The family child care home environment and children's diet quality

Benjamin‐Neelon, Sara E.; Vaughn, Amber; Tovar, Alison; Østbye, Truls; Mazzucca, Stephanie; Ward, Dianne S.

doi:10.1016/j.appet.2018.03.024

Cited by 47 publications

(48 citation statements)

References 46 publications

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“…The finding that total HEI scores (overall diet quality) did not improve is not expected. Overall HEI scores in children in both states were relatively low (about 60 out of 100 possible points) but consistent with prior observations of children's dietary intake in ECE centers [21,[52][53][54] and family child care homes [55,56]. In these studies, consistent with our findings, children scored highest in whole fruit, total fruit, and dairy components.…”

Section: Discussionsupporting

confidence: 91%

Healthy Eating Policy Improves Children’s Diet Quality in Early Care and Education in South Carolina

et al. 2020

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Policies to promote healthy foods in early care and education (ECE) in the United States exist, but few have been prospectively evaluated. In South Carolina, a statewide program serving low-income children in ECE enacted new policies promoting healthy foods. We conducted an evaluation to measure changes in dietary intake among children in ECE exposed and not exposed to the new policy. Using direct observation, we assessed dietary intake in 112 children from 34 ECE centers in South Carolina and 90 children from 30 ECE centers in North Carolina (a state with no policy). We calculated Healthy Eating Index-2015 (HEI) scores to measure diet quality consumed before and after the policy was enacted. We fit mixed-effects linear models to estimate differences in HEI scores by state from baseline to post-policy, adjusting for child race, number of children enrolled, director education, center years in operation, participation in the Child and Adult Care Food Program (CACFP), and center profit status. The policy increased HEI scores for whole fruits, total fruits, and lean proteins, but decreased scores for dairy. Thus, the policy was associated with some enhancements in dietary intake, but additional support may help improve other components of diet.

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Section: Discussionsupporting

confidence: 91%

Healthy Eating Policy Improves Children’s Diet Quality in Early Care and Education in South Carolina

et al. 2020

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“…Secondary outcomes include changes in FCCH practices from the pre-post surveys and the EPAO and changes in FCCH nutrition and activity environments from the EPAO. This analysis will assess the overall EPAO nutrition score and subscales created by the UNC originators of the tool [102].…”

Section: Methodsmentioning

confidence: 99%

Improving nutrition and physical activity environments of family child care homes: the rationale, design and study protocol of the ‘Healthy Start/Comienzos Sanos’ cluster randomized trial

et al. 2019

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Background Early childhood is a crucial time to foster healthy eating and physical activity (PA) habits, which are critical for optimal child health, growth and development. Child care facilities are important settings to promote healthy eating and PA and prevent childhood obesity; however, almost all prior intervention studies have focused on child care centers and not family child care homes (FCCH), which care for over 1.6 million U.S. children. Methods This paper describes Healthy Start/Comienzos Sanos, a cluster-randomized trial evaluating the efficacy of a multicomponent intervention to improve nutrition and PA environments in English and Spanish-speaking FCCH. Eligible child care providers complete baseline surveys and receive a two-day FCCH observation of the home environment and provider practices. Parent-consented 2–5 year-old children are measured (height, weight, waist circumference), wear accelerometers and have their dietary intake observed during child care using validated protocols. FCCH providers are then randomly assigned to receive an 8-month intervention including written materials tailored to the FCCH providers’ need and interest, videos, peer support coaching using brief motivational interviewing, and periodic group meetings focused on either nutrition and PA (Intervention) or reading readiness (Comparison). Intervention materials focus on evidence-based nutrition and physical activity best practices. The initial measures (surveys, two-day observation of the FCCH and provider practices, child diet observation, physical measures, and accelerometer) are assessed again 8 and 12 months after the intervention starts. Primary outcomes are children’s diet quality (Healthy Eating Index), time in moderate and vigorous PA and sedentary PA during child care. Secondary outcomes include FCCH provider practices and foods served, and PA environments and practices. Possible mediators (provider attitudes, self-efficacy, barriers and facilitators) are also being explored. Process evaluation measures to assess reach, fidelity and dose, and their relationship with dietary and PA outcomes are included. Discussion Healthy Start/Comienzos Sanos fills an important gap in the field of childhood obesity prevention by rigorously evaluating an innovative multicomponent intervention to improve the nutrition and physical activity environments of FCCH. Trial registration (# NCT02452645 ) ClinicalTrials.gov Trial registered on May 22, 2015. Electronic supplementary material The online version of this article (10.1186/s12889-019-6704-6) contains supplementary material, which is available to authorized users.

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“…Moreover, nearly 50% of vegetables consumed in ECE were fried potatoes, and only 8% were the more nutrient-dense dark green or brightly colored vegetables [15]. Other studies of young children in the US and the Netherlands have found similar results [14,[16][17][18]. In the UK, limited data suggest that children are also served insufficient quantities of fruits and vegetables.…”

Section: Introductionmentioning

confidence: 85%

Perceived Barriers to Fruit and Vegetable Gardens in Early Years Settings in England: Results from a Cross-Sectional Survey of Nurseries

et al. 2019

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Garden-based interventions may increase child intake of fruits and vegetables and offset food costs, but few have been conducted in early care and education (ECE). This study assessed whether nurseries were interested in and perceived any barriers to growing fruits and vegetables. Surveys were mailed to a cross-sectional sample of nurseries in 2012–2013 throughout England. Nurseries were stratified based on socioeconomic status as most, middle, or least deprived areas. We fit logistic regression models to assess the odds of nurseries interested in growing fruits and vegetables and perceiving any barriers, by deprivation tertile. A total of 851 surveys were returned (54% response). Most nurseries (81%) were interested in growing fruits and vegetables. After adjustment, there was no difference in interest in the middle (OR 1.55; CI 0.84, 2.78; p = 0.16) or most (OR 1.05; CI 0.62, 1.78; p = 0.87) deprived areas, compared to the least deprived. Nurseries reported barriers to growing fruits and vegetables, including space (42%), expertise (26%), and time (16%). Those in the most deprived areas were more likely to report space as a barrier (OR 2.02; 95% CI 1.12, 3.66; p = 0.02). Nurseries in the most deprived areas may need creative solutions for growing fruits and vegetables in small spaces.

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The family child care home environment and children's diet quality

Abstract: Foods and beverages served, in addition to nutrition education and nutrition policies in family child care homes, may be promising intervention targets for improving child diet quality.

Cited by 47 publications

References 46 publications

Healthy Eating Policy Improves Children’s Diet Quality in Early Care and Education in South Carolina

Healthy Eating Policy Improves Children’s Diet Quality in Early Care and Education in South Carolina

Improving nutrition and physical activity environments of family child care homes: the rationale, design and study protocol of the ‘Healthy Start/Comienzos Sanos’ cluster randomized trial

Perceived Barriers to Fruit and Vegetable Gardens in Early Years Settings in England: Results from a Cross-Sectional Survey of Nurseries

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