An Experiential Learning Program to Promote Healthy Eating and Physical Activity at an Australian Children’s Museum: Formative Research with Caregivers and Staff

ABSTRACT

Background

Healthy eating (HE) and physical activity (PA) are essential for children’s health and well-being. Innovative approaches, informed by formative research, are crucial to promoting these behaviors. Experiential learning, involving active, hands-on approaches, may be an effective way to encourage healthy behaviors in children. Children’s museums could contribute to health education by providing a variety of educational opportunities.

Purpose

To inform the design of an experiential learning Healthy Living program for children at an Australian children’s museum.

Methods

A qualitative study involving focus group discussions with 23 caregivers and in-depth interviews with 6 staff were conducted to explore perceptions of caregivers and staff working in an Australian children’s museum (Discovery Space) relating to potentially effective experiential learning strategies for promoting children’s healthy behaviors. Data were transcribed verbatim and thematically analyzed in NVivo 12.

Results

Key considerations for promoting HE and PA children through experiential learning activities include involving caregivers, engaging children through processes such as providing choice and stimulating curiosity, and selecting appropriate activity types such as simple, engaging, fun, hands-on, sensory play, and music-based activities.

Translation to Health Education Practice

Experiential learning activities that address these key considerations can promote HE and PA in children and should be studied in future studies. Competencies and sub-competencies in two areas of responsibility, (I) Assessment of Needs and Capacity and (V) Advocacy, were addressed.

Background

Promoting healthy eating and physical activity among children is important to begin the establishment of long-term healthy habits.¹ Early childhood and childhood are pivotal periods for the promotion of these behaviors.^2,3 A multitude of lifestyle interventions aiming to promote healthy eating and physical activity among children has been implemented and evaluated.^4–6 These interventions comprise different approaches and have been delivered in different settings, particularly formal educational settings such as schools or early childhood education and care centers. A novel setting that has received less attention for health promotion is children’s museums. Children’s museums are characterized as “user-friendly, interactive, hands-on, attractive, non-threatening and stimulating places designed and developed for children.”⁷

Children’s museums afford unique opportunities for children and their caregivers to participate in play-based experiential learning activities and explore key concepts through facilitated experiences.⁸ Furthermore, children’s museums, in particular, can play a role in health education by providing educational opportunities for visitors, such as through exhibits and educational programs, to increase awareness and promote healthy behaviors in children.⁹ Additionally, museums can form partnerships with research institutions to develop health education initiatives and programs to promote health literacy and encourage healthy behaviors that could contribute to improved health and well-being for their visitors¹⁰

Experiential learning theory posits that children learn through exposure to new concepts and by processing their cognitive and emotional experiences.¹¹ Children play a central role in experiential learning activities, engaging with and exploring specific phenomena. Such activities go beyond the provision of information or instructions and intentionally involve children’s input and encourage children to be creative, problem solve and reflective.¹² The engaging and interactive nature of experiential learning is a potentially effective approach for promoting healthy eating and physical activity among children.¹³

Two recent systematic literature reviews on healthy eating and physical activity experiential learning interventions with children aged birth to 12 years demonstrated that healthy eating and physical activity-related knowledge, attitudes and behaviors can be improved using experiential learning approaches.^14,15 These reviews highlighted many potentially effective experiential learning activities, such as taste testing, cooking, gardening, sensory evaluation of foods and enjoyable practical physical activities (e.g., fitness activities, games and challenges. A few studies showed large effect sizes for improving children’s healthy eating and physical activity knowledge, attitudes and behaviors.^16,17 Most experiential learning interventions have been implemented in school settings among primary school-aged children. It is important to explore additional experiential intervention options that target younger children (i.e., less than 5 years) and opportunities outside of formal school settings, which can concurrently engage caregivers. Programs of this nature (promoting healthy eating and physical activity) at children’s museums can create awareness about healthy habits among children and their families. Healthy habits such as the consumption of healthy foods and being physically active can eventually lead to maintaining good health and prevent chronic conditions such as obesity, diabetes, heart disease, and hypertension. The Early Start Discovery Space (hereafter referred to as the “Discovery Space”) at the University of Wollongong, Australia, is a children’s museum that provides a play-based experiential learning environment for children aged from birth to 10 years and their caregivers. On average, around 2,000 members visit Discovery Space each week (weekdays = 1312, weekends = 712), with the average age of children of 3–5 years. Discovery Space has a range of unique experiences/exhibits and resources that are ideal for promoting healthy eating and physical activity among children through play. These include a play marketplace, which is a grocery store-like exhibit where children fill their shopping trollies with food models of groceries that they would like to “buy.” In the play café, children choose to prepare meals using food models, including sandwich ingredients (e.g., tomato, lettuce etc.) and pizza toppings. A circle garden includes climbing structures, hidden garden pathways, and sand pits to inspire children toward active play, agility, and balance. Other facilities include an arts and crafts space, a storybook reading nook and an outdoor play space. The Discovery Space has also constructed a few monthly activity themes based on fairy tales, animals, houses and homes, textiles and fabrics, dinosaurs and Antarctica.¹⁸

The Discovery Space, with its large number of preschool-aged visitors and carers and relevant existing experiences that could be adapted, was identified as a setting in which to trial an experiential learning intervention to promote healthy eating and physical activity. In the development of such a program, it was necessary to obtain insights from the Discovery Space staff (educators and manager) and users/visitors on the topics to be addressed, the activities to be included and the available resources. The effectiveness of interventions may be enhanced when formative research is undertaken to inform intervention design.¹⁹ Establishing relationships with intervention stakeholders, such as caregivers and staff, can also enhance intervention effectiveness and sustainability.²⁰

Purpose

The purpose of this qualitative study was to explore the perceptions of caregivers (visitors) and staff (educators and the manager) at a children’s museum (Discovery Space) on key components of a healthy eating and physical activity experiential learning children’s program. Children’s museums can be excellent perfect environments for promoting healthy lifestyles in children, particularly because children’s engagement and exploration can be guided by their caregivers.

Methods

Study design

This qualitative study was part of a larger study that explored the feasibility and acceptability of an experiential learning healthy eating and physical activity promotion program implemented in a children’s museum. A qualitative case study design (focus group discussions and in-depth interviews) was used to collect rich data to understand caregivers’ and staff’s perceptions and to inform the design and development of the experiential learning intervention.

Participants and recruitment

Focus group participants were caregivers of children aged 3–10 years. Participants were eligible if they: (1) were a carer for at least one child aged 3–10 years; (2) were a member of the Discovery Space and had visited the space within the last year, and (3) spoke English. Participants were recruited through Discovery Space member e-mails and flyers in the venue. Participants were provided with a participant information sheet and consent forms and all participants provided digital consent beforehand. Semi-structured interviews were conducted with staff from Discovery Space, including the Manager of Education & Experience and coordinators who delivered programs in Discovery Space. All staff provided informed written consent before the interviews.

Data collection procedure

The study was approved by the University of Wollongong Human Research Ethics Committee (Reference No 2019/290). Data was collected in September and October 2019. Focus groups with parents/caregivers were conducted by two moderators (SV and TA) using a discussion guide with open-ended questions and probes. Groups were conducted in a meeting room adjacent to Discovery Space, lasted approximately 60 minutes and were audio recorded. Parents/caregivers were offered light refreshments during the sessions and childcare support as needed. The in-depth interviews with staff were conducted by SV, face-to-face at the University of Wollongong using a semi-structured interview guide. Each interview lasted approximately 60 minutes and was audio recorded.

The focus group discussion guide was developed using guidelines outlined by (Krueger and Casey²¹ and a review of relevant literature on the topic of healthy eating and physical activity for children.²² Subject matter experts in the field of nutrition and physical activity were consulted to gather input on the types of questions and topics that would be most useful in eliciting information from participants. A preliminary version of the focus group discussion guide was then developed, which was tested with a small group of caregivers to ensure that the questions were clear and effective in eliciting the desired information. The guide was revised, based on feedback from the pilot test and finalized for use in the focus group discussions. The topic areas for caregivers FDG were (1) the positive ideas/strategies for encouraging healthy eating and physical activity in children and (2) suggestions for potentially successful and engaging activities for children. The final FDG guide consisted of 10 open-ended questions designed to explore (1) caregiver’s perceptions of healthy eating and physical activity in children, 2) positive ideas and strategies for encouraging healthy eating and physical activity in children, and (3) suggestions for activities to encourage healthy eating at the Discovery Space.

The topic areas for the staff interview guide comprised components of effective and engaging experiential learning activities, resources needed for such activities, and the operational and logistical aspects related to the implementation of activities in the Discovery Space. The final in-depth interview guide consisted of 10 open-ended questions designed to explore the perceptions of staff on (1) the current most engaging exhibits for children in the children’s museum (Discovery Space), (2) guidelines used when developing activities at exhibits, (3) suggestions for potential integration of healthy eating and physical activity themed activities, (4) opportunities and potential challenges, and (5) facilities and resources for potential integration of a healthy living (health promotion) program at a children’s museum (Discovery Space). Data from the parent’s focus group were collected until saturation was reached.²³

Data analysis

All audio recordings were transcribed verbatim. The transcripts were transferred to NVivo 12 software²⁴ and analyzed using thematic analysis. Each participant was assigned a unique ID based on their group number and identity (for example FG1P1: Focus Group 1 Parent 1; S1: Staff). An iterative process of coding data was conducted to identify the main codes and themes.^25,26 Following coding by the first author, two independent reviewers (SDV and RAJ) read the data multiple times and recorded their initial thoughts and ideas. Subsequently, the researchers reviewed the codes independently, looking for relationships, connections, and patterns to group them into potential themes. Both researchers then created their own sub-themes, and themes and met to discuss and corroborate findings. Together, the researchers refined the themes and subthemes and arrived at a consensus for their respective labels. Final themes and sub-themes were jointly created and agreed upon by two other authors (DPC and BK). Lastly, the researchers selected relevant quotes from the parent’s and staff’s open-ended responses that best illustrated the identified themes and subthemes. These quotes were integrated throughout this paper to aid in the explanation and description of themes and subthemes.

Results

Participants comprised 23 caregivers (22 mothers and 1 father) and six staff members. The average age of the caregivers was 35 years (34.3–35.5 years) years and on average participants had two children with a mean age of 3.9 years across the sample. The staff were all permanent staff at Discovery Space. Three main themes were identified from the focus groups and interviews: (1) Involvement of caregivers; (2) Engagement of children; and (3) Components of engaging activities. Table 1 shows the key themes and the sub-themes.

Table 1. Themes and sub-themes from focus groups and interviews involving caregivers and staff.

Theme	Sub-themes
Involvement of caregivers	Role modeling
	Caregiver presence
Engagement of children	Choice and autonomy
	Curiosity
	Involvement
Type of activities	Simple and fun activities
	Sensory play activities
	Hands-on activities
	Music-based activities

Theme 1 – involvement of caregivers

Role modeling

Both caregivers and staff suggested that the caregiver’s involvement was important for children to engage in experiential learning activities related to healthy eating and physical activity. Several parents suggested that their excitement about healthy foods directly influenced their children’s excitement about healthy foods. For example, one parent mentioned that if they “genuinely get excited about eating salads, they [their children] see that and eat them too” (FG 3, P2), and are more inclined to try the same types of foods. Likewise, parents suggested that if they were involved in physical activities, then their children were more likely to be involved. Some parents mentioned their children only played when their parents played with them. One parent specifically mentioned this regarding bike riding: “My children are more likely to ride their bike if we ride our bike” (FG 2, P4).

Caregiver presence

Staff suggested that if parents were present (and ideally involved) in activities at Discovery Space, children would have more confidence to participate and engage. One staff summed this up by commenting

Experiences that get children to work together with their adult or their carers are very important – using that collaboration. That’s always very important because children learn more when, especially in our space, they are more engaged when they’re working alongside their adult so that helps (S4).

The staff mentioned three specific examples within Discovery Space where they had noted this. This first was with craft activities. Craft activities are provided regularly throughout the day at Discovery Space and usually involve children sitting at a table and participating in an age-appropriate art activity (which is usually focused on a monthly theme). Staff noted that if caregivers were present during the art activities (i.e., sitting next to their child or close by), then children were more involved in the activity and stayed for the duration of the art session.

Another example where caregivers’ presence was important was in the play Café Experience In this activity, children have the option of being a waiter or waitress taking orders from customers (i.e., caregivers). Staff suggested that children were more engaged if their parents pretended to be the customer and placed the orders at the café. Staff suggested that the activities were

“Effective … when the parents [got] involved [as] the shopkeeper or ordered food at the café” and when “all of the family got to participate as well” (S1). Finally, staff mentioned the importance of parents being present during story time. Staff suggested that children were more interested in stories when parents sat together with their children during the reading. This was supported by statements such as “Storytime is something that I think parents come to sit down with their children and relax a little bit and both parents and kids enjoy it” (S3).

Theme 2 – engagement of children

Choice and autonomy

Caregivers consistently suggested that children’s choice and autonomy were particularly important to encourage children to participate in healthy eating. Caregivers suggested different ways to increase children’s choice and autonomy, however, the main suggestion was allowing children to choose and serve their own food. Caregivers suggested that letting their children choose and serve their own food encouraged a sense of confidence and autonomy which in turn helped them experience new foods. This was supported by several comments from parents such as:

If they have an element of control or choice. If you put little tongs with the salad and they choose what they eat and then if they choose it, they eat it and that’s how they started eating salads” (FG 1, P3) and “Have all the food out on the table and it’s a bit of a novelty in helping yourself, so we do that at home, like if we’re doing salad or tacos or veggies (FG 1, P3).

Caregivers also suggested that sometimes they needed to guide their children in making the right choices to ensure that they ate enough healthy food. Caregivers guided their children in the number of fruits and vegetables that they needed to place on their plates, for example. As one caregiver explained “So, we would put parameters on their choice as well, so there’ll be salads,

Okay, you’ve got to have two different vegetables, at least. At least two different types from that plate” so they could choose what they wanted but what they chose, they had to eat. So, it was kind of like we gave them that parameter with the illusion of freedom” (FG 2, P2) and “I don’t care which two colors you choose or three colors you choose, you just need to have at least two different ones (FG 1, P3)

Staff and caregivers highlighted several activities at the Discovery Space that intentionally encouraged children’s food choices, for example in the marketplace (play grocery store exhibit) and the café experiences. For example, a parent stated that

My kids love playing cafés and writing their own menus. They write out the menu and draw them too so things like that where there’s a game associated with it and also if they try to order a pizza and then they can choose what toppings they like (FG 1, P3).

Curiosity

Caregivers suggested that children are naturally curious about why they should eat healthy foods, like vegetables and fruits, and often asked questions about which fruits and vegetables were good for them and what happens to them when they eat them. Caregivers suggested that their children were more curious and in turn more interested in eating certain fruits and vegetables, especially vegetables if they made “real-life” connections for the children (i.e., connections with colors or connections with associated body parts). Examples of comments from caregivers which supported the curiosity of children and their need for real-life connections included:

When you make connections, with the body parts and food such as that it is good for eyes etc., it works” (FG 1, P3); and “You need to eat your carrots because they’re good for your eyes”, you know, associating the color, and again, it’s that sort of phase in their development where they’re learning all the colors and associating it with why you would eat that particular thing” (FG2, P3); and “One thing I have noticed pretty consistently with children is that they talk about what a veggie does and the benefit of having it (FG 3, P2).

Caregivers suggested that it was their responsibility to help their children make connections and links with the body to ensure that they understood the benefit of eating fruit and vegetables. For example, one parent said, “You’ve got to help them to make those links [to the body] because if you don’t help them to make the links, they won’t because they’re not all self-aware” (FG 1, P3). Another parent stated that

Kids aren’t aware of what’s happening in their body, so you need to help them … like, connect what food, how food makes your body feel. If you can help those connections to happen, they will then slowly learn to make a better choice (FG 4, P1).

Staff also mentioned that it was very important to heighten children’s curiosity and make real-life connections with activities to promote healthy lifestyles. Staff felt that the most beneficial and engaging experiences for children at Discovery Space were those where children could reflect on lived experiences, for example, the marketplace. The foods and groceries in the marketplace mimicked real-life groceries in aspects such as packaging, shape and texture. Referring to the exhibits, one staff commented, “Ones that reflect the real lived experiences of children and their real lives – things like the Marketplace, the Construction, ones that they can sort of connect to their life I think are good” (S2). Another caregiver said that

When they see it, they see that it’s real, it’s relevant to them, it’s something that they see all the time so that’s why I think the Marketplace – it’s a supermarket, they might see mum or dad shopping all the time and that’s how children learn is by watching others, being parallel to others and watching what they do (S3).

Involvement

All caregivers suggested that involving their children in the preparation of food was important. They suggested that when they involved their children in the process of preparing food and cooking, their children were more interested in eating the food. Some of the statements parents made about involving children were:

So, she helps in doing the smoothie with me too, yep, and then drinks it, no problem”. (FG 1, P2); “I guess at home the way I try and incorporate food or any of that is by getting my son to cook it with me. You know, if I’m making pizza or something like that I try and get him to come and put everything in and I find he’s more excited about eating it if he’s aeen helping me in the preparation” (FG 2, P3); and “I just chopped up cherry tomatoes and capsicum into little shapes and then they put cheese on it, and they just made faces and it was really good” “My kids are really interested in helping me make food (FG 3, P1).

The engagement of children in physical activity yielded limited data from both sets of focus groups despite probing questions, as the discussions were redirected back to healthy eating by the participants.

Theme 3: type of activities

Simple and fun activities

Caregivers and staff both expressed that experiential learning activities to promote healthy eating and physical activity would need to be simple and fun and provide some sense of challenge for children. These sentiments were particularly true for physical activities with one parent mentioning that “ … making things fun for kids helps a lot.” Another caregiver said that “Making activities fun, like dancing – every kid loves dancing and that doesn’t feel boring at all. I mean if you have kids who aren’t really into moving and stuff, dancing is always fun” (FG 3, P1). Staff supported this with comments such as “But in general, the activities that go well are ones that the children are involved in, that they are hands-on, they are doing something, and it’s fun” (S 2) and “I guess sometimes simple can be more effective … I think sometimes just having a simple case of resources and an idea that can just be really flexible is pretty effective” (S 1).

Sensory play activities

Many caregivers across the groups expressed that sensory play activities using fruits and vegetables were important in encouraging children’s interest. They suggested that children need to become familiar with the sensory properties of food such as texture, taste, smell and color before they were willing to try them. Some examples in support of this include:

Including the sensory type of stuff; different smells, different feel, texture, those sorts of things” (FG I, P2) and “Sensory play, that whole concept of exposing them to touching and feeling (FG 2, P3).

Hands-on activities

Staff suggested that the best activities were the ones where children were involved the most and had opportunities for hands-on experiences. Staff also suggested that activities to promote healthy eating and physical activity need to be fun and engaging and simple, for example, “In general, the activities that go well are ones that the children are involved in, that they are hands-on, they are doing something, and it’s fun” (S 3).

Music-based activities

Several caregivers and staff suggested that music-based activities, including “actions songs like head, shoulders, knees and toes” (FG 1, P2) and dance would potentially work well to promote physical activity for children, specifically younger children, as supported by the following statements:

I think music works really well for everyone but especially that toddler, preschooler age; music just makes them really move, put some music on – it’s something they can do at home too” (FG 2, P3) and, “I think the more singing, movement, the action that you have, yep, definitely and with young children, you can incorporate singing into everything (S2).

There was limited data about physical activity examples of experiential learning activities as the discussions were more focused on healthy eating.

Discussion

This study explored the perceptions of stakeholders of the Discovery Space children’s museum to inform the development of a healthy eating and physical activity program at Discovery Space. Three overarching themes were identified: involvement of parents, engagement of children and provision of types of activities to engage children. The themes provide insights into potential experiential learning opportunities and delivery strategies to support settings such as the Discovery Space to promote healthy eating and physical activity for young children.

Theme 1 – involvement of caregivers

The first key theme was the importance of parental involvement, specifically parental role modeling and parental presence/support in implementing healthy eating and physical activity experiential learning activities. The importance of parental role modeling to inform positive behaviors is well-documented for young children.^27–29 A recent review of healthy eating experiential learning interventions in children suggests that one of the key characteristics of successful interventions was parental involvement.¹⁵ This review included 25 studies, of which nine included parental involvement. One of the most effective interventions in this review was that conducted by Chen et al.¹⁷ which demonstrated that a family-based program (i.e., with parental involvement) positively impacted vegetable and fruit intake among children (mean effect size d = 1.3). Other non-experiential learning interventions that focused on healthy eating have consistently shown that parental role modeling, particularly fruit and vegetable consumption, was positively associated with children’s dietary intake and preference for fruits and vegetables.^28,30 An experimental study by Addessi et al.³¹ on the impact of social influences on the acceptance of novel foods found that 2–5-year-old children were more likely to try a new food if their parents ate the same food, compared to if parents did not also eat the same food. The importance of parental involvement in healthy eating and physical activity promotion programs for preschool-aged children is also highlighted by a study based in pre-school setting by Sharma et al.³²

Several qualitative studies investigated factors influencing children’s healthy eating and physical activity,^33,34 and a few have identified parental modeling as a key theme in children’s healthy eating behaviors. Hayter et al.³⁵ conducted a qualitative study (utilizing focus groups and interviews) that explored parental accounts of feeding preschool children conducted at a center for children under five and their families. Similar to the current study, parental role modeling was a key theme identified. A study conducted in Australia by Walsh et al.³⁶ on fathers’ perspectives on the diets and physical activity behaviors of their young children also identified parental role modeling as an important influencing factor.

The impact of parental role modeling on children’s physical activity seems to be mixed. In a review of 44 studies, three reported on the association between parental role modeling and young children’s physical activity, however, no positive associations were reported.³⁷ However, review³⁷ also found that three different studies reported positive associations between maternal role modeling only (and not fathers) with young children’s physical activity.^38–40 As such, role modeling by mothers may be particularly important in encouraging children’s active participation in physical activities.⁴¹ However, given the change in parental roles in the last decade,⁴² role modeling of both parents might be a key contributor. Additionally, other aspects including parental monitoring, parental motivation and parental knowledge may be important in promoting physical activity among young children.³⁷ These influences have been more extensively studied than parental modeling and perhaps should also be considered. In relation to experiential programs, a recent review involving 12 studies found that parental modeling was not a key factor within interventions that were effective in changing children’s physical activity behaviors.¹⁴ However, it should be noted that these studies were in primary school-aged children and thus the application to young children may be limited.

Parents/caregivers and staff suggested that the presence and support of a caregiver were important in encouraging children’s healthy eating and physical activity behaviors. This aligns with other evidence showing the effect of parental support on children’s healthy eating and physical activity behaviors. Two reviews showed that parental support (active guidance) was strongly associated with children’s healthy food consumption⁴³ and that parental social support was strongly positively associated with children’s eating behaviors.⁴⁴ In other studies, parental support for healthy eating (fruit and vegetable consumption), through encouragement and facilitation, was positively associated with children’s fruit and vegetable intake.^45,46 All of these studies have been conducted in older children, however, it is likely that parental support, as suggested in this study, would be at least as important for young children.

Parental support, as suggested in this study, may also be important in the promotion of physical activity among young children. Parental support may take many forms, but support such as encouragement, provision of physical activity equipment, parent participation in physical activity with their children⁴⁷ and parental highlighting of the health benefits of physical activity⁴⁸ are important factors related to increased physical activity in children. An experiential learning intervention study⁴⁹ evaluated the effects of a school-based program to promote physical fitness and physical activity among primary school children and analysis of covariance and Cohen’s d effect sizes found that parental social support (positive reinforcement) for participation in physical activities helped improve physical activity in children. Parental/caregiver support behaviors are important determinants of child physical activity and healthy eating, thus parental/caregiver involvement and support should be considered in intervention approaches in promoting healthy behaviors in children.

Theme 2 – engagement of children

The second identified theme was the engagement of children in activities, specifically enabling children’s choice and autonomy, curiosity and providing opportunities for children to be involved. Enhancing children’s choice and autonomy was identified by both caregivers and staff in relation to healthy eating. This finding is consistent with other studies. In their observational study, Powell et al.⁵⁰ explored the relationship between family mealtime practices and children’s eating behaviors. They showed that when caregivers allowed children some autonomy in relation to food choice, children tended to choose healthier foods. DeCosta et al.⁵¹ showed that providing choices during mealtimes for young children resulted in a greater overall intake of healthy foods, such as vegetables. To date, most of the research in the area of food choice and autonomy is in older children.⁵² However, it is feasible to suggest that this also exists in younger children. The importance and potential impact of children’s choice is further highlighted by international organizations such as the American Academy of Pediatrics⁵³ and broader policy recommendations such as the recent position statement “Nurturing Children’s Healthy Eating” which explicitly state that ‘children should be given the opportunity to make their own food choices by participating in menu planning and food preparation”.⁵⁴

Both caregivers and educators highlighted that children were more likely to engage in healthy eating and physical activity if their curiosity was piqued. Few studies have investigated the relationship between children’s curiosity and consumption of healthy food or participation in physical activity. Sick et al.⁵⁵ investigated 10–13-year-old children’s reasons for accepting or rejecting food. They showed that curiosity was important for children’s acceptance of novel healthy foods. This finding was particularly true for girls (i.e., girls’ curiosity resulted in them trying more novel healthy foods compared to boys).

A qualitative study exploring teachers’ and caregivers’ perceptions of children’s curiosity and exploration also highlighted curiosity as an important aspect of learning in children.⁵⁶ When children are given the opportunity to fulfil their curiosity through self-directed, safe and playful exploration, learning occurs naturally.⁵⁷ Further research is needed in this area, specifically with younger children but it is plausible to suggest that creating curiosity about healthy foods in relation to their benefits for the body may spark interest in young children and increase their motivation to try different types of foods^57,58 and potentially engage in different physical activities.

Children’s involvement in food preparation and cooking was also highlighted as important. This finding is supported by several other quantitative studies among both young and older children. In preschool-aged children, Metcalfe et al.’s⁵⁹ study showed that involving children, aged 3 to 4 years, in food preparation was predictive of healthier dietary behaviors in young children (for example, increased consumption of fruits and vegetables and a decreased consumption of fast food). Several studies in children, aged 5–10 years have shown a positive association between children’s involvement in food preparation and the consumption of healthy foods, such as salads and vegetables.^60–62 For example, an Australian study explored the association between parent-reported vegetable preparation practices for 5 to 6-year-old children and children’s vegetable intake.⁶¹ They reported a positive association between children’s preparation practices and increased vegetable acceptance and intake. Another study examined children’s involvement in the meal preparation and its effect on vegetable intake and showed that involving children in meal preparation positively affected subsequent intake (i.e., children who cooked their own meals, had higher intakes of foods such as salads and increased general positive emotions).⁶² A large Canadian study of children aged 10–11 years (n = 3398) showed that a higher frequency of involvement in family food preparation and cooking was associated with more favorable fruit and vegetable preferences, self-efficacy for selecting and eating healthy foods,⁶³ and better diet quality among children (i.e., ate 1 more serving/day of vegetables and fruit compared with children who never helped).⁶⁴ The consistent positive associations between children’s involvement in food preparation and more healthful diets are likely a result of the increased familiarity with foods.⁶⁵

Furthermore, a systematic review that investigated the impact of experiential learning interventions on children’s healthy eating-related knowledge, attitudes and behaviors¹⁵ highlighted that the involvement of children in food preparation and cooking was one aspect of interventions that may have contributed to positive outcomes, such as children’s increased intake of and preferences for healthy foods (such as fruits and vegetables) and their decreased reluctance to try new foods.^66–68 However, in these studies, food preparation was used in combination with other activities such as taste testing.

To the best of our knowledge, only one qualitative study has explored parents’ views of their 5 – 6-year-old children’s food choices. This study, conducted in Australia with 17 parents, also found that involving children in the preparation of food had a perceived positive impact on children’s food choices.⁶⁹ Collectively, the evidence suggests that the involvement of children in the preparation and cooking of healthy foods may contribute to healthier dietary behaviors in young children.

Theme 3: type of activities

Caregivers and staff suggested that activities used to promote healthy eating and physical activity among young children would need to be simple and fun and could include sensory /hands-on and music-based activities. Sensory play and learning through exploration are not new concepts in child development.^70,71 Sensory play builds nerve connections in brain pathways, which leads to the ability to complete more complex learning tasks.⁷² Children develop their language skills, cognitive processes, problem-solving skills and social interaction as a result of sensory play.⁷³ Several studies in preschool-aged children have utilized sensory play/hands-on activities to promote healthy eating and showed positive results. For example,⁷⁴ found that sensory play activities using fruits and vegetables encouraged fruit and vegetable tasting in preschool children more than non-food play or visual exposure alone. A recent intervention study⁷⁵ examined preschool children’s engagement in tactile sensory tasks and found that sensory play with fruits increased children’s acceptance and enjoyment of fruits.

Rather than an emphasis on food tasting alone, broader sensory play through the senses by smelling, touching, hearing, and watching healthy foods seems an effective strategy for encouraging healthy food consumption in children.⁷⁶ Furthermore, Dazeley et al.⁷⁷ explored the impact of exposure to foods’ non-taste sensory properties on young children’s willingness to try fruit and vegetables. The results of their study demonstrated that hands-on activities with unfamiliar fruits and vegetables enhanced children’s willingness to taste these foods and supports the potential of such activities within healthy eating initiatives. Sensory play activities with food may enhance children’s willingness to try new foods through increased exposure⁷⁸ and familiarization with new foods.⁷⁹

In this study, the focus from caregivers and staff was predominantly on healthy eating rather than physical activity, despite probing questions related to both topics. It may be that encouraging healthy eating is perceived as more difficult for caregivers and hence it was easier to identify aspects that would make the promotion of healthy eating easier. Alternatively, it may be that caregivers perceive healthy eating as more of a priority than the promotion of physical activity. It is well documented that caregivers and early childhood educators perceive young children to be active and little intentional effort is needed to promote physical activity.⁴⁷ In reality, children are not meeting the current physical activity recommendations⁸⁰ and guidelines,⁸¹ thus the promotion of healthy eating and physical activity are both priorities. Establishing healthy physical activity habits from a young age is important as physical activity has many health benefits for young children⁸² and physical activity levels track from preschool to primary school and then from primary school to adolescents.⁸³

The use of semi-structured interviews enabled an in-depth exploration of caregivers’ and museum staff’s perceptions of key elements of experiential learning activities, which would be appropriate for the promotion of healthy eating and physical activity. However, the sample was small (although data were collected until saturation) and was limited to members of UOW’s Discovery Space thus potentially limiting the generalizability of the data. Future studies could explore the perceptions of caregivers of children under 5 years and 6–10 years separately to identify strategies for the design of more age-specific activities. Furthermore, evaluating the socioeconomic and demographic backgrounds of families in future studies would help identify strategies that can facilitate participation by diverse communities.

Translation to Health Education Practice

This study provides insights into potentially effective strategies for experiential learning activities promoting healthy eating and physical activity among children. Understanding caregivers’ and staff’s perceptions of appropriate experiential learning activities to promote healthy eating and physical activity is beneficial in the development of future effective experiential learning programs. Findings from this study suggest that key considerations for the development of effective experiential learning activities to promote healthy eating and physical activity among young children include: i) involving caregivers (presence and role modeling), ii) applying processes to engage children (providing choice, autonomy and stimulating curiosity), and iii) selecting appropriate types of activities (simple, engaging, fun, hands-on, sensory play and music-based). Promoting healthy eating and physical activity from birth is particularly important for optimal health and well-being, thus effective strategies such as experiential learning approaches may be important in engaging children in activities that reinforce these health behaviors. The result of this study provides researchers and educators with information that will allow them to design more effective interventions to increase healthy eating and physical activity, promote healthy behaviors among children and improve overall health outcomes.

The study complies with the competencies and sub-competencies in two areas of responsibility: Area I: Assessment of Needs and Capacity and Area V: Advocacy, outlined by the 2020 Health Education Specialist Practice Analysis II (HESPA II 2020), accredited by the National Commission for Health Education Credentialing Inc. (NCHEC).⁸⁴ The following competencies and sub-competencies from Area I were applied in the design and evaluation of this study: 1.1.3 Identify existing and available resources, policies, programs, practices, and interventions, 1.1.4 Examine the factors and determinants that influence the assessment process, 1.1.5 Recruit and/or engage priority population(s), partners, and stakeholders to participate throughout all steps in the assessment, planning, implementation, and evaluation processes, 1.2.2 Establish collaborative relationships and agreements that facilitate access to data, 1.2.7 Determine primary data collection needs, instruments, methods, and procedures. The Area V competencies and sub-competencies applied include: 5.1.1 Examine the determinants of health and their underlying causes (e.g., poverty, trauma, and population-based discrimination) related to identified health issues, 5.1.3 Identify factors that facilitate and/or hinder advocacy efforts (e.g., amount of evidence to prove the issue, the potential for partnerships, political readiness, organizational experience or risk, and feasibility of success), 5.1.5 Identify existing coalition(s) or stakeholders that can be engaged in advocacy efforts, and 5.4.2 Use the results of the evaluation to inform next steps.

Acknowledgments

We would like to thank Taylor Ambrose for her assistance in conducting the focus group discussions. We would like to express our appreciation to the participants of the focus groups.

Disclosure statement

No potential conflict of interest was reported by the author(s).