Does adherence to child care nutrition and physical activity best practices differ by child care provider's participation in support programs and training?

K. A. Loth; A. Shanafelt; C. S. Davey; J. O'Meara; J. Johnson-Reed; N. Larson; S. Nanney

doi:10.1016/j.childyouth.2019.104417

Does adherence to child care nutrition and physical activity best practices differ by child care provider's participation in support programs and training?

K. A. Loth, A. Shanafelt, C. S. Davey, J. O'Meara, J. Johnson-Reed, N. Larson, S. Nanney

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Introduction: To date, gaps exist in our understanding of how child care provider participation in various support programs is associated with the reported implementation of nutrition and physical activity best practices by child care providers. Thus, the purpose of the current study was to compare implementation of nutrition and physical activity best practices among child care providers engaged in the Child and Adult Food Care Program (CACFP), Parent AWARE, and other training opportunities, to implementation among providers who do not participate in each of these opportunities. Methods: Cross-sectional analysis of survey data collected from a stratified-random sample of licensed family-home and center-based child care settings (Family-homes n=394; Centers n= 224) in XXX from Month-Month 20XX. Descriptive statistics and multiple regression models were used to characterize differences in adherence to best practices based on program participation (CACFP, Parent AWARE, training) and type of child care setting (center versus family-home). Surveys measured self-reported engagement in nutrition and PA best practices as well as participation in CACFP, Parent Aware, and training opportunities. Results: Center-based child care providers participating in CACFP adhered to more nutrition and PA best practices than those not involved in CACFP. Further, with one exception, participating in Parent AWARE and engagement in training were positively associated with adherence to nutrition practices in center and family-home setting, and with adherence to PA practices in family homes. Conclusions: Child care providers should be encouraged to participate in available support programs; advocates should work to identify and remove barriers to support program participation.

Original language	English (US)
Article number	104417
Journal	Children and Youth Services Review
Volume	105
DOIs	https://doi.org/10.1016/j.childyouth.2019.104417
State	Published - Oct 2019

Bibliographical note

Funding Information:
The original Healthy Start, Healthy State study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co-PIs: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield provided funding ($76,000) for the current Healthy Start, Healthy State Study (2016) (PI: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive ($2,500).

Funding Information:
Members of the stakeholder group contributed significantly to the survey development and interpretation of the findings: Minnesota Department of Education, Minnesota Department of Health, Minnesota Department of Human Services, ECE Licensing, Minnesota Licensed Family Child Care Association, Minnesota Child Care Resource and Referral Network, West Central Initiative, Minnesota Extension/SNAP-Ed, Public Health Law Center, Hunger Impact Partners, Parent Aware, Bloomington Public Health, Renewing the Countryside, Partners in Nutrition, Center for Prevention, Head Start, Child and Adult Food Program Sponsors (e.g. Providers Choice). The authors would like to acknowledge the contributions of Natasha Frost and Anna Ayers Looby of the Public Health Law Center for their ECE law and regulatory expertise and syntheses of best practices across multiple entities. Additional University of Minnesota staff and student support included Susan Lowry and Annette Nicolai for providing data management and quality control checks and Brittany Stotmeister and Carly Griffiths for recruitment and data collection. This study was made possible by Marilyn “Susie” Nanney, a pioneer in child nutrition and obesity research and a strong advocate for policy and training support for educators across all child care and school environments. Susie died tragically in the summer of 2018, she is sorely missed by all her colleagues and collaborators. The original Healthy Start, Healthy State study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co-PIs: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield provided funding ($76,000) for the current Healthy Start, Healthy State Study (2016) (PI: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive ($2,500). KAL assisted with study planning and design; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; developed manuscript concept and design; prepared, edited and reviewed final manuscript. AS assisted with study planning and design; lead participant recruitment and data acquisition; assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. CSD assisted with study planning and design; assisted with participant recruitment and data acquisition; lead data cleaning and organization; completed analysis of data; critically revised manuscript and gave final approval of the article to be published. JM assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. JJR assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. NL assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. SN was the guarantor of integrity of the entire study; developed study concept and design; defined intellectual content; obtained funding for the study; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the University of Minnesota Institutional Review Board. Written informed consent was obtained from all subjects. None of the authors of this manuscript have any conflicts of interest to disclose. The University of Minnesota authors have no conflicts of interest to report.Members of the stakeholder group contributed significantly to the survey development and interpretation of the findings: Minnesota Department of Education, Minnesota Department of Health, Minnesota Department of Human Services, ECE Licensing, Minnesota Licensed Family Child Care Association, Minnesota Child Care Resource and Referral Network, West Central Initiative, Minnesota Extension/SNAP-Ed, Public Health Law Center, Hunger Impact Partners, Parent Aware, Bloomington Public Health, Renewing the Countryside, Partners in Nutrition, Center for Prevention, Head Start, Child and Adult Food Program Sponsors (e.g. Providers Choice). The authors would like to acknowledge the contributions of Natasha Frost and Anna Ayers Looby of the Public Health Law Center for their ECE law and regulatory expertise and syntheses of best practices across multiple entities. Additional University of Minnesota staff and student support included Susan Lowry and Annette Nicolai for providing data management and quality control checks and Brittany Stotmeister and Carly Griffiths for recruitment and data collection. This study was made possible by Marilyn “Susie” Nanney, a pioneer in child nutrition and obesity research and a strong advocate for policy and training support for educators across all child care and school environments. Susie died tragically in the summer of 2018, she is sorely missed by all her colleagues and collaborators. The original Healthy Start, Healthy State study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co-PIs: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield provided funding ($76,000) for the current Healthy Start, Healthy State Study (2016) (PI: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive (,500). KAL assisted with study planning and design; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; developed manuscript concept and design; prepared, edited and reviewed final manuscript. AS assisted with study planning and design; lead participant recruitment and data acquisition; assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. CSD assisted with study planning and design; assisted with participant recruitment and data acquisition; lead data cleaning and organization; completed analysis of data; critically revised manuscript and gave final approval of the article to be published. JM assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. JJR assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. NL assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. SN was the guarantor of integrity of the entire study; developed study concept and design; defined intellectual content; obtained funding for the study; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the University of Minnesota Institutional Review Board. Written informed consent was obtained from all subjects. None of the authors of this manuscript have any conflicts of interest to disclose. The University of Minnesota authors have no conflicts of interest to report.

Publisher Copyright:
© 2019

Keywords

Child and Adult Care Food Program
Child care
Child care training
Nutrition best practices
Physical activity best practices
Quality rating improvement system

Publisher link

10.1016/j.childyouth.2019.104417

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Cite this

@article{c6cdeb0fb52e4e6a92933948ca39d155,

title = "Does adherence to child care nutrition and physical activity best practices differ by child care provider's participation in support programs and training?",

abstract = "Introduction: To date, gaps exist in our understanding of how child care provider participation in various support programs is associated with the reported implementation of nutrition and physical activity best practices by child care providers. Thus, the purpose of the current study was to compare implementation of nutrition and physical activity best practices among child care providers engaged in the Child and Adult Food Care Program (CACFP), Parent AWARE, and other training opportunities, to implementation among providers who do not participate in each of these opportunities. Methods: Cross-sectional analysis of survey data collected from a stratified-random sample of licensed family-home and center-based child care settings (Family-homes n=394; Centers n= 224) in XXX from Month-Month 20XX. Descriptive statistics and multiple regression models were used to characterize differences in adherence to best practices based on program participation (CACFP, Parent AWARE, training) and type of child care setting (center versus family-home). Surveys measured self-reported engagement in nutrition and PA best practices as well as participation in CACFP, Parent Aware, and training opportunities. Results: Center-based child care providers participating in CACFP adhered to more nutrition and PA best practices than those not involved in CACFP. Further, with one exception, participating in Parent AWARE and engagement in training were positively associated with adherence to nutrition practices in center and family-home setting, and with adherence to PA practices in family homes. Conclusions: Child care providers should be encouraged to participate in available support programs; advocates should work to identify and remove barriers to support program participation.",

keywords = "Child and Adult Care Food Program, Child care, Child care training, Nutrition best practices, Physical activity best practices, Quality rating improvement system",

author = "Loth, {K. A.} and A. Shanafelt and Davey, {C. S.} and J. O'Meara and J. Johnson-Reed and N. Larson and S. Nanney",

note = "Funding Information: The original Healthy Start, Healthy State study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co-PIs: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield provided funding ($76,000) for the current Healthy Start, Healthy State Study (2016) (PI: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive ($2,500). Funding Information: Members of the stakeholder group contributed significantly to the survey development and interpretation of the findings: Minnesota Department of Education, Minnesota Department of Health, Minnesota Department of Human Services, ECE Licensing, Minnesota Licensed Family Child Care Association, Minnesota Child Care Resource and Referral Network, West Central Initiative, Minnesota Extension/SNAP-Ed, Public Health Law Center, Hunger Impact Partners, Parent Aware, Bloomington Public Health, Renewing the Countryside, Partners in Nutrition, Center for Prevention, Head Start, Child and Adult Food Program Sponsors (e.g. Providers Choice). The authors would like to acknowledge the contributions of Natasha Frost and Anna Ayers Looby of the Public Health Law Center for their ECE law and regulatory expertise and syntheses of best practices across multiple entities. Additional University of Minnesota staff and student support included Susan Lowry and Annette Nicolai for providing data management and quality control checks and Brittany Stotmeister and Carly Griffiths for recruitment and data collection. This study was made possible by Marilyn “Susie” Nanney, a pioneer in child nutrition and obesity research and a strong advocate for policy and training support for educators across all child care and school environments. Susie died tragically in the summer of 2018, she is sorely missed by all her colleagues and collaborators. The original Healthy Start, Healthy State study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co-PIs: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield provided funding ($76,000) for the current Healthy Start, Healthy State Study (2016) (PI: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive ($2,500). KAL assisted with study planning and design; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; developed manuscript concept and design; prepared, edited and reviewed final manuscript. AS assisted with study planning and design; lead participant recruitment and data acquisition; assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. CSD assisted with study planning and design; assisted with participant recruitment and data acquisition; lead data cleaning and organization; completed analysis of data; critically revised manuscript and gave final approval of the article to be published. JM assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. JJR assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. NL assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. SN was the guarantor of integrity of the entire study; developed study concept and design; defined intellectual content; obtained funding for the study; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the University of Minnesota Institutional Review Board. Written informed consent was obtained from all subjects. None of the authors of this manuscript have any conflicts of interest to disclose. The University of Minnesota authors have no conflicts of interest to report.Members of the stakeholder group contributed significantly to the survey development and interpretation of the findings: Minnesota Department of Education, Minnesota Department of Health, Minnesota Department of Human Services, ECE Licensing, Minnesota Licensed Family Child Care Association, Minnesota Child Care Resource and Referral Network, West Central Initiative, Minnesota Extension/SNAP-Ed, Public Health Law Center, Hunger Impact Partners, Parent Aware, Bloomington Public Health, Renewing the Countryside, Partners in Nutrition, Center for Prevention, Head Start, Child and Adult Food Program Sponsors (e.g. Providers Choice). The authors would like to acknowledge the contributions of Natasha Frost and Anna Ayers Looby of the Public Health Law Center for their ECE law and regulatory expertise and syntheses of best practices across multiple entities. Additional University of Minnesota staff and student support included Susan Lowry and Annette Nicolai for providing data management and quality control checks and Brittany Stotmeister and Carly Griffiths for recruitment and data collection. This study was made possible by Marilyn “Susie” Nanney, a pioneer in child nutrition and obesity research and a strong advocate for policy and training support for educators across all child care and school environments. Susie died tragically in the summer of 2018, she is sorely missed by all her colleagues and collaborators. The original Healthy Start, Healthy State study (2010) was funded by the University of Minnesota and University of Wisconsin Clinical and Translational Science Institutes (Co-PIs: Nanney, MS and LaRowe, T). Through a cooperative agreement, the Center for Prevention at Blue Cross and Blue Shield provided funding ($76,000) for the current Healthy Start, Healthy State Study (2016) (PI: Nanney, MS). Additional unspecified funds were provided by Minnesota Hunger Impact Partners and used to increase the provider incentive (,500). KAL assisted with study planning and design; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; developed manuscript concept and design; prepared, edited and reviewed final manuscript. AS assisted with study planning and design; lead participant recruitment and data acquisition; assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. CSD assisted with study planning and design; assisted with participant recruitment and data acquisition; lead data cleaning and organization; completed analysis of data; critically revised manuscript and gave final approval of the article to be published. JM assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. JJR assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. NL assisted with interpretation of data; critically revised manuscript and gave final approval of the article to be published. SN was the guarantor of integrity of the entire study; developed study concept and design; defined intellectual content; obtained funding for the study; assisted with participant recruitment and data acquisition; participated in data cleaning and organization; assisted with in interpretation of data; critically revised manuscript and gave final approval of the article to be published. This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects/patients were approved by the University of Minnesota Institutional Review Board. Written informed consent was obtained from all subjects. None of the authors of this manuscript have any conflicts of interest to disclose. The University of Minnesota authors have no conflicts of interest to report. Publisher Copyright: {\textcopyright} 2019",

year = "2019",

month = oct,

doi = "10.1016/j.childyouth.2019.104417",

language = "English (US)",

volume = "105",

journal = "Children and Youth Services Review",