Invitation to Tender: Research partner – early years nutrition (EYN) in settings

Background

At Impact on Urban Health we believe that all children should have the opportunity to thrive, regardless of where they grow up. A key factor in ensuring this is access to nutritious, affordable food wherever they live, play, or go to school/nursery.

As part of our Children’s Health and Food programme, Impact on Urban Health wants to champion the importance of the early years and advocate for nutritious food in these settings.

Good nutrition and health in the early years play a crucial role in a child’s development and growth. Furthermore, it is also a critical phase for establishing social behaviors, including eating habits, which can influence food preferences and nutrition in later life. Good early nutrition can also contribute to better child health.

Early years settings are an ideal food environment in which to help young children to eat well. These settings include state-maintained nurseries, private and voluntary institutions (PVIs) and childminders. 92% of 3–4-year-olds are registered for childcare provision. If a child is in full day care from breakfast to dinner, they could be eating approximately 90% of their daily energy and nutrient intake in that setting. Incoming childcare reform is set to increase the number of meals eaten in settings – the number of hours 2-year-olds are expected to spend in childcare is predicted to rise by 33% by 2028.

Since 2022, Impact on Urban Health has partnered with Bremner & Co to build an understanding of the barriers and enablers to good nutrition in early years settings. This started with an early years settings review, which explored and tested opportunities for influencing policy and practice. The report recommended two critical success factors for the early years sector where Impact on Urban Health could have maximum impact: advocacy and research/data.

Since 2023, Impact on Urban Health’s early years settings work has focused on these two strands:

• Advocacy in the EYN sector: We have been working alongside academics, advocacy organisations, charities, the early education sector, settings, and local government as part of an informal working group (EYN stakeholders). The aim of this group has been to identify and coalesce around policy and advocacy goals, discuss the evidence needed to support policy changes, and share research and insights.
• Research and data: The gap in evidence for EYN is considerable and crosses infrastructure, nutritional analysis, access and uptake. There is strong agreement between Impact on Urban Health and the EYN stakeholders that investment in an evidence base is needed to support advocacy opportunities. EYN stakeholders agree that focusing on nutrition (what children eat) is the most useful starting point. The EYN stakeholders have worked with Impact on Urban Health on the co-design of this tender.

Key research priorities

We are eager to understand more about food and drink provision and consumption in early years settings. Some likely successful outcomes for our research would include:

1. We understand the nutritional quality, quantity and appropriateness of food and drink that children in early years settings are eating, benchmarked against government guidance.
2. We understand the extent to which, if at all, food provision differs between setting types (state-maintained, PVIs and childminders) and provision types (commercially catered, local authority provided, in-house, packed lunch only). This should include breakfast, main meals, snacks and drinks where applicable.
3. We capture how existing infrastructure (facilities, staff, knowledge, funding, and operations) influences provision, consumption and quality through engagement with settings and practitioners.
4. We understand whether families at the intersection of economic disadvantage and structural racism are disproportionately affected by their access to healthy and nutritious food in early years settings.

We are a place-based foundation, and the inner-city London boroughs of Lambeth and Southwark are our home, and by learning what works in these areas, we hope to influence others to take up successful approaches in other urban neighbourhoods. This research should also focus on Lambeth and Southwark.

We have chosen to focus on children aged one to school age. We recognise the importance of nutrition for under ones, but also that at this age, there are several nutritional composition feeding stages (weaning, puree, finger food, etc.), which fall outside of our scope.

Methodology

We will take a collaborative approach to this research. At the outset, we will work with the research partner to agree the research questions and implementation plan, including specific approaches, activities, and outputs.

A mixed-methods approach: we expect this work will require a mixture of quantitative and qualitative methodologies. The research will look at:

1. Food provision in breadth (e.g., using menu analysis, setting surveys for example)
2. Food provision and consumption in depth (e.g., using nutritional analysis of food served and packed lunches in a settings environment).
3. Key differentiators to food provision could include setting and provision type, infrastructure and percentage of families from lower socio-economic background.

The research will need to incorporate food prepared in-house, food provided by a local authority, food provided by a private caterer, and no provision (packed lunch). It should also cover breakfast, main meals, snacks and drinks, where applicable. We would like the research team to engage with practitioners in settings to understand barriers.

We expect applicants to propose how they will sample settings in an appropriate way from two local authorities (Lambeth and Southwark), using a stratified sample based on the early years make up in the area. Nationally, the make-up of settings is 65% PVIs, 23% state-maintained, and 12% childminders. The settings will also need to be represented by lower and higher areas of deprivation. We would like a minimum of 20 settings involved in the in-depth research.

Considerations and limitations: Research indicates that settings may be experiencing research fatigue. They are also under-resourced and struggling with the cost-of-living crisis. We expect the applicants to put forward recommendations on:

• How they would develop a detailed recruitment plan targeting relevant settings.
• How they would leverage existing networks and relationships to identify and engage potential settings.
• How they would use multiple recruitment channels.
• What incentivisation they would propose.

This project needs to be appropriately framed to ensure that settings and parents who provide packed lunches do not feel stigmatised. Whilst the outputs will review quality, settings should be aware that we are equally looking at constraints, barriers and enablers – with the aim of facilitating positive change, not focusing on negative outcomes.

Anecdotal evidence indicates that due to settings needing to charge more for food (due to funding constraints and food inflation), there is a perceived rise in the proportion of packed lunches being brought into settings. There would need to be robust ethical consideration to how packed lunches are audited within settings, with parental consent received.

What we are looking for

A research partner must demonstrate the following knowledge and skills to support us to meet our research goals:

• Expert knowledge of the early years sector – including the challenges currently facing the sector, the makeup of settings and the potential barriers to good nutrition.
• Research skills – including being able to collect, analyse, synthesise and present both quantitative and qualitative data and insights to various audiences.
• Participant recruitment – We expect that recruitment of early years settings may be challenging in the current context and that the research partner must have a robust plan for recruitment within the given parameters. We will support the recruitment process with our existing networks in Southwark and Lambeth.
• Nutrition skills – experience of analysing both menus and food provision against a set of standards – in this instance it will be the Public Health Guidance and example menus for Early Years (PDF). We expect that this will require onsite observation of provision in settings, as opposed to just analysing presented menus, although this may form part of the methodology.
• Facilitation skills to share and reflect research findings iteratively with multiple audience groups – the EYND group, our parent panel, and practitioners for example.
• Expert project management skills.
• Experience of managing projects focusing on health equity.
• Experience of undertaking qualitative research with a diverse group of stakeholders.

We also require a research partner who demonstrates:

• Commitment to equitable and inclusive learning, research, and evaluation practices.
• Commitment to, and experience of, ethical research practices, ideally including working in settings alongside children.
• Flexibility to adapt to issues quickly and adjust plans and approaches as needed.
• Awareness of the burden data collection may place on settings and local authorities, and a research proposal that takes account of this.

Budget and time frame

Our budget for this research work is £70,000, including expenses and VAT.

Indicative timings are: appointment of a research partner and a round of team and project inductions in late August 2024, with recruitment of settings to follow in September/October 2024. We expect interim findings to be presented in February/March 2025 and a final report in April/May 2025.

Key deliverables:

• A detailed research plan, to be agreed with Impact on Urban Health and Bremner & Co upon kick off (September 2024).
• Interim learning session to be held with Impact on Urban Health and Bremner & Co to share emerging learning (TBC, likely February/March 2025)
• A final report summarising the findings and key insights for internal purposes and for use by the EYN stakeholders (April/May 2025).
• Engagement with various partners – the EYN stakeholders, Impact on Urban Health’s parent panel, practitioners, Impact on Urban Health partners and public affairs team across the course of the project.
• The development of the report into an academic journal report is desirable, and we are interested to hear the research partner’s suggestions.