An exploratory randomised controlled trial of a public health nutrition intervention delivered in children's centres in Islington and Cornwall

• Published in: The Lancet (British edition) 2013-11, Vol.382 (S3), p.S100-S100
• Main Authors: Watt, Richard G, Prof, Hayter, Arabella, MA, Ohly, Heather, MSc, Pikhart, Hynek, PhD, Draper, Alizon, PhD, Crawley, Helen, PhD, McGlone, Pauline, PhD, Cooke, Lucy, PhD, Moore, Laurence, Prof, Pettinger, Claire, PhD, Rees, Gail
• Format: Article
• Language: English
• Subjects: beverages; ethics; Family size; food policy; Fruits; Internal Medicine; Intervention; Nutrition; nutritional intervention; parents; planning; preschool children; Public health; quantitative analysis; randomized clinical trials; recruitment; Research ethics; researchers; vegetable consumption; Vegetables
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(13)62525-8

Abstract Background The diets of preschool children are a cause for concern, with low intakes of fruit and vegetables and high intakes of sugary foods and drinks. A poor diet in early life can have a substantial effect on a child's immediate and longer term health and contributes to broader health inequalities. The aim of this study was to develop, implement, and assess a multifaceted nutrition intervention delivered in children's centres. Methods In line with MRC guidance for assessment of complex interventions, a mixed methods approach was used. Initially, a detailed developmental phase was undertaken with a combination of qualitative and quantitative methods to identify the nature and type of intervention needed. Detailed consideration was also given to the theoretical basis of the intervention. A multifaceted public health nutrition intervention programme was designed on the basis of the findings from the developmental phase of the study. An exploratory randomised controlled trial was done in children's centres in Islington and Cornwall to assess the newly developed intervention. 16 children's centres from both areas were randomised. Children's centres were randomly selected by the statistician from centres who expressed an interest in participating. In Cornwall, random selection was stratified by geographical location and deprivation to ensure representativeness. Participants attending intervention centres were invited to attend a 4-week nutrition programme. Staff at the intervention centres also received nutrition training and support in developing food policies. Participants attending the control centres received usual nutrition advice and support. Because of the nature of the intervention, neither the participants nor the researchers assessing the outcomes were masked to group assignment. The primary outcome was the child's daily fruit and vegetable consumption measured by weight consumed per day. Analysis was by intention to treat. A detailed process investigation was also undertaken to assess the acceptability and feasibility of the intervention and trial method. Full ethics approval was received from Camden and Islington Community Research Ethics Committee (REC 09/HO722/56). This trial is registered with ISRCTN, number CCT-NAPN-21453. Findings 394 families were recruited, 199 in the intervention group and 195 in the control group. At 6-month follow-up, 77% (n=304) of families were retained in the study. Mean number of children was 1·83 (SD 0·91)