Barriers and enablers to menu planning guideline implementation in Australian childcare centres and the role of government support services

Objective: To explore government support service access, perceived barriers/enablers to menu planning, and menu compliance in Long Day Care (LDC) centres in Victoria, Australia where the Victorian government-funded Healthy Eating Advisory Service (HEAS) is available to provide free LDC menu planning support. Design: Cross-sectional study design. Data collected from online surveys with the option of uploading 2-weeks of menus and recipes. Menu compliance was scored for quantity, quality, and variety. Barriers/enablers to menu planning guideline implementation were determined using the Theoretical Domains Framework (TDF). Independent T-tests, one-way ANOVA and Chi-square tests assessed relationships between characteristics, barriers/enablers, and menu scores. Setting: Eighty-nine LDC centres that prepares food onsite. Participants: LDC staff responsible for menu planning (n=89) and menus from 18 centres. Results: Fifty-five percent of centres had accessed HEAS. Of 18 provided menus, only one menu was compliant with menu planning guidelines. HEAS access was associated with higher average scores in 4 of 7 TDF domains, namely knowledge/awareness, skills/role, reinforcement/influence, and optimism/intent. There were no correlations between menu score and barriers/enablers, however menu quality scores were higher for those accessing HEAS. Conclusions: Childcare-specific government support services may be an important public health nutrition strategy and may improve menu planning guideline implementation as well as menu quality, however this does not necessarily translate into menu compliance. Research should confirm these findings in larger studies to ascertain uptake of these services. Public health efforts should focus on exploring barriers and enablers to uptake of government support services to increase reach and acceptability.