Enhancing healthy eating and active environments in early learning settings: findings from the eHealth study

Introduction Early childhood educators are important influencers of children's eating and activity behaviors, making them key targets for interventions aimed at improving nutrition and physical activity practices and fostering healthier childcare environments.Objective To evaluate the impact of the eHealth professional development program in improving early childhood education and care (ECEC) nutrition and physical activity environments, educators' nutrition knowledge, attitudes, and behaviors, and educators' perceptions of program acceptability.Method This study was conducted in licensed ECEC centers in one Canadian province. The study used a two-armed quasi-experimental pre-test/post-test design with intervention and control groups and repeated measures to evaluate a 10-month eHealth program informed by Social Cognitive Theory and the Interconnected Model of Professional Growth Theory. The program aimed to enhance educators' capacity to implement evidence-based nutrition and physical activity practices. Delivered in annual cohorts from 2019 to 2021, it comprised two phases: (1) a 12-week series of online educational modules with accompanying virtual Communities of Practice meetings, and (2) a five-month follow-up period involving monthly implementation-coaching virtual Communities of Practice meetings. Validated questionnaires assessed center-level and educator-level outcomes at baseline, five (midpoint), and 10 months (end-of-program). Semi-structured interviews explored perceptions of program acceptability.Results Compared with controls, significant improvements in center-level nutrition and physical activity environments (mean change 0.362, p = 0.002, Cohen's d = 0.72), and educator nutrition knowledge, attitudes, and behaviors (mean change 5.467, p = 0.023, Cohen's d = 0.69) were observed at midpoint and maintained at the end-of-program. Qualitative findings indicated high acceptability, with educators describing the program as relevant, feasible, and supportive of integrating practices into daily routines.Conclusion The eHealth professional development program was acceptable and associated with improvements in educators' knowledge and adherence to nutrition and physical activity practice guidelines, with sustained effect over time. Scalable, digitally delivered professional development may offer a promising strategy to support healthier ECEC environments.