IntroductionFamily child-care homes (FCCHs) provide care and nutrition for millions of US children, including 28% in Rhode Island. New proposed regulations for FCCHs in Rhode Island require competencies and knowledge in nutrition. We explored nutrition-related practices and attitudes of FCCH providers in Rhode Island and assessed whether these differed by provider ethnicity or socioeconomic status of the enrolled children.MethodsOf 536 licensed FCCHs in Rhode Island, 105 randomly selected FCCH providers completed a survey about provider nutrition attitudes and practices, demographics of providers, and characteristics of the FCCH, including participation in the federal Child and Adult Care Food Program (CACFP). No differences between CACFP and non-CACFP participants were found; responses were compared by provider ethnicity using χ2 tests and multivariate models.ResultsNearly 70% of FCCHs reported receiving nutrition training only 0 to 3 times during the past 3 years; however, more than 60% found these trainings to be very helpful. More Hispanic than non-Hispanic providers strongly agreed to sitting with children during meals, encouraging children to finish their plate, and being involved with parents on the topics of healthy eating and weight. These differences persisted in multivariate models.DiscussionAlthough some positive practices are in place in Rhode Island FCCHs, there is room for improvement. State licensing requirements provide a foundation for achieving better nutrition environments in FCCHs, but successful implementation is key to translating policies into real changes. FCCH providers need culturally and linguistically appropriate nutrition-related training.

Growing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participants) who participated in an HIV prevention trial. Associations found between use of drugs and alcohol by one or both partners and sexual risk indicators varied by type of substance and whether male or female partner or both partners reported use. The findings suggest multiple ways in which substance use of male and female partners may be contributing to the heterosexual transmission of HIV and other STDs among African Americans and underscore the need for HIV prevention strategies to address dyadic patterns of substance use that lead to sexual risks.

Background: The food and activity environments of childcare have been identified as promising areas in which to improve nutrition and activity for children. Methods: Of the 292 centers caring for children 18-60 months of age, 107 randomly selected directors completed a survey. The survey queried nutrition and physical activity practices, attitudes of providers and staff, and demographics of the enrolled children and the center, including participation in the federal Child and Adult Care Food Program (CACFP). Responses were compared for CACFP compared with non-CACFP participating centers. Results: CACFP center directors reported serving more fruit, fried potatoes, beans, 100 % fruit juice, non-fat milk and water compared with non-CACFP directors. Sixty-four percent of CACFP centers and 87 % of non-CACFP centers served no vegetables the previous day (p = .0973). There were no differences in the amount of physical activity time reported by CACFP status. Also, 81 % of directors reported never or rarely allowing screen time in the previous week. Directors of Non-CACFP centers were more likely (93 %) to strongly agree that they were able to identify healthy foods and (87 %) that healthy foods are available where they shop than CACFP center directors (65 %, p = 0.0088, 54 %, p = 0. 0354, respectively). Discussion: More nutritious foods (fruit, beans, 100 % fruit juice, non-fat milk and water) were provided in CACFP centers, compared with non-CACFP centers, but no differences in physical activity were identified. However, non-CACFP directors were better able to access and identify healthy foods. CACFP guidelines regarding food served were likely responsible for the more nutritious foods, though CACFP providers may be challenged by fewer skills and lower educational background. Conclusions: Stronger guidelines supporting both food and activity would bolster policies for childcare centers and improve the nutrition and physical activity environments in this setting.