Attitudes, concerns, and likelihood for action related to young children's overweight among early childhood program staff

Communicating With Head Start Families About Children's Weight Status: A Phenomenological Approach

BACKGROUND

To support the early identification of childhood obesity, Head Start (HS) implemented a body mass index screening program. This program provides opportunities for HS to communicate with families about children's weight status. Limited research is available describing the methods used to communicate this information.

OBJECTIVE

Explore common experiences of HS health/nutrition managers (HNM) when communicating information to families about children's weight status.

STUDY DESIGN, SETTINGS, AND PARTICIPANTS

Twenty-eight in-depth telephone interviews with HNM across North Carolina (n = 15) and Ohio (n = 13).

STUDY DESIGN/ANALYSIS

Phenomenology guided the study design and analysis. The themes focused on HNM's lived experiences with their body mass index screening program. Interviews were recorded and transcribed verbatim.

RESULTS

Four emergent themes identified: (1) strategies for communicating weight status to families; (2) family response to communication strategies; (3) educational, staff support, and counseling opportunities for families; and (4) challenges engaging families in childhood obesity prevention efforts.

CONCLUSIONS AND IMPLICATIONS

Head Start programs acknowledged the importance of communicating children's weight status; however, there are inconsistencies in methods used and information communicated across programs. Head Start programs have community partners who support obesity prevention efforts; however, these partnerships may be underused. More research is needed to explore effective and sensitive communication methods for HS families regarding children's weight status.

Examining Nutrition and Physical Activity Policies and Practices in Maryland's Child Care Centers

BACKGROUND

Child care settings provide opportunities for obesity prevention by implementing nutrition/physical activity best practices. This study examines how center policies, provider training, family education, and center demographics relate to best practices for nutrition/physical activity in Maryland's child care centers.

METHODS

A survey, including minor modifications to The Nutrition and Physical Activity Self-Assessment for Child Care (Go NAP SACC), was sent by e-mail to center directors statewide. Best practice sum scores (dependent variable) were calculated, including physical activity (17 items), feeding environment (18 items), and food served (19 items). Adjusted regression models analyzed the number of nutrition/physical activity policies, provider training topics, and family education opportunities related to best practice scores.

RESULTS

Response rate was 40% (n = 610/1506) with 69% independent centers (vs. organization sponsored), 19% with Child and Adult Care Food Program (CACFP enrolled), and 50.2% centers with majority (≥70%) Caucasian children and 16.8% centers with majority African American children. Centers reported 40.8% of physical activity best practices, 52.0% of feeding environment best practices, and 51.6% of food served best practices. Centers reported (mean) 7.9 of 16 nutrition/physical activity-relevant policies, 6.9 of 13 provider training topics, and 4.4 of 8 family education opportunities. Regression models yielded associations with best practices: policies and provider training with feeding environment (B = 0.26, p < 0.001; B = 0.26, p = 0.001, respectively); policies with foods served (B = 0.22, p = 0.002); and policies, provider training, and feeding environment with physical activity (B = 0.19, p = 0.001; B = 0.24, p = 0.010; B = 0.38, p < 0.001).

CONCLUSIONS

Nutrition/physical activity best practices in child care are supported by specific policies, provider training, and family education activities.

Concepts and strategies on how to train and motivate teachers to implement a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study

The key person for the implementation of kindergarten-based behavioural interventions is the kindergarten teacher. When conducting intervention studies in kindergartens, training sessions are needed to train and motivate kindergarten teachers for programme implementation. This paper presents the systematic development of the teachers' trainings executed in the ToyBox-intervention - a kindergarten-based and family-involved obesity prevention programme for children aged 4-6. Based on concepts for the education of kindergarten teachers, on general strategies for successful programme implementation and on the ToyBox programme-specific requirements, the aims of the teachers' trainings were defined and an overall concept was deduced. Regarding the concept for the ToyBox teachers' training sessions, it is concluded that the training modules should focus on presenting information on the practical implementation of the intervention. Furthermore, these modules should also include self-efficacy enhancing components and should give kindergarten teachers opportunities to share experiences. Regarding the didactic methods applied in the ToyBox teachers' training sessions, constructivist learning approaches that facilitate active participation, reflective thinking and personal involvement were implemented. Emphasis was put not only on the content but especially on the didactic methods of teachers' trainings in order to enhance devotion to, and quality and sustainability of the ToyBox-intervention.

Creating potential for common ground and communication between early childhood program staff and parents about young children's eating

OBJECTIVES

To explore child care staff and parent perspectives and communications about children's eating in child care.

DESIGN

Focus groups (FGs) conducted with child care staff and parents.

SETTING

Four Western states in the United States.

PARTICIPANTS

Thirty-nine child care staff in 7 FGs and 25 parents in 6 FGs.

PHENOMENON OF INTEREST

Thoughts and concerns about children's eating and opportunities to improve communication between staff and parents.

ANALYSIS

Content analysis (FG coding inter-rater reliability: staff = 0.74; parents = 0.81) and identification of meta-themes.

RESULTS

Three meta-themes were identified: (1) recognition of positive influences of the child care setting in children's development of healthy eating; (2) concerns about children's eating in child care and at home; and (3) strategies to improve communications and transactions related to children's eating.

CONCLUSIONS AND IMPLICATIONS

Staff reported that their roles included informing parents about food at mealtimes in child care (eg, menus, recipes) but also educating parents about child nutrition and feeding. Parents valued daily information about their child's eating to adjust home mealtimes and to feel connected to their child. Barriers to effective communication included limited time and concerns regarding parent reactions and defensiveness. Staff requested training about child nutrition and feeding and about sensitive communications with parents.