Cited by 13Health Policy Implementation ScienceMobile Health and mHealth ApplicationsElectronic Health Records Systems

Barriers and Enablers to Adoption of Digital Health Interventions to Support the Implementation of Dietary Guidelines in Early Childhood Education and Care: Cross-Sectional Study

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Grady, Alice, Barnes, Courtney, Wolfenden, Luke, Lecathelinais, Christophe, Yoong, Sze Lin·2020·Journal of Medical Internet Research

Published version of a preprint

Abstract

Background: Few Australian childcare centers provide foods consistent with sector dietary guidelines. Digital health technologies are a promising medium to improve the implementation of evidence-based guidelines in the setting. Despite being widely accessible, the population-level impact of such technologies has been limited due to the lack of adoption by end users. Objective: This study aimed to assess in a national sample of Australian childcare centers (1) intentions to adopt digital health interventions to support the implementation of dietary guidelines, (2) reported barriers and enablers to the adoption of digital health interventions in the setting, and (3) barriers and enablers associated with high intentions to adopt digital health interventions. Methods: A cross-sectional telephone or online survey was undertaken with 407 childcare centers randomly sampled from a publicly available national register in 2018. Center intentions to adopt new digital health interventions to support dietary guideline implementation in the sector were assessed, in addition to perceived individual, organizational, and contextual factors that may influence adoption based on seven subdomains within the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) of health and care technologies framework. A multiple-variable linear model was used to identify factors associated with high intentions to adopt digital health interventions. Results: Findings indicate that 58.9% (229/389) of childcare centers have high intentions to adopt a digital health intervention to support guideline implementation. The changes needed in team interactions subdomain scored lowest, which is indicative of a potential barrier (mean 3.52, SD 1.30), with organization’s capacity to innovate scoring highest, which is indicative of a potential enabler (mean 5.25, SD 1.00). The two NASSS subdomains of ease of the adoption decision (P<.001) and identifying work and individuals involved in implementation (P=.001) were significantly associated with high intentions to adopt digital health interventions. Conclusions: A substantial proportion of Australian childcare centers have high intentions to adopt new digital health interventions to support dietary guideline implementation. Given evidence of the effectiveness of digital health interventions, these findings suggest that such an intervention may make an important contribution to improving public health nutrition in early childhood.

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  1. [12]WHO Guideline: Recommendations on Digital Interventions for Health System Strengthening 2019 2020-11-13 Geneva, Switzerland World Health Organization https://apps.who.int/iris/bitstream/handle/10665/311941/9789241550505-eng.pdf?ua=1 31162915
  2. [19]Plumb M Kautz K Barriers to the integration of information technology within early childhood education and care organisations: A review of the literature Proceedings of the Australasian Conference on Information Systems 2016 Australasian Conference on Information Systems November 30-December 4, 2015 Adelaide, Australia
  3. [30]Poissant L Curran J The development of a questionnaire to assess organizational readiness to adopt e-health technologies Proceedings of the Annual Canadian Association for Health Services and Policy Research (CAHSPR) Conference 2007 Annual Canadian Association for Health Services and Policy Research (CAHSPR) Conference June 2007 Toronto, ON Ottawa, ON Canadian Association for Health Services and Policy Research 33

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Authors
Grady, A., Barnes, C., Wolfenden, L., Lecathelinais, C., & Yoong, S. L.
Affiliations
  • Hunter Medical Research Institute (AU)
  • Hunter New England Local Health District (AU)
Corresponding author
Grady, Alice
Venue
Journal of Medical Internet Research
Published
2020-11-20
Volume
22
Issue
11
Pages
e22036
ISSN
1438-8871 (ISSN-L)
OpenAlex
W3104076316
Cited by
12
References
34
Citations by year
2025: 2 · 2024: 3 · 2023: 4 · 2021: 3
FWCI
1.83
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • NOVA (University of Newcastle Australia) (submittedVersion, cc-by)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
Keywords
digital health interventions, technology adoption, dietary guidelines, early childhood education and care, daycare centers, implementation barriers and facilitators, NASSS framework, adoption intention, public health nutrition
MeSH terms
Child, Child Day Care Centers, Child, Preschool, Cross-Sectional Studies, Female, Humans, Male, Surveys and Questionnaires, Telemedicine, Nutrition Policy

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