Child care environments foster children’s healthy eating habits by providing exposure to healthy foods and feeding practices. We assessed the healthfulness of nutrition environments, menu/meal quality, and the achievement of Child and Adult Care Food Program (CACFP) guidelines and best practices in Oklahoma CACFP-enrolled family child care homes (FCCHs) (n = 51). Two-day classroom observations were conducted. Healthfulness of classroom nutrition environments was assessed using the Environment and Policy Assessment and Observation (EPAO). Foods served to and consumed by children were quantified using the Dietary Observations in Child Care (DOCC) tool. Nutrient analysis was performed to determine total energy for foods listed on menus, served to, and consumed by children. Menu and meal food variety and CACFP Guideline Achievement Scores were determined. Average nutrition environment score was 11.7 ± 1.2 (61.5% of maximum possible score). Energy (kcals) from menus and consumed by children was insufficient to meet two-thirds of their daily reference intake. Children were exposed to 1.7 vegetables and 1.3 fruits per meal. CACFP Guideline Achievement Scores were 66.3% ± 7.8 for menus and 59.3% ± 7.6 for mealtimes. Similar to previous research, our findings indicate a need for improved FCCH nutrition practices. Tailored interventions for FCCHs are needed.

Objective: Describe nutrition and physical activity practices, nutrition self-efficacy and barriers, and food program knowledge within Family Child Care Homes (FCCH), and differences by staffing. Design: Baseline, cross-sectional analyses of the Happy Healthy Homes randomized trial (NCT03560050). Setting: FCCH in Oklahoma, United States Participants: FCCH providers (n=49, 100% women, 30.6% Non-Hispanic Black, 2.0% Hispanic, 4.1% American Indian/Alaska Native, 51.0% Non-Hispanic white, 44.2±14.2 years of age. 53.1% had additional staff) self-reported nutrition and physical activity practices and policies, nutrition self-efficacy and barriers, and food program knowledge. Differences between providers with and without additional staff were adjusted for multiple comparisons (p<0.01). Results: The prevalence of meeting all nutrition and physical activity best practices ranged from 0.0-43.8% and 4.1-16.7%, respectively. Average nutrition and physical activity scores were 3.2±0.3 and 3.0±0.5 (max 4.0), respectively. Sum nutrition and physical activity scores were 137.5±12.6 (max 172.0) and 48.4±7.5 (max 64.0), respectively. Providers reported high nutrition self-efficacy and few barriers. The majority of providers (73.9-84.7%) felt they could meet food program best practices; however, knowledge of food program best practices was lower than anticipated (median 63-67% accuracy). More providers with additional staff had higher self-efficacy in family style meal service than did those who did not (p=0.006). Conclusions: Providers had high self-efficacy in meeting nutrition best practices and reported few barriers. While providers were successfully meeting some individual best practices, few met all. Few differences were observed between FCCH providers with and without additional staff. FCCH providers need additional nutrition training on implementation of best practices.

ipes), Educators as Sources of Nutrition Information, and Cultural Customs and Family Feeding. Caregivers indicated a desire to receive nutrition education via printed methods, in-person classes, and text messages. This group also asked for detail about how foods nourish preschoolers, as well as strategies and recipes to make healthy foods -especially vegetables -appeal to children. Conclusion: Themes that emerged show nutrition content preferences are focused on vegetable feeding strategies as well as providing clarity about what foods are healthy for preschoolers. Delivery methods themes reveal that a multi-pronged approach is key to meeting this population where they are -electronically, in person, and in print.