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Umstattd Meyer MR, Houghtaling B, Wende ME, Kheshaifaty KH, Delgado H, Eze SA, Mecate C, Summerall Woodward R, Morgan RL, Krey KJ. A scoping review of policies to encourage breastfeeding, healthy eating, and physical activity among rural people and places in the United States. BMC Public Health 2024; 24:2160. [PMID: 39123168 PMCID: PMC11313091 DOI: 10.1186/s12889-024-19173-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/17/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Rural U.S. residents experience a disproportionate burden of diet and physical activity (PA) related chronic disease compared to urban residents, due to resource and economic challenges. Diverse policy approaches for chronic disease prevention have been implemented to address barriers to breastfeeding, healthy eating, and PA. Therefore, the purpose of this paper is to describe policy supports for breastfeeding, healthy eating, and/or PA occurring in rural U.S. areas. METHODS A scoping review was conducted March-June 2020 to identify policy, systems, and environment change approaches occurring in the rural U.S. for breastfeeding, healthy eating, and PA. Search procedures were guided by the PRISMA-ScR, Arksey and O'Malley's work (2007), and a science librarian. Medline, PubMed, Web of Science, and Agricola were used to identify peer-reviewed research. ProQuest Dissertations and Theses A&I were used to identify dissertation research. Grey literature searches included Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Policy results are reported and inclusion criteria were: (1) breastfeeding, healthy eating, and/or PA focus; (2) about policy factors; (3) specific to U.S. rural populations/places; and (4) English language. Outcomes (study/source design, objective(s), methods/measurement, setting, population characteristics, behavioral focus, policy-specific results) were extracted into a standardized Excel document. RESULTS Results include 122 total sources: original research, with some sources referencing multiple behaviors, (n = 74 sources: 8 breastfeeding, 41 healthy eating, 42 PA), grey literature (n = 45 sources: 16 breastfeeding, 15 healthy eating, 27 PA), and graduate research (n = 3 sources: 1 breastfeeding, 2 healthy eating, 1 PA). Breastfeeding policy initiatives included policies or programs at hospitals, increasing access to resources, and improving culture or norms at workplaces. Healthy eating policy initiatives included increasing access to healthy foods, reducing financial burden, implementing programs, food assistance programs, and healthy food prescriptions at healthcare facilities. PA policy initiatives focused on Complete Streets, joint or shared use efforts, Safe Routes to Schools, master plans for greenways, trails, and/or transportation, school health plans, and childcare/school standards. CONCLUSIONS Results from this scoping review compile and offer commentary on existing policy solutions to improve breastfeeding, healthy eating, and/or PA in the rural U.S.
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Affiliation(s)
- M Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA.
| | | | - Marilyn E Wende
- Department of Health Education and Behavior, College of Health and Human Performance University of Florida, Gainesville, FL, USA
| | - Khawlah H Kheshaifaty
- School of Nutrition and Food Science, Louisiana State University Agricultural Center, Louisiana State University, Baton Rouge, LA, USA
| | - Haley Delgado
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Stephanie A Eze
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Cassady Mecate
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Rebekah Summerall Woodward
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | | | - Kathy J Krey
- School of Education, Baylor University, Waco, TX, USA
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Samuel-Hodge CD, Gizlice Z, Guy AR, Bernstein K, Victor AY, George T, Hamlett TS, Harrison LM. A Mixed-Method Evaluation of a Rural Elementary School Implementing the Coordinated Approach to Child Health (CATCH) Program. Nutrients 2023; 15:2729. [PMID: 37375633 PMCID: PMC10304257 DOI: 10.3390/nu15122729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/29/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Despite children living in rural US areas having 26% greater odds of being affected by obesity compared to those living in urban areas, the implementation of evidence-based programs in rural schools is rare. We collected quantitative data (weight and height) from 272 racially and ethnically diverse students at baseline, and qualitative data from students (4 focus groups), parents, and school staff (16 semi-structured interviews and 29 surveys) to evaluate program outcomes and perceptions. At the 2-year follow-up, paired data from 157 students, represented by racial/ethnic groups of 59% non-Hispanic White, 31% non-Hispanic Black, and 10% Hispanic, showed an overall mean change (SD) in BMI z-score of -0.04 (0.59), a decrease of -0.08 (0.69) in boys, and a significant -0.18 (0.33) decrease among Hispanic students. Boys had a mean decrease in obesity prevalence of 3 percentage points (from 17% to 14%), and Hispanic students had the largest mean decrease in BMI percentile. Qualitative data showed positive perceptions of the CATCH program and its implementation. This community-engaged research, with collaboration from an academic institution, a health department, a local wellness coalition, and a rural elementary school, demonstrated successful CATCH program implementation and showed promising outcomes in mean BMI changes.
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Affiliation(s)
- Carmen D. Samuel-Hodge
- Gillings School of Global Public Health, Department of Nutrition, Center for Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., Room 216, CB #7426, Chapel Hill, NC 27599-7426, USA
| | - Ziya Gizlice
- Center for Health Promotion & Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., CB #7426, Chapel Hill, NC 27599-7426, USA; (Z.G.); (A.R.G.); (K.B.); (A.Y.V.); (T.S.H.)
| | - Alexis R. Guy
- Center for Health Promotion & Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., CB #7426, Chapel Hill, NC 27599-7426, USA; (Z.G.); (A.R.G.); (K.B.); (A.Y.V.); (T.S.H.)
| | - Kathryn Bernstein
- Center for Health Promotion & Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., CB #7426, Chapel Hill, NC 27599-7426, USA; (Z.G.); (A.R.G.); (K.B.); (A.Y.V.); (T.S.H.)
| | - Aurore Y. Victor
- Center for Health Promotion & Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., CB #7426, Chapel Hill, NC 27599-7426, USA; (Z.G.); (A.R.G.); (K.B.); (A.Y.V.); (T.S.H.)
| | - Tyler George
- Division of General Medicine, School of Medicine, University of North Carolina at Chapel Hill, 102 Mason Farm Rd. #3100, Chapel Hill, NC 27599, USA;
| | - Trevor S. Hamlett
- Center for Health Promotion & Disease Prevention, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., CB #7426, Chapel Hill, NC 27599-7426, USA; (Z.G.); (A.R.G.); (K.B.); (A.Y.V.); (T.S.H.)
| | - Lisa M. Harrison
- Granville Vance Public Health, 1032 College St., Oxford, NC 27565, USA;
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Kracht CL, Burkart S, Flanagan EW, Melnick E, Luecking C, Neshteruk C. Policy, system, and environmental interventions addressing obesity and diet-related outcomes in early childhood education settings: A systematic review. Obes Rev 2023; 24:e13547. [PMID: 36601716 PMCID: PMC10214414 DOI: 10.1111/obr.13547] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/06/2022] [Indexed: 01/06/2023]
Abstract
Early childhood education (ECE) settings play an important role in child dietary intake and excess weight gain. Policy, systems, and environment (PSE) approaches have potential to reduce disparities in children at higher risk for obesity. The purpose of this review was to (1) characterize the inclusion of populations at higher risk for obesity in ECE interventions and (2) identify effective ECE interventions in these populations. Seven databases were searched for ECE interventions. Intervention characteristics and methodological quality were assessed in 35 articles representing 34 interventions. Interventions identified were mainly a combination of ECE and parent interventions (41%) or stand-alone ECE intervention (29%), with few multisector efforts (23%) or government regulations assessed (5%). Many included policy (70%) or social environment components (61%). For Aim 1, two thirds were conducted in primarily populations at higher risk for obesity (67%). Studies were rated as fair or good methodological quality. For Aim 2, 10 studies demonstrated effectiveness at improving diet or reducing obesity in populations at higher risk for obesity. Most included a longer intervention (i.e., >6 months), multiple PSE components, and formative work. Opportunities to incorporate more PSE components in ECE-based interventions and collaborate with parents and communities are warranted to improve child health.
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Affiliation(s)
- Chelsea L. Kracht
- Clinical Science Department, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Sarah Burkart
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Emily W. Flanagan
- Clinical Science Department, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Emily Melnick
- College of Health Solutions, Arizona State University, Phoenix, Arizona, USA
| | - Courtney Luecking
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, Kentucky, USA
| | - Cody Neshteruk
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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McIsaac JLD, MacQuarrie M, Barich R, Morris S, Turner JC, Rossiter MD. Responsive Feeding Environments in Childcare Settings: A Scoping Review of the Factors Influencing Implementation and Sustainability. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11870. [PMID: 36231167 PMCID: PMC9564844 DOI: 10.3390/ijerph191911870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/16/2023]
Abstract
Children benefit from responsive feeding environments, where their internal signals of hunger and satiety are recognized and met with prompt, emotionally supportive and developmentally appropriate responses. Although there is existing research on responsive feeding environments in childcare, there is little synthesized literature on the implementation practices using a behavior change framework. This scoping review sought to explore the factors influencing the implementation and sustainability of responsive feeding interventions in the childcare environment, using the behavior change wheel (BCW). A total of 3197 articles were independently reviewed and 39 met the inclusion criteria. A thematic analysis identified the factors influencing the implementation and sustainability of responsive feeding, including the following: (1) pre-existing nutrition policies, (2) education and training, (3) provider beliefs and confidence, (4) partnership development and stakeholder engagement and (5) resource availability. The most common BCW intervention functions were education (n = 39), training (n = 38), environmental restructuring (n = 38) and enablement (n = 36). The most common policy categories included guidelines (n = 39), service provision (n = 38) and environmental/social planning (n = 38). The current literature suggests that broader policies are important for responsive feeding, along with local partnerships, training and resources, to increase confidence and efficacy among educators. Future research should consider how the use of a BCW framework may help to address the barriers to implementation and sustainability.
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Affiliation(s)
- Jessie-Lee D. McIsaac
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Madison MacQuarrie
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Rachel Barich
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Sarah Morris
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Joan C. Turner
- Department of Child and Youth Study, Faculty of Education, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada
| | - Melissa D. Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
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Kenney EL, Mozaffarian RS, Ji W, Tucker K, Poole MK, DeAngelo J, Bailey ZD, Cradock AL, Lee RM, Frost N. Moving from Policy to Practice for Early Childhood Obesity Prevention: A Nationwide Evaluation of State Implementation Strategies in Childcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10304. [PMID: 36011939 PMCID: PMC9408404 DOI: 10.3390/ijerph191610304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 06/12/2023]
Abstract
Policies requiring childcare settings to promote healthy eating, physical activity, and limited screentime have the potential to improve young children's health. However, policies may have limited impact without effective implementation strategies to promote policy adoption. In this mixed-methods study, we evaluated the type, quality, and dose of implementation strategies for state-level childcare licensing regulations focused on healthy eating, physical activity, or screentime using: (1) a survey of state licensing staff and technical assistance providers (n = 89) in 32 states; (2) a structured review of each state's childcare licensing and training websites for childcare providers; and (3) in-depth, semi-structured interviews with 31 childcare licensing administrators and technical assistance providers across 17 states. Implementation strategies for supporting childcare providers in adopting healthy eating, physical activity, and screentime regulations vary substantially by state, in quantity and structure. Childcare programs' financial challenges, staff turnover, and lack of adequate facilities were identified as key barriers to adoption. Access to federal food programs was seen as critical to implementing nutrition regulations. Implementation resources such as training and informational materials were rarely available in multiple languages or targeted to providers serving low-income or racially/ethnically diverse families. There is a substantial need for implementation supports for ensuring policies are successfully and equitably implemented in childcare.
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Affiliation(s)
- Erica L. Kenney
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Rebecca S. Mozaffarian
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Wendy Ji
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Kyla Tucker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Mary Kathryn Poole
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Julia DeAngelo
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Zinzi D. Bailey
- Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Angie L. Cradock
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Rebekka M. Lee
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Natasha Frost
- Public Health Law Center, Mitchell Hamline School of Law, St. Paul, MN 55105, USA
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Elford A, Gwee C, Veal M, Jani R, Sambell R, Kashef S, Love P. Identification and Evaluation of Tools Utilised for Measuring Food Provision in Childcare Centres and Primary Schools: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4096. [PMID: 35409781 PMCID: PMC8998327 DOI: 10.3390/ijerph19074096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 12/04/2022]
Abstract
BACKGROUND Children aged 2-11 years spend significant hours per week in early childhood education and care (ECEC) and primary schools. Whilst considered important environments to influence children's food intake, there is heterogeneity in the tools utilised to assess food provision in these settings. This systematic review aimed to identify and evaluate tools used to measure food provision in ECEC and primary schools. METHODS The Preferred Reporting Items for Systematic Reviews (PRISMA) was followed. Publications (2003-2020) that implemented, validated, or developed measurement tools to assess food provision within ECEC or primary schools were included. Two reviewers extracted and evaluated studies, cross checked by a third reviewer and verified by all authors. The Academy of Nutrition and Dietetics Quality Criteria Checklist (QCC) was used to critically appraise each study. RESULTS Eighty-two studies were included in the review. Seven measurement tools were identified, namely, Menu review; Observation; Weighed food protocol; Questionnaire/survey; Digital photography; Quick menu audit; and Web-based menu assessment. An evidence-based evaluation was conducted for each tool. CONCLUSIONS The weighed food protocol was found to be the most popular and accurate measurement tool to assess individual-level intake. Future research is recommended to develop and validate a tool to assess service-level food provision.
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Affiliation(s)
- Audrey Elford
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia;
| | - Cherice Gwee
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (C.G.); (M.V.)
| | - Maliney Veal
- Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (C.G.); (M.V.)
| | - Rati Jani
- School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD 4222, Australia;
| | - Ros Sambell
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Perth, WA 6027, Australia;
| | - Shabnam Kashef
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
| | - Penelope Love
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3216, Australia;
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Kear K, Stotz S, Love K, Cox GO, Birch LL, Cotwright CJ. Assessing health disparities in foods and beverages served in early care and education programs across Georgia. Pediatr Obes 2021; 16:e12787. [PMID: 33729706 DOI: 10.1111/ijpo.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/22/2020] [Accepted: 02/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Obesity disproportionately impacts children who are Black and Hispanic, those who live in rural communities and those who have low income. Predisposition to obesity early in life is profoundly impacted by feeding habits during the preschool years. The early care and education (ECE) setting impacts children's health by providing daily meals. OBJECTIVE The goal of this study was to identify whether or not health disparities in foods and beverages served in ECE programs in Georgia exist based on socioeconomic, demographic and geographic variables. METHODS A random sample was drawn from 3054 ECE programs across the state of Georgia. The likelihood of serving specific foods and beverages in ECE programs in the previous day was measured. Percentages and frequencies, logistic regressions, Spearman's rho and Odds ratio tests determined outcomes. RESULTS A total of 974 surveys were returned. Data were stratified based on the income level of the participant families, race of enrolled children and geographic location of the ECE program. Disparities existed between programs based on race of enrolled children and geographic location. For example, although the odds of providing sweets increased by 0.6% as the percentage of Black children enrolled increased, the provision of healthier foods, such as the odds of providing fruits (P = .001), vegetables (P = .001) and protein (P = .001) also increased. However, after results were adjusted for covariates findings did not remain significant. CONCLUSIONS Future research focused on evaluating the foods and beverages provided in ECE programs and the relationship of how income, race and location are related may provide further understanding about the disproportionate childhood obesity rates in America.
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Affiliation(s)
- Kathryn Kear
- Department of Foods and Nutrition, University of Georgia College of Family and Consumer Sciences, Athens, Georgia, USA
| | - Sarah Stotz
- Centers for American Indian and Alaska Native Health, University of Colorado Denver - Anschutz Medical Campus, Denver, Colorado, USA
| | - Kim Love
- K.R. Love Quantitative Consulting and Collaboration, Athens, Georgia, USA
| | - Ginnefer O Cox
- Department of Foods and Nutrition, University of Georgia College of Family and Consumer Sciences, Athens, Georgia, USA
| | - Leann L Birch
- Department of Foods and Nutrition, University of Georgia College of Family and Consumer Sciences, Athens, Georgia, USA
| | - Caree J Cotwright
- Department of Foods and Nutrition, University of Georgia College of Family and Consumer Sciences, Athens, Georgia, USA
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Kohel K, Hatton-Bowers H, Williams N, Dev D, Behrends D, Hulse E, Rida Z, Dingman H, Dinkel D, Gebhart L. Improving Breastfeeding Environments and Feeding Practices in Family Child Care Homes with the Go NAP SACC Program. Matern Child Health J 2021; 25:510-520. [PMID: 33389587 DOI: 10.1007/s10995-020-03075-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Breastfeeding and responsive feeding are important practices that support the health of infants and women. In the United States, breastfeeding continuation rates remain lower than recommended, and working women face additional challenges with breastfeeding continuation. Providers in a family child care setting are uniquely positioned to support and provide important resources to families in their breastfeeding and infant feeding practices. METHODS The Go NAP SACC program was designed to improve the nutrition and physical activity environments and practices in child care settings serving infants and young children. This evaluation focuses on Breastfeeding and Infant Feeding in Nebraska Family Child Care Homes (FCCH). ASSESSMENT Paired-sample t-tests were used to examine differences in pre-post evaluation scores. A repeated measure ANCOVA was used to examine differences between rural-urban settings. Nebraska FCCH met recommendations at pre-test, and exceeded recommendations at post-test (p < .05). Rural and urban FCCH performed equally well in 18 of 22 items, indicating little difference in the ability to provide supportive environments and adhere to best practices in both settings. Improvement in family engagement items were significant at the p < .001 level. Family engagement in FCCH is an important area for intervention that was well-received by provider participants. CONCLUSION This evaluation shows that the Go NAP SACC program improves breastfeeding and infant feeding environments and practices in rural and urban FCCH. Interventions should continue to focus on basic and practical education and professional development for FCCH providers, with emphasis on intentional family engagement and support.
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Affiliation(s)
- Kara Kohel
- Nebraska Extension, Institute of Agriculture and Natural Resources, University of Nebraska-Lincoln, Lincoln, USA. .,Nebraska Extension in Seward County, 322 South 14th Street, Seward, NE, 68434, USA.
| | - Holly Hatton-Bowers
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, USA
| | - Natalie Williams
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, USA
| | - Dipti Dev
- Department of Child, Youth and Family Studies, University of Nebraska-Lincoln, Lincoln, USA
| | - Donnia Behrends
- Department of Nutrition and Health Science, University of Nebraska-Lincoln, Lincoln, USA
| | - Emily Hulse
- Center for the Child & Community, Children's Hospital & Medical Center, Lincoln, NE, USA
| | - Zainab Rida
- Nebraska Department of Education, Lincoln, NE, USA
| | - Holly Dingman
- Center for the Child & Community, Children's Hospital & Medical Center, Lincoln, NE, USA
| | - Danae Dinkel
- School of Health & Kinesiology, University of Nebraska At Omaha, Omaha, NE, USA
| | - Liz Gebhart
- Nebraska Department of Health and Human Services, Lincoln, NE, USA
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Eastern North Carolina Head Start Teachers' personal and professional experiences with healthy eating and physical activity: a qualitative exploration. Public Health Nutr 2020; 24:3460-3476. [PMID: 33190662 DOI: 10.1017/s1368980020003687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Explore the interrelationship between teachers' personal and professional socio-ecological structures while examining Head Start (HS) teachers' experiences with (1) trying to eat healthy and engage in physical activity (PA) and (2) promote healthy eating and PA in their classrooms. DESIGN In-depth semi-structured interviews were collected from March through June 2017. Researchers designed the data collection and analysis methods using a phenomenological approach. All interviews were recorded using digital audio and transcribed verbatim. SETTING Seven HS centres in two rural eastern North Carolina counties. PARTICIPANTS Teachers (n 15) who had recently participated in a healthy eating and physical activity intervention. Participants were 100 % female, an average age of 43 years (sd 9·6) and primarily Black/African American (93·3 %). RESULTS Eighteen primary themes were identified providing unique insight into individual, social and environmental determinants that may influence teachers' personal health behaviours and professional health promotion practices. Findings indicated that teachers want to improve health behaviours personally (individual/family health) and professionally (children/families served); however, barriers exist at all levels impacting their ability to improve their own health and facilitate positive behaviours among the children/families they serve. Many teachers observed connections between their personal and professional experiences, but not beyond the individual level. CONCLUSIONS Study findings highlight the importance of considering and emphasising the potential relationship between personal and professional determinants of health when working with early childhood teachers. Findings from this study may be useful for informing the development, implementation and evaluation of future health promotion interventions using teachers as implementers.
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Arcan C, Davey C, LaRowe TL, Nanney MS. Provider-Selected Training Needs and Associations With Related Practices in Childcare Settings in Minnesota and Wisconsin. THE JOURNAL OF SCHOOL HEALTH 2020; 90:869-877. [PMID: 32954497 DOI: 10.1111/josh.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/30/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Early care and education settings (ECE) are potential venues for young children to develop healthy lifestyle habits. The study assesses training needs and associations with relevant practices of licensed ECE providers across Minnesota and Wisconsin. METHODS A random sample of 823 providers completed a 97-item survey assessing nutrition and physical activity (PA) practices and training needs. Logistic regression, adjusted for program type (center- and family home-based), and location (urban/rural) examined associations between the top 3 selected training needs and provider practices. RESULTS Top training needs: (1) ways to effectively engage parents about healthy eating and PA, (2) low-cost ways to serve healthy foods, and (3) fun and easy nutrition education curricula. Providers who reported being not happy/somewhat happy vs happy/very happy with parent communication were more likely to need training to engage parents. Among providers who prepared food on-site, shopping at Farmer's Market had lower odds of needing training for serving healthy meals on a budget. Not having completed nutrition training in the past year providers were more likely to need training for fun and easy nutrition education curricula. CONCLUSIONS Providers need additional training to improve communication with parents, healthy food shopping practices, and nutrition-related games.
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Affiliation(s)
- Chrisa Arcan
- Assistant Professor, , Family, Population, and Preventive Medicine, Stony Brook University, HSC Level 3, Suite 086, Stony Brook, NY 11794-8036
| | - Cynthia Davey
- Senior Biostatistician, , Biostatistical Design and Analysis Center, Clinical and Translational Science Institute, University of Minnesota, 717 Delaware St. SE, Minneapolis MN 55414
| | - Tara L LaRowe
- Faculty Associate, , Coordinator-Didactic Program in Dietetics, Department of Nutritional Sciences, University of Wisconsin-Madison, 1415 Linden Drive, Madison, WI 53706
| | - Marilyn S Nanney
- Associate Professor, , University of Minnesota, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414
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Dev DA, Garcia AS, Dzewaltowski DA, Sisson S, Franzen-Castle L, Rida Z, Williams NA, Hillburn C, Dinkel D, Srivastava D, Burger C, Hulse E, Behrends D, Frost N. Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska. Prev Med Rep 2020; 17:101021. [PMID: 31908908 PMCID: PMC6939097 DOI: 10.1016/j.pmedr.2019.101021] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 11/01/2019] [Accepted: 11/13/2019] [Indexed: 12/13/2022] Open
Abstract
Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children's dietary intake. Childcare settings vary in organizational structure - childcare centers (CCCs) vs. family childcare homes (FCCHs) - and in geographical location - urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p < .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations.
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Affiliation(s)
- Dipti A. Dev
- Department of Child Youth and Family Studies, Louise Pound Hall, University of Nebraska-Lincoln, 512 N 12th St, Lincoln NE, 68588-0366, USA
| | - Aileen S. Garcia
- Department of Child Youth and Family Studies, Louise Pound Hall, University of Nebraska-Lincoln, 512 N 12th St, Lincoln NE, 68588-0366, USA
- Department of Counseling and Human Development, South Dakota State University, Brookings, SD, USA
| | - David A. Dzewaltowski
- Buffett Early Childhood Institute, Department of Health Promotion, University of Nebraska Medical Center, 986075 Nebraska Medical Center, Omaha, NE 68198-4365, USA
| | - Susan Sisson
- Department of Nutritional Sciences, College of Allied Health, University of Oklahoma Health Sciences Center, 1200 N Stonewall, Suite 3057, Oklahoma City, OK 73117-1215, USA
| | - Lisa Franzen-Castle
- Department of Nutrition and Health Sciences, Ruth Leverton Hall, University of Nebraska-Lincoln, 1700 N 35th St, Lincoln, NE 68583-0806, USA
| | - Zainab Rida
- Nebraska Department of Education, 301 Centennial Mall South, P.O. Box 94987, Lincoln, NE 68509-4987, USA
| | - Natalie A. Williams
- Department of Child Youth and Family Studies, Louise Pound Hall, University of Nebraska-Lincoln, 512 N 12th St, Lincoln NE, 68588-0366, USA
| | - Carly Hillburn
- Department of Nutrition and Health Sciences, Ruth Leverton Hall, University of Nebraska-Lincoln, 1700 N 35th St, Lincoln, NE 68583-0806, USA
| | - Danae Dinkel
- School of Health and Kinesiology, H&K Building, University of Nebraska, Omaha, 6001 Dodge Street, Omaha, NE 68182, USA
| | - Deepa Srivastava
- Cooperative Extension, University of California Agriculture & Natural Resources, 4437-B South Laspina Street, Tulare, CA 93274, USA
| | - Christina Burger
- Nebraska Department of Education, 301 Centennial Mall South, P.O. Box 94987, Lincoln, NE 68509-4987, USA
| | - Emily Hulse
- Children’s Hospital & Medical Center, 2021 Transformation Drive, Suite 1250, Lincoln, NE 68508, 402.955.6887, USA
| | - Donnia Behrends
- Department of Nutrition and Health Sciences, Ruth Leverton Hall, University of Nebraska-Lincoln, 1700 N 35th St, Lincoln, NE 68583-0806, USA
| | - Natasha Frost
- Senior Staff Attorney, Public Health Law Center, USA
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Dinkel D, Dev D, Guo Y, Sedani A, Hulse E, Rida Z, Abel K. Comparison of Urban and Rural Physical Activity and Outdoor Play Environments of Childcare Centers and Family Childcare Homes. FAMILY & COMMUNITY HEALTH 2020; 43:264-275. [PMID: 32658027 DOI: 10.1097/fch.0000000000000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The purpose of this study was to examine the physical activity environment in childcare programs across type (childcare centers [CCCs] and family childcare homes [FCCHs]) and geographic location (urban and rural) as assessed by physical activity best practices according to the Go Nutrition and Physical Activity Self-assessment in Child Care. Results showed CCCs compared with FCCHs reported higher achievement of best practices. Further, urban childcare programs (CCCs and FCCHs) reported higher achievement of best practices in comparison to rural childcare programs. There is a need to deliver targeted interventions that promote children's physical activity in FCCHs and CCCs in rural areas.
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Affiliation(s)
- Danae Dinkel
- School of Health and Kinesiology, University of Nebraska at Omaha, Omaha (Dr Dinkel); Department of Child, Youth, and Family Studies, University of Nebraska, Lincoln (Dr Dev and Ms Guo); Nebraska Department of Health & Human Services, Lincoln (Mss Sedani and Abel); University of Oklahoma Health Sciences Center, Oklahoma City (Ms Sedani); Children's Hospital and Medical Center, Center for the Child & Community, Lincoln, Nebraska (Ms Hulse); Nebraska Department of Education, Lincoln (Dr Rida); and Family Service WIC, Lincoln, Nebraska (Ms Abel)
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13
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Park SH, Min H. Promoting a healthy childcare environment: A focus group study of childcare providers' perspectives. Nurs Health Sci 2019; 22:254-262. [PMID: 31854129 DOI: 10.1111/nhs.12675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022]
Abstract
Establishing healthy habits in the childcare setting for children aged 2-5 is pivotal for their healthy development and obesity prevention. The purpose of this qualitative study was to explore the perceptions and practices that childcare providers demonstrate when they promote healthy eating and physical activity among preschoolers. Four focus group interviews with 16 childcare providers were conducted in northwest Florida. A semistructured focus group guide was used. Discussions were audiorecorded and transcribed verbatim. Content analysis was performed to analyze the data with the use of ATLAS.ti software. This study followed the COREQ guidelines. Three major themes emerged from the data: (i) efforts to encourage children to eat healthfully and engage in physical activity; (ii) challenges in promoting healthy behaviors among children; and (iii) the need for more childcare provider training and parental involvement to encourage healthy eating. Regular childcare provider training and parental involvement are needed to establish a healthy environment for preschoolers.
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Affiliation(s)
- So Hyun Park
- College of Nursing, Florida State University, Tallahassee, Florida, USA
| | - Haeyoung Min
- College of Nursing, Gyeongsang National University, Jinju, South Korea
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14
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de Zwarte D, Kearney J, Corish CA, Glennon C, Maher L, Johnston Molloy C. Randomised study demonstrates sustained benefits of a pre-school intervention designed to improve nutrition and physical activity practices. J Public Health (Oxf) 2019; 41:798-806. [PMID: 30281073 DOI: 10.1093/pubmed/fdy173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/21/2018] [Accepted: 09/11/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Health-promoting programmes must demonstrate sustained efficacy in order to make a true impact on public health. This study aimed to determine the effect of the Healthy Incentive for Pre-schools project on health-promoting practices in full-day-care pre-schools 18 months after a training intervention. METHODS Thirty-seven pre-schools completed the initial study and were included in this follow-up study. The intervention consisted of one training session with either the pre-school 'manager-only' or 'manager and staff' using a specifically developed needs-based training resource pack comprised of written educational material and a validated health-promoting practice evaluation tool. Direct observation data of health-promoting practices were collected and allocated a score using the evaluation tool by a research dietitian at three time points; pre-intervention, between 6 and 9 months post-intervention and at 18-month follow-up. An award system was used to incentivise pre-schools to improve their scores. RESULTS Health-promoting practice scores improved significantly (P < 0.001) from the 6-9 month post-intervention to the 18-month follow-up evaluation. No significant differences were observed between 'manager-only' and 'manager and staff' trained pre-schools. CONCLUSIONS The introduction of a pre-school evaluation tool supported by a training resource was successfully used to incentivise pre-schools to sustain and improve health-promoting practices 18 months after intervention training.
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Affiliation(s)
- Diewerke de Zwarte
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - John Kearney
- School of Biological Sciences, Dublin Institute of Technology, Dublin 8, Republic of Ireland
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - Corina Glennon
- Community Nutrition and Dietetic Service, Health Service Executive Dublin Mid-Leinster, Primary Care Unit, St. Loman's Hospital Campus, Co. Westmeath, Republic of Ireland
| | - Lorraine Maher
- Community Nutrition and Dietetic Service, Health Service Executive Dublin Mid-Leinster, Primary Care Unit, St. Loman's Hospital Campus, Co. Westmeath, Republic of Ireland
| | - Charlotte Johnston Molloy
- Community Nutrition and Dietetic Service, Health Service Executive Dublin Mid-Leinster, Primary Care Unit, St. Loman's Hospital Campus, Co. Westmeath, Republic of Ireland
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15
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Razak LA, Jones J, Clinton-McHarg T, Wolfenden L, Lecathelinais C, Morgan PJ, Wiggers JH, Tursan D'Espaignet E, Grady A, Yoong SL. Implementation of policies and practices to increase physical activity among children attending centre-based childcare: A cross-sectional study. Health Promot J Austr 2019; 31:207-215. [PMID: 31206852 DOI: 10.1002/hpja.268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 06/13/2019] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED Supporting centre-based childcare services to create physical activity (PA) environments is a recommended strategy to improve child PA. This study aimed to describe the implementation of PA policies and practices by these services, and to examine the associations with service characteristics. METHODS Nominated supervisors of childcare services (n = 309) in the Hunter New England region, New South Wales, Australia, completed a telephone interview. Using previously validated measures, the interview assessed the implementation of evidence-based practices shown to be associated with child PA. This includes: (a) provision of active play opportunities, (b) portable play equipment availability, (c) delivery of daily fundamental movement skills, (d) having at least 50% of staff trained in promoting child PA the past 5 years and (e) having written PA and small screen recreation policies. RESULTS Although 98% (95% CI 96, 99) of childcare services provided active play opportunities for at least 25% of their daily opening hours, only 8% (95% CI 5, 11) of services fully implemented all policies and practices; with no service characteristic associated with full implementation. Long day care service had twice the odds of having a written PA policy (OR 2.0, 95% CI 0.7, 5.8), compared to preschools (adjusted for service size, socio-economic disadvantage and geographical location). CONCLUSIONS Improvements could be made to childcare services' operations to support the promotion of child PA. SO WHAT?: To ensure the benefits to child health, childcare services require support to implement a number of PA promoting policies and practices that are known to improve child PA.
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Affiliation(s)
- Lubna A Razak
- Hunter New England Population Health, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Jannah Jones
- Hunter New England Population Health, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Tara Clinton-McHarg
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia.,School of Psychology, University of Newcastle, Callaghan, NSW, Australia
| | - Luke Wolfenden
- Hunter New England Population Health, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | | | - Philip J Morgan
- Faculty of Education & Arts, Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Callaghan, NSW, Australia
| | - John H Wiggers
- Hunter New England Population Health, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Edouard Tursan D'Espaignet
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,School of Rural Medicine, University of New England, Armidale, NSW, Australia
| | - Alice Grady
- Hunter New England Population Health, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
| | - Sze Lin Yoong
- Hunter New England Population Health, Newcastle, NSW, Australia.,School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, NSW, Australia
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16
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Larson N, Loth KA, Nanney MS. Staff Training Interests, Barriers, and Preferences in Rural and Urban Child Care Programs in Minnesota. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2019; 51:335-341. [PMID: 30205928 DOI: 10.1016/j.jneb.2018.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To describe any rural-urban differences in child care providers' (1) past training on the facilitation of child healthy eating and physical activity and (2) views relevant to the design of trainings. METHODS Cross-sectional analysis of data from the 2016 Healthy Start, Healthy State survey of Minnesota child care providers (rural, n = 232; urban, n = 386). Licensed family home-based care providers and providers working at licensed centers responded online or by mail to measures of desired training content, barriers, and delivery mode preferences. RESULTS Training barriers that were more often a concern for rural compared with urban providers included scheduling outside work hours, difficulties finding trainings, and travel (all P < .001). Rural and urban providers identified similar preferences with regard to training content and delivery. CONCLUSIONS AND IMPLICATIONS The findings suggest it would be worthwhile for future research to examine whether rural providers' training participation is affected by uniquely relevant participation barriers.
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Affiliation(s)
- Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
| | - Katie A Loth
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
| | - Marilyn S Nanney
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN
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Parsons K, Rutkowski EM, Turel O. Health behavior knowledge among Hispanic California islanders: Evaluation of a parental educational intervention. J SPEC PEDIATR NURS 2019; 24:e12235. [PMID: 30779417 DOI: 10.1111/jspn.12235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 12/21/2018] [Accepted: 01/30/2019] [Indexed: 01/23/2023]
Abstract
PURPOSE To evaluate the impact of a school nurse-led pilot parent-focused education program for healthy eating and physical activity to reduce childhood obesity. DESIGN AND METHODS A quasi-experimental intervention design was used to assess the knowledge of 11 Hispanic mothers regarding healthy food choices and physical activity over a period of 1 year. RESULTS There was an improvement in parental knowledge domains. Children's body mass index (BMI) stabilized at the 1-year follow-up in the intervention group, while the BMI increased in the nonintervention group. Outcomes included improvement in parental health knowledge and children's BMI. PRACTICE IMPLICATIONS Pediatric and school nurses have a powerful role in preventive education. Knowledge gained by identifying the benefits of healthy food choices and physical activity for Hispanic mothers of obese children can be transformed into lifestyle changes for their children's weight control that begins in the home.
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Affiliation(s)
- Karla Parsons
- School of Nursing, California State University, Fullerton, California
| | | | - Ofir Turel
- Department of Information Systems and Decision Sciences, California State University, Fullerton, California
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18
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Gold AL, Bennett K, Jansen RJ, Mobley AR, Procter SB, Smathers C, Contreras D, Peters P, Keim A, Oscarson R. Ripple Effects of the Communities Preventing Childhood Obesity Project. Health Promot Pract 2018; 21:308-318. [DOI: 10.1177/1524839918788581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research examines the practice of community coaching within coalitions in the Communities Preventing Childhood Obesity project. A quasi-experimental design was used in seven Midwestern states. Each state selected two rural, low-income communities with functioning health coalitions. Coalitions were randomly assigned to be intervention or comparison communities. After 4 years of the coaching intervention, ripple effect mapping served as one method for examining the coalitions’ work that may affect children’s weight status. A research team from each state conducted ripple effect mapping with their two coalitions, resulting in 14 ripple maps. Community capitals framework and the social–ecological model were used for coding the items identified within the ripple maps. A quantitative scoring analysis determined if differences existed between the intervention and comparison coalitions in terms of the activities, programs, funding, and partnerships for social–ecological model score (e.g., individual, community, policy levels), community capitals score, and ripples score (e.g., number of branches formed within the maps). All scores were higher in intervention communities; however, the differences were not statistically significant ( p > .05). Assessing community assets, such as availability of a community coach, is necessary in order to decide whether to deploy certain resources when designing health promotion strategies.
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Affiliation(s)
| | | | | | | | | | | | - Dawn Contreras
- Michigan State University Extension, East Lansing, MI, USA
| | - Paula Peters
- K-State Research and Extension, Manhattan, KS, USA
| | - Ann Keim
- University of Wisconsin–Extension, Cooperative Extension, Madison, WI, USA
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Larson N, Ayers Looby A, Frost N, Nanney MS, Story M. What Can Be Learned from Existing Investigations of Weight-Related Practices and Policies with the Potential to Impact Disparities in US Child-Care Settings? A Narrative Review and Call for Surveillance and Evaluation Efforts. J Acad Nutr Diet 2017; 117:1554-1577. [PMID: 28774504 DOI: 10.1016/j.jand.2017.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 06/12/2017] [Indexed: 01/30/2023]
Abstract
Child-care settings and the combination of policies and regulations under which they operate may reduce or perpetuate disparities in weight-related health, depending on the environmental supports they provide for healthy eating and activity. The objectives of this review are to summarize research on state and local policies germane to weight-related health equity among young children in the United States and on how federal policies and regulations may provide supports for child-care providers serving families with the most limited resources. In addition, a third objective is to comprehensively review studies of whether there are differences in practices and policies within US child-care facilities according to the location or demographics of providers and children. The review found there is growing evidence addressing disparities in the social and physical child-care environments provided for young children, but scientific gaps are present in the current understanding of how resources should best be allocated and policies designed to promote health equity. Additional research is needed to address limitations of prior studies relating to the measurement of supports for weight-related health; complexities of categorizing socioeconomic position, ethnicity/race, and urban and rural areas; exclusion of legally nonlicensed care settings from most research; and the cross-sectional nature of most study designs. There is a particularly great need for the development of strong surveillance systems to allow for better monitoring and evaluation of state policies that may impact weight-related aspects of child-care environments, implementation at the program level, and needed implementation supports.
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