Assessing the scalability of evidence-based healthy eating and physical activity interventions in early childhood education and care: A cross-sectional study of end-user perspectives

Objectives: To describe early childhood education and care (ECEC) services: i) perceptions regarding the scalability of healthy eating and physical activity interventions; and ii) associations between scalability and service characteristics. Methods: A cross-sectional survey was conducted with a randomly selected sample of ECEC services across Australia. The scalability of 12 healthy eating and physical activity interventions was assessed using items based on the Intervention Scalability Assessment Tool. Higher scores represented higher perceived scalability. Results: From 453 participants, the highest scoring healthy eating and physical activity interventions were 'providing healthy eating education and activities for children' (M43.05) (out of 50) and 'providing sufficient opportunities for child physical activity' (M41.43). The lowest scoring was 'providing families with lunchbox guidelines' (M38.99) and 'engaging families in activities to increase child physical activity' (M38.36). Services located in rural areas, compared to urban areas, scored the overall scalability of both healthy eating and physical activity interventions significantly lower. Conclusions: Perceptions regarding the scalability of healthy eating and physical activity interventions in the ECEC setting vary according to service characteristics. Implications for public health: Findings identify where government investment and implementation efforts may be prioritised to facilitate scale-up. An investigation into the barriers and support required for lower-scoring interventions is warranted.