designRCT study design• Randomly selected children’s centres (16)

• Randomly allocated to intervention or control group (8 pairs)

• Pairs matched by location and deprivation

• Baseline and 6 month follow-up evaluations

Evaluation methodsEvaluation methods• Primary outcome: children’s consumption of

fruits and vegetables (24 hour recalls)

• Secondary outcome: children’s consumption of sugary drinks and snacks (24 hour recalls)

• Other dietary outcomes and parents’ knowledge, attitudes etc (questionnaire)

Sample characteristicsSample characteristics• Total 394 families recruited (Cornwall = 190)

• Children aged 18 months – five years

• Good retention rate to follow-up (77%)

• As many low income families as possible

• Matched groups

Positive feedbackPositive feedback‘Talking to other parents was great and realising I wasn’t the only one going through it’

‘To see the children getting involved was inspiring’

‘She’s eating tangerines and cucumber which she never did before. She even gets cross if I forget to buy them!’

Key resultsKey resultsChild’s diet

Actual values of difference at follow up

Difference in change between INT & CON

Intervention Control Whole sample

Fruit + Veg intake (g) 28.7 6.422.3

(-3.2, 47.8)

Fruit intake(g) 19.1 8.210.8

(-13.0, 34.6)

Veg intake (g) 9.6 -1.811.5

(0.1, 22.8)Fruit intake (excluding

>1 portion juice)37.5 27.8

9.6(-6.4, 25.7)

Sugary drinks (ml) -9.3 22.8-32.1

(-85.6, 21.4)Sugary snacks (#

occasions)-0.06 0.11

-0.17(-0.34, 0.01)

Process evaluationProcess evaluation• Engagement with staff was important

• Nutrition training important

• Group dynamics could be challenging

• Difficulty of applying RCT model

• Most and least useful components

Future contact detailsFuture contact detailsDr Gail Rees

Lecturer in Human Nutrition

Plymouth University

gail.rees@plymouth.ac.uk