Training Child Care Inspectors to Deliver Health Messaging: A Quality Improvement Pilot Project

Abstract

Early childhood obesity is at epidemic proportions. Early child care providers have a unique opportunity to instill healthy eating and active living behaviors in children that can foster lifelong health. Academic-community partnerships that involve collaborations between child care centers, local public health departments, and universities provide one avenue to strengthening healthy eating and active living-related knowledge and skills among early child care providers. This quality improvement pilot intervention, titled Healthy Child Care Makes a Healthy Start, is one example of this type of collaboration. This quality improvement pilot project consisted of two complementary intervention components. Inspectors were trained to cofacilitate a strategic planning process with university researchers to help providers implement healthy eating and active living-related policy, system, and environment changes in their child care homes and centers. An average of five changes were implemented in participating child care locations. Inspectors also received training on health-related best practices and delivered 1-minute health messages to child care providers during routine inspection visits. This type of innovative partnership has the potential to leverage a currently existing relationship between child care providers and licensing and regulation inspectors and shift the relationship to include dissemination and implementation of health messaging in child care center and home settings.

Responsive Feeding Environments in Childcare Settings: A Scoping Review of the Factors Influencing Implementation and Sustainability

“…Another study suggested that interventions that include teacher training should not be executed too quickly, they must account for adequate time for educators to internalize the information and incorporate the newly learned practices into their regular practices [54]. Several studies noted the significance of the qualifications of the individuals delivering the training and those involved with receiving the training for the intervention [42,[55][56][57][58][59]. Two studies noted that it was important to have a qualified educator deliver the training, as they can often assist providers with adopting responsive feeding practices, such as serving meals family-style and sitting with children during mealtimes [42,59].…”

“…Two studies noted that it was important to have a qualified educator deliver the training, as they can often assist providers with adopting responsive feeding practices, such as serving meals family-style and sitting with children during mealtimes [42,59]. Farewell et al [56] found success in leveraging childcare inspectors to deliver education to childcare centres, as they had ongoing relationships with childcare providers prior to the intervention and, therefore, had the potential to positively affect the attitudes and practices of the childcare community. Furthermore, one study noted that the perceived credibility and qualifications of those who delivered the training was more important than the frequency of the training and resulted in greater uptake and positive changes in practices [59].…”

“…Providers' confidence in their knowledge about child feeding and nutrition and their abilities to use responsive feeding practices and support a healthy eating environment was also noted as essential in multiple articles [38,46,50,56,61]. Lanigan [46] described the importance of provider confidence in their gain of nutrition-related knowledge, as this improved their efforts to communicate with families about positive child feeding and healthy eating, in general.…”

“…One study found success in improving staff confidence to support children's healthy eating and to discuss this topic with parents through professional development and curriculum modules [50]. Another found that participating in strategic planning improved staff confidence in implementing policy, system and environment changes, including various responsive feeding practices in their childcare setting [56].…”

Implementation of Healthy Eating Interventions in Center-Based Childcare: The Selection, Application, and Reporting of Theories, Models, and Frameworks

“…And the Fit-or-Fix described process and factors to be considered in process evaluations. Two (14%) of the process-focused approaches used were developed specifically for center-based childcare services: one was the Assess, Identify, and Make it happen for preschools; the other was a set of steps to help local leaders with the implementation of Assess, Identify, Make it Happen (AIM) Empirical support 89 Application to a specific setting 89 Process guidance 89 Implementation steps 89 Developing a more flexible version of AIM-P for childcare home settings 89 Evaluation-focused approaches Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM)…”