Training early childcare providers in evidence-based nutrition strategies can help improve nutrition policies and practices of early childcare centres serving racially and ethnically diverse children from low-income families

Abstract

Our findings support training ECC directors, faculty and staff in evidence-based nutrition strategies to improve the nutrition policies and practices of ECC serving racially and ethnically diverse children from low-income families. The intervention resulted in improvements in some nutrition policies and practices, but not others. There remains a need to further develop the evaluation base involving the effectiveness of policy and practice interventions within ECC serving children in high-need areas.

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

“…Healthy Start moves the field forward for obesity prevention interventions in child care settings. Few rigorous intervention studies addressing obesity prevention have been conducted in child care settings [110–122]; and most of this previous work has been conducted in centers, not in FCCH. Published intervention studies have not included FCCH, which represent 13% of the spaces available for care in Rhode Island for pre-school aged children and FCCP care for 1.6 million children in the U.S. [123, 124] Only one other randomized controlled trial is currently evaluating an obesity prevention intervention in FCCH [57, 58].…”

“…The interventions involve: tailored written materials, videos, support coaching using brief MI, and community gatherings. Previous studies in child care have focused on intervention strategies such as food service [112, 114, 120] and curriculum changes [113, 122]; interventions directed toward center-based teachers, such as in-person training [110, 116, 125], non-tailored written materials [116, 119, 122, 125], academic detailing [119], and other types of technical assistance, and strategies that included parent and teacher modeling [121].…”

Pragmatic implementation studies to improve nutrition practices and policies: childcare during the first 1000 days as a contributor to long-term health

“…The paper by Hollar et al . published in this issue of Public Health Nutrition is an encouraging example of how a coordinated, well-planned pragmatic study can lead to positive outcomes from a policy and practice perspective in early childcare centres in Broward County, Florida, USA ( 16 ) . The authors implemented a multicomponent intervention and train-the-trainer programme to provide both training and technical assistance, and thereby to improve the nutrition context, policies and practices at the centres.…”

“…They targeted vulnerable groups in society (children from low-income families who were ethnically diverse) and partnered directly with the staff within the centres, working together on a ‘bottom up’ approach. Focused training, practical resources and expert support all contributed to improved nutrition environments in the centres ( 16 ) . The initiative demonstrates significant capacity building by identifying enablers for change within the early childcare system and leveraging current resources.…”

“…Hollar et al . have shown the value of investing in early childcare nutrition education and engaging professionals within this context, as well as the opportunity these settings present in providing care to children within the first 1000 d, consequently supporting childhood overweight and obesity prevention and early intervention agendas ( 16 ) . In our recent experiences of overweight and obesity management for children of all ages, we identified that children are being referred to specialist services too late – they are already morbidly obese and experiencing detrimental impacts due to their size ( 23 ) .…”