Document Type

Theses, Ph.D


Available under a Creative Commons Attribution Non-Commercial Share Alike 4.0 International Licence

Publication Details

Thesis submitted for the awrd of Doctor of Philosophy to Technological University Dublin, February 2013.


While many children are now cared for outside the home, inadequate nutrition and physical activity practices in pre-schools have been reported. This study aimed to develop a validated nutrition and health related evaluation tool and an education information resource for pre-schools, and determine whether their use can promote improved food service and nutrition and physical activity practices in this setting. Following a pilot phase undertaken in Co. Wicklow (n 12), pre-schools providing a full day care service in the Midland Area of Ireland were invited to participate in the study (n, 100). Direct observation was used to collect data (food and fluid provision; physical activity; outdoor time; staff practices and availability of nutrition and health resources) in each pre-school during one full day both prior to, and 6-9 months following the training period, using the specifically developed data collection tool, the Pre-school Health Promotion Activity Scored Evaluation Form. Post-intervention, self-assessment data were also collected using the same evaluation tool. All foods offered were recorded using household measures, and a photographic food atlas developed specifically for this project. A Delphi investigation was undertaken to identify pre-schools’ most favoured incentives for project inclusion. Of 76 services that registered interest in participating, pre-intervention data were collected in 58 facilities. Pre-schools were randomised into 2 training intervention groups: a ‘manager only trained’ group (n, 27); and a ‘staff and manager trained’ group (n, 18). Pre-intervention, poor nutrition and health practices were observed. Significant improvement (P< 0.05) in nutrition and health related practice was observed within both intervention delivery groups in all areas evaluated; training of staff had no significant impact on overall practice. Scores assigned by direct independent observation were lower than pre-school self-assessment scores. Grant aid for food and physical activity, and project participation recognition, were the incentives most favoured by pre-schools. This intervention was the first in Irish pre-schools to demonstrate that Pre-school Health Promotion Activity Scored Evaluation Form use supported by education improved practice with no significant additional effect of staff education.