Zoekresultaten

Effect and process evaluation of a preschool-based intervention to promote an early childhood education and care teacher-parent partnership about healthy behaviours in children: Study protocol for the cluster randomised controlled trial CO-HEALTHY

BackgroundEarly Childhood Education and Care (ECEC) teachers at urban preschools are potential key figures to promote healthy behaviours in disadvantaged young children and to engage parents in lifestyle-related topics. An ECEC teacher-parent partnership regarding healthy behaviours may support parents and stimulate their children’s development. However, it is not an easy task to establish such a collaboration and ECEC teachers need tools to communicate with parents about lifestyle-related topics. This paper describes the study protocol of a preschool-based intervention (CO-HEALTHY) to promote an ECEC teacher-parent partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children.MethodsA cluster randomised controlled trial will be performed at preschools in Amsterdam, the Netherlands. Preschools will be randomly allocated to an intervention or control group. The intervention consists of a toolkit with 10 parent-child activities and associated training for ECEC teachers. The activities were composed using the Intervention Mapping protocol. At intervention preschools, ECEC teachers will carry out the activities during standard contact moments. Parents will receive associated intervention materials and will be encouraged to perform similar parent-child activities at home. At control preschools, the toolkit and training will not be implemented. The primary outcome will be the teacher- and parent-reported partnership regarding healthy eating, physical (in)activity and sleeping behaviours in young children. The perceived partnership will be assessed by a questionnaire at baseline and at 6 months. In addition, short interviews with ECEC teachers will be held. Secondary outcomes include the knowledge, attitude, food- and activity-related practices of ECEC teachers and parents. Furthermore, children’s eating, physical (in)activity and sleeping behaviours, and weight development will be assessed. A process evaluation of the intervention will be made.DiscussionThe intervention aims to provide a practical tool for ECEC teachers at urban preschools to promote an ECEC teacher-parent partnership regarding a healthy lifestyle in young children.Trial registrationNetherlands Trial Register (NTR): NL8883. Date registered: September 8, 2020.

The effects of a preschool-based intervention for Early Childhood Education and Care teachers in promoting healthy eating and physical activity in young children: A cluster randomised controlled trial

The need for excess weight gain prevention in disadvantaged young children is widely recognised. Early Childhood Education and Care teachers are potential key actors in early interventions to prevent overweight and obesity. This study examines the effects of a preschool-based intervention for teachers in promoting healthy eating and physical activity in young children. A cluster randomised controlled trial was conducted at 41 preschools in a deprived area of Amsterdam, The Netherlands. The intervention consisted of 2 programmes that were applied in succession: A Healthy Start and PLAYgrounds for TODdlers. The study period was 9 months. Primary outcomes were assessed via questionnaires and included teachers’ knowledge, attitude, food/activity-related practices, and level of confidence in promoting healthy behaviours. Secondary outcomes in this study were teachers’ and children’s BMI (z-score), body composition, dietary intake and physical activity level. Intention-to-treat analyses were performed using linear mixed models. In total, 115 teachers and 249 children (mean age 3.0 (0.2) years) were included. A positive effect on teachers’ knowledge about the Dutch dietary guidelines was found after the programme A Healthy Start (difference = 1.38; 1-sided 95% CL = 0.29; p = 0.02). This effect was not sustained at 9 months (difference = 0.34; 1-sided 95% CL = -0.76; p = 0.31). The overall intervention had a positive effect on 3 of the 5 attitude statements regarding a healthy lifestyle (difference ranged from 0.34 to 0.55) and on the practice scale Activity-related-Modelling (difference = 0.16; 1-sided 95% CL = 0.06; p = 0.01). No intervention effects were observed on food-related practice scales and the level of confidence in promoting healthy behaviours. At this stage, no effects were seen on teachers’ and children’s BMI (z-score). This study contributes to the professional development of Early Childhood Education and Care teachers and addresses the call for interventions to prevent overweight/obesity and to minimise health inequalities in young children.

Training interaction skills of pre-service ECEC teachers

Effects of early childhood education training and video interaction guidance on teachers’ interactive skills

Research has demonstrated that teachers working in early childhood education and care (ECEC) are proficient in offering emotional support to young children, but markedly weaker when it comes to instructional support. We conducted a controlled experimental study in the Netherlands, to investigate the effects of targeted in-service training on improving teachers’ instructional support. Teachers (N = 72) were randomly assigned to four conditions: an intensive early childhood education (ECE) training (N = 17), video interaction guidance (VIG) (N = 16), a combination of both training programs (N = 18), or a control condition with no training (N = 21). Teachers’ interactive skills were measured pre- and postintervention, according the scales of the Caregiver Interaction Profile (CIP). The ECE training improved the proficiency of teachers’ verbal communication and offering developmental stimulation. VIG proved to be effective in teachers’ fostering positive peer interactions between children. Intensive and targeted training can successfully improve the quality of teachers’ instructional support in ECEC settings, although more research on effective elements of professional development of ECEC teachers is needed.

A realist synthesis of interprofessional collaborative practices in early intervention for children with speech, language and communication needs

BackgroundInterprofessional collaborative practices (IPCP) are considered to be a crucial factor in the optimal support of young children (3–6 years) with speech, language and communication needs (SLCN) in inclusive early childhood education and care (ECEC).AimsTo investigate IPCP in interventions using a collaborative approach for young children with SLCN in ECEC, by identifying mechanisms within IPCP and how these mechanisms relate to specific context factors and professional and child-related outcomes.MethodsA realist review of 22 empirical intervention studies, published between 1994 and 2019, was conducted to synthesise context-mechanism-outcome (CMO) configurations, combining context factors, IPCP mechanisms and outcomes at staff and child level.Main ContributionReciprocal IPCP mechanisms were reported together with interprofessional intervention practices, whereas one-directional IPCP mechanisms were restricted to gains in professional development. Our review further suggests that collective ownership of intervention goals, combined with personal cooperation and communication skills of staff, is vital for inclusive practices and functional communication of children with SLCN.ConclusionOur review has revealed indications for effective IPCP mechanisms, context factors at staff level, and positive outcomes for the professional development of staff working with children with SLCN. In addition, our findings support a link between IPCP and child-related outcomes regarding speech, language and communication development. Future studies should increase our insight into how practitioners, children and families profit from daily collaborative practices.WHAT THIS PAPER ADDSWhat is already known on this subjectInterventions using a collaborative approach for young children (3-6 years) with SLCN in ECEC are considered to be part of the optimal support of these children.What this paper adds to existing knowledgeConducting a realist review of 22 empirical studies on collaborative intervention offered the possibility to identify specific context factors, IPCP mechanisms and professional and child-related outcomes and to synthesise CMO configuations. Findings suggest multiple routes from effective delivery of SLCN services to improvement of speech, language and communication development, supporting the suggested beneficial function of collaboration between multiple professions. Collective ownership of intervention goals, combined with personal cooperation and communication skills of staff, seems to be vital for inclusive practices and functional communication of children with SLCN. Reciprocal IPCP mechanisms were reported together with interprofessional intervention practices, whereas one-directional IPCP mechanisms were restricted to gains in professional development.What are the potential or actual clinical implications of this work?High-quality collaborative intervention for children with SLCN in requires awareness of and critical reflection on IPCP mechanisms in order to improve outcomes for both professionals and children. Both, institutional structural support and individual communicative and cooperative skills are required to increase interprofessional collaboration with the aim to meet the needs of every individual child with SLCN.

Interprofessional collaborative practices for children with speech, language and communication needs in early childhood education and care: comparing Dutch and Norwegian perspectives

Interprofessional collaboration and practice (IPCP) is considered the cornerstone for effective service delivery for children with speech language and communication needs (SLCN). Following Stutsky and Spence Laschinger’s framework, we investigated IPCP-related differences between Dutch and Norwegian professionals in a cross-national comparative survey study. The personal relational skills of communication, trust and situational factor support structures were related to interprofessional collaboration in both countries. Trust was a stronger predictor for the Dutch sample than the Norwegian sample. A moderated moderation analysis revealed that the relationship between IPCP and perceived team effectiveness is moderated by trust for the Dutch professionals but not for their Norwegian colleagues. Trust may play a vital role for interprofessional teams in the Dutch context because service delivery is mainly characterised by the pull-out intervention of specialised professionals. In the integrated early intervention context of Norway, emphasis on professional communication skills seems a fruitful strategy to enhance the effectiveness of teams. Early intervention service delivery may be strengthened by structural facilitation and building networks to develop trust across professionals and organisations, which supports the development of professional competence relevant to IPCP in early intervention service delivery.