Supporting responsive feeding in early childhood education centres: a process evaluation of the CELEBRATE feeding...

Early childhood education centres are key settings for fostering self-regulation skills related to food through responsive feeding environments. The CELEBRATE Feeding coaching intervention aimed to support early childhood educators in implementing these practices across eight centres in two Canadian provinces. Using the RE-AIM framework, quantitative and qualitative data from coaching logs, pre- and post-intervention surveys, observations, interviews, and a 6-month post-intervention survey were analysed as part of the process evaluation. The intervention reached a diverse range of educators and children, resulting in improvements in responsive feeding behaviours, with observation scores significantly increasing (38.2-45.8 on a 63-point scale, P < .001) from baseline to post-intervention. Interviewed centre staff (n = 37) reported engaging more frequently in responsive feeding practices and observed positive changes in children's food intake and independence. Most surveyed educators (>90%) found the 6-month duration and monthly visits appropriate, with strong support from their coach. Educators valued expert guidance and practical resources and felt motivated and capable in adopting responsive feeding practices. Challenges included communication, scheduling barriers, and educator turnover. Follow-up data indicated that all centres continued key practices, though some barriers remained. Overall, the intervention had a positive impact, though addressing logistical barriers is crucial for long-term sustainability.