Nutrition-Related Practices of Family Child Care Providers and Differences by Ethnicity

Abstract

Background: Child care settings play an important role in shaping children's eating behaviors; yet few studies have included family child care homes (FCCHs). We examined provider-reported nutrition-related practices in FCCHs and observed adherence to nutrition guidelines from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC), exploring differences by provider ethnicity. Methods: We assessed baseline data from a cluster-randomized trial, including surveys with FCCH providers and observational data collected at the FCCH. We examined provider-reported nutrition-related practices and if providers met NAP SACC guidelines using observational data. Differences by ethnicity were assessed using chi-square and multivariate log-linear analysis adjusting for education. Results: Providers completed a telephone survey (n = 166, 100% female and 72% Hispanic) and participated in 2 full-day observations (n = 119). Many providers reported engaging in positive nutrition-related practices. Significant differences by ethnicity included the following: Hispanic providers less likely to report feeding practices that were responsive to children's self-regulation, but also less likely to report eating and drinking unhealthy foods/beverages in front of children and having screens on during meals and more likely to report seeking nutrition trainings. Using observational data, only 10 of 26 NAP SACC practices were met by >60% of providers. Few ethnic differences in meeting guidelines were found (7 of 26 practices). Conclusions: While providers engage in some positive nutrition practices, improvement is needed to ensure that all providers actually meet evidence-based guidelines. Ethnic differences in certain practices underscore the need for culturally relevant trainings. Trial registration number: NCT02452645.

Knowledge, Attitudes and Practices of Australian Trainee Childcare Educators Regarding Their Role in the Feeding Behaviours of Young Children

“…When comparing observational versus self-report studies, researchers emphasise that all child feeding practices are unlikely to occur within one mealtime, therefore several time points should be studied to accommodate variations in feeding practices across the day or week [13]. Desirable feeding practices are also more likely to be recorded in self-report studies due to social desirability bias [55]. In our study, participants perceived their limited observation of desirable child feeding practices within the childcare setting to be the result of parental influence, established childcare procedures and training of centre staff.…”

“…Sisson et al (2017) [46] reported that communicating with parents is essential for childcare educator motivation; that educators feel discouraged if their healthy eating efforts are unsupported within the home environment. Working with childcare educators to increase their efficacy in having mutually respectful, constructive conversations with families about potentially sensitive feeding issues is therefore an important consideration if learnt knowledge is expected to translate into practice [24,46,55,62].…”

“…Understanding and supporting child control and self-regulation appear key to a childcare educator's ability to implement responsive child feeding practices [42]. It is understood that personal beliefs, such as concerns about own health and weight status [39], past and current food security [47] and cultural dietary practices [55], all influence a childcare educator's child feeding practices. New practices however can be taught by acknowledging existing educator beliefs and experiences [48] and providing specific knowledge on how to apply a particular practice [49].…”

“…Training should also reiterate the important, often undervalued, role of the childcare educator in shaping the health of children within their care [46]. An important component of training should include communication skills to enhance collaborative parental engagement [46,63,72], to teach children about nutrition [55] and to create champions to drive change within the childcare environment [36]. Without the necessary knowledge, confidence and skills to understand and enact health promotion practices, it is unlikely that changes to enhance healthy eating behaviours and food provision within the childcare setting will be implemented by childcare staff.…”

“…The increasing number of children and amount of time spent in childcare provides strong rationale to explore the important role that childcare services and childcare educators can play in providing supportive food environments and feeding practices to young children in their care [24,[53][54][55]. A focus on the provision of healthy environments during the early years is also considered the most cost effective obesity prevention strategy [56].…”