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Kerr EM, Hewitt L, Ryan ST, Norman J, Kelly B, Hammersley ML, Lum M, Okely AD. Correlates of children's dietary intake, physical activity and sedentary behavior in home-based childcare: A systematic review. Prev Med Rep 2022; 30:101999. [PMID: 36237835 PMCID: PMC9551212 DOI: 10.1016/j.pmedr.2022.101999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/30/2022] Open
Abstract
This systematic review assessed the correlates of children's dietary intake, physical activity and sedentary behavior in home-based childcare. A systematic search of five databases with articles published between January 2000 and July 2021 was conducted. Articles were included if they contained data from a home-based childcare (birth-5 years) setting; were a quantitative study that reported children's dietary intake, physical activity or sedentary behavior; included variables associated with children's dietary intake, physical activity or sedentary behavior; and were published in English. Correlates were categorized using McLeroy’s social ecological framework. Risk of bias was assessed using the Office of Health Assessment and Translation (OHAT) Risk of Bias Rating Tool. Fifteen studies met the inclusion criteria; six assessed children's dietary intake, and nine assessed physical activity and/or sedentary behaviors. Studies were conducted in the USA (n = 12) and Canada (n = 3). Seventy-three correlates were identified, for children's dietary intake (n = 11), physical activity (n = 35) and sedentary behavior (n = 27). Ethnicity and the food provided to children were associated with children's dietary intake in two studies; both from the same study sample. Indoor play space was positively associated with physical activity in two separate studies. No consistent associations for children's dietary intake, physical activity, or sedentary behavior outcomes were found between studies, however few studies assessed the same correlates. High-quality studies conducted in different countries that assess the nutrition and physical activity environments in home-based childcare using reliable and consistent methods are needed. This review was registered with PROSPERO, no. CRD42019103429.
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Affiliation(s)
- Erin M. Kerr
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia
- Corresponding author.
| | - Lyndel Hewitt
- Illawarra Health Medical Research Institute, Wollongong, NSW, Australia
- Illawarra Shoalhaven Local Health District, Wollongong Hospital, New South Wales 2500, Australia
| | - Sarah T. Ryan
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia
| | - Jennifer Norman
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia
- Health Promotion Service, Illawarra Shoalhaven Local Health District, Wollongong, NSW, Australia
- Illawarra Health Medical Research Institute, Wollongong, NSW, Australia
| | - Bridget Kelly
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia
| | - Megan L. Hammersley
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia
| | - Melanie Lum
- Hunter New England Population Health, Wallsend, New South Wales 2287, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales 2308, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales 2300, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales 2308, Australia
| | - Anthony D. Okely
- Early Start, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, NSW, Australia
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Gans KM, Tovar A, Kang A, Ward DS, Stowers KC, von Ash T, Dionne L, Papandonatos GD, Mena N, Jiang Q, Risica PM. A multi-component tailored intervention in family childcare homes improves diet quality and sedentary behavior of preschool children compared to an attention control: results from the Healthy Start-Comienzos Sanos cluster randomized trial. Int J Behav Nutr Phys Act 2022; 19:45. [PMID: 35428298 PMCID: PMC9013065 DOI: 10.1186/s12966-022-01272-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/09/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Childcare settings are important environments for influencing child eating and physical activity (PA). Family childcare homes (FCCH) care for many children of low-income and diverse racial/ethnic backgrounds who are at greater risk for poor diet quality, low PA, and obesity, but few interventions have targeted this setting. The aim of this study was to assess the efficacy of a multicomponent intervention conducted in FCCH on the diet quality and PA of 2-5 year old children in their care. TRIAL DESIGN Cluster randomized trial. METHODS The cluster-randomized trial, Healthy Start/Comienzos Sanos (2015-2019) evaluated an 8-month nutrition and PA intervention that included four components: (1) monthly telephone calls from a support coach using brief motivational interviewing, (2) tailored reports, newsletters and videos, (3) group support meetings, and (4) active play toys. After completing baseline measurement, FCCH were randomized into intervention or comparison groups in matched pairs. Both groups received the same intervention components but on different topics (intervention: nutrition/PA vs. comparison: reading readiness/literacy). Evaluation staff were blinded to group assignment. Child primary outcome measures collected at baseline and 8-months included: 1) Healthy Eating Index (HEI-2015) scores calculated from diet observation, and 2) accelerometer measurement of PA. Process measures were collected from field data and provider surveys. Generalized Estimating Equation Models assessed changes in HEI-2015 scores and PA over time by experimental condition. RESULTS Ethnically diverse FCCH providers (n = 119) and 2-to-5-year-old children in their care (n = 377) were included in the final analysis. Process evaluation showed high participation in all intervention components except for group meetings. Compared to children in comparison group FCCH, children in intervention FCCH increased total HEI-2015 scores by 7.2 points (p < .001) including improvement in component scores for vegetables (0.84 points, p = .025) and added sugar (0.94 points, p = .025). For PA, compared to children in the comparison group, children in intervention FCCH decreased sedentary time by 5.7% (p = .021). CONCLUSIONS The multicomponent Healthy Start intervention was effective in improving diet quality and sedentary behavior of children in FCCH, which demonstrates the promise of obesity prevention interventions in this setting. Future research could include enhancing the Healthy Start intervention to strengthen the PA component, considering virtual peer support, and determining how to best translate and disseminate the intervention into FCCH nationally. TRIAL REGISTRATION National Institutes of Health, NCT02452645 . Registered 5 May 2015.
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Affiliation(s)
- Kim M. Gans
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT 06269 USA
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
| | - Alison Tovar
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
| | | | - Dianne Stanton Ward
- Department of Nutrition, Gillings School of Global Public Health, 135 Dauer Drive 245 Rosenau Hall, CB #7461, Chapel Hill, NC 27599 USA
| | - Kristen Cooksey Stowers
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT 06269 USA
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT 06103 USA
| | - Tayla von Ash
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
| | - Laura Dionne
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
| | | | - Noereem Mena
- Division of Nutritional Sciences, Cornell University, Ithaca, NY USA
| | - Qianxia Jiang
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, Storrs, CT 06269 USA
| | - Patricia Markham Risica
- Brown University School of Public Health, Box G-121-5, 121 S. Main St, Providence, 02912 USA
- Center for Health Promotion and Health Equity, Brown School of Public Health, Box G-121 8, Providence, RI 02912 USA
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Scenario Analysis of a Municipality’s Food Purchase to Simultaneously Improve Nutritional Quality and Lower Carbon Emission for Child-Care Centers. SUSTAINABILITY 2021. [DOI: 10.3390/su13105551] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Public procurement has been highlighted as an important strategic tool to drive sustainable development. The present study aimed at providing direction for decreasing greenhouse gas emissions (GHGE) by 25% for the food purchased by child-care centers in the City of Copenhagen while simultaneously providing nutritionally adequate, affordable and tasty menus. Baseline data were provided by compiling food purchase data with datasets matching each food item to a proxy food item and further with databases containing nutrient and GHGE information. For each food item, the edible amount was estimated in order to evaluate nutritional content and GHGE per 10 MJ. Two scenarios were modeled, i.e., a plant-rich diet and a lacto-ovo vegetarian diet directed at children two to five years old based on current purchase practice. Finally, the diets were translated into guidelines for menu planning. Amounts of pulses, nuts and seeds, as well as dark green vegetables and plant-based fats, were increased substantially in the two scenarios, while animal fat was decreased and the amount of meat was either reduced or eliminated in the plant-rich and lacto-ovo vegetarian diets, respectively. These kinds of changes in public food procurement have the power to significantly affect the transition toward a more healthy and sustainable food system.
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Dietary Contributors to Food Group Intake in Preschool Children Attending Family Childcare Homes: Differences between Latino and Non-Latino Providers. Nutrients 2020; 12:nu12123686. [PMID: 33260442 PMCID: PMC7761496 DOI: 10.3390/nu12123686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 11/17/2022] Open
Abstract
While there are several factors that contribute to the diet quality of children in childcare, one contributing factor in Family Childcare Homes (FCCHs) is the provider's ethnicity. However, research examining the food items provided in this setting is limited; in particular, with regards to differences between FCCHs of Latino and non-Latino providers. The aim of this study was to identify and describe the food items that contribute to food group intake in preschool-aged children attending FCCHs, and to examine differences by provider ethnicity. This secondary data analysis used baseline data from Healthy Start/Comienzos Sanos: a cluster-randomized trial. Children's dietary intake was collected using the Dietary Observation in Child Care method and entered into Nutrition Data System for Research software. Food groups were based on the Nutrition Coordinating Center classification. Contribution of food items to their respective food group was calculated as a proportion, using ratio of means and presented as a percentage. Ethnic differences were tested with ANCOVA (p < 0.05) with Bonferroni adjustments for multiple comparisons. All providers (n = 120) were female and 67.5% were Latino. Most fruit consumed by children was in the form of juice (85%), three-fourths of the grains consumed were refined (75%), and half of the sweets consumed were syrup/honey/jelly (50%). Most of the vegetables consumed were non-starchy (61%), nearly three-fourths of dairy consumed was low-fat (71%), and vegetable oils contributed the most to the fats group (89%). Food items differed by provider's ethnicity, with children cared for by non-Latino providers consuming a higher proportion of fruit juice, animal fats and a lower proportion of legumes (p < 0.001 for all). Children with Latino providers consumed a lower proportion of non-starchy vegetables, low-fat dairy, and nuts/seeds (p < 0.001 for all). FCCH providers could offer more whole fruits and grains and a greater variety of vegetables. Differences by ethnicity suggest providers could benefit from culturally tailored recommendations.
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