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Research Results Child Care/Preschool
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Of the nation's 21 million preschool children, 13 million attend a child-care facility, where they consume a substantial portion of their daily foods and calories. Many federal, state and local policies govern child-care and preschool facilities, but there has been little research to date about policies related to nutrition in these settings. The aims of studies in this area are to identify policy and environmental changes in child-care and preschool settings that can help prevent childhood obesity.
Title: Improving Nutrition in Home Child Care: Are Food Costs a Barrier?
RWJF Grant ID: 63046
Principal Investigator: Donna Johnson, PhD, RD
Organization: University of Washington
Results: Improving the nutritional quality of foods served in child care may come at a higher cost according to a study of foods served in child-care homes participating in the Child and Adult Care Food Program (CACFP). Researchers found that higher daily food expenditures were associated with higher total food energy and higher nutritional quality of menus. Food expenditures were strongly and positively associated with the number of portions of whole grains and fresh produce served, even after controlling for the total amount of food served.
Title: Validity of a Measure to Assess the Child-Care Nutrition and Physical Activity Environment
RWJF Grant ID: 63150
Principal Investigator: Marlene Schwartz, PhD
Organization: Yale University
Results: This paper discusses the development and validity of a self-administered survey to assess the nutrition and physical activity environment of child-care centers. The survey assesses four areas related to nutrition and physical activity: center policies, practices related to the social environment, physical environment and nutrition quality. To evaluate criterion validity of the survey, researchers compared survey data to data collected through in-person interviews and direct observation. The self-report survey demonstrated adequate criterion validity for evaluating the child-care nutrition and physical activity environment. Agreement was highest for nutrition and policy domains and lowest for physical activity and barriers to promoting health.
Title: More Nutritious Food is Served in Child-Care Homes Receiving Higher Federal Food Subsidies
RWJF Grant ID: 63046
Principal Investigator: Donna Johnson, PhD, RD
Organization: University of Washington
Results: More than 3.2 million children are enrolled in child-care programs that participate in and receive reimbursement for food from the United States Department of Agriculture’s Child and Adult Care Food Program (CACFP). This paper discusses the results of a study which tested the hypothesis that higher CACFP reimbursement rates for food result in higher food expenditure and higher nutritional quality of food served in family child-care homes. Researchers found that providers receiving higher reimbursement spent significantly more on food ($2.36 per child per day) than those receiving lower reimbursement ($1.96 per child per day). Child-care providers receiving the higher rate of reimbursement served healthier food with more protein, whole grains, vitamins and minerals.
Related Publication: University of Washington, Center for Public Health Nutrition. The Case for Increasing Federal Food Subsidies in Child Care: Results from a study involving 64 child care homes serving 450 children in King County. Issue Brief, April 2011. Available at http://depts.washington.edu/uwcphn/reports/Brief4-food_subsidies_child_care.pdf
Title: Barriers to Obesity Prevention in Head Start
RWJF Grant ID: 63042
Principal Investigator: Robert Whitaker, MD, MPH
Organization: Temple University
Results: This article details findings gleaned from a national survey of all directors of Head Start, a program that provides early childhood education to nearly one million lower-income children, approximately one third of whom are obese. With respect to implementing policies and practices to address obesity, program directors identified three key barriers: lack of time, money and knowledge. Minimizing these barriers, the authors conclude, will require federal resources.
Title: Reaching Staff, Parents, and Community Partners to Prevent Childhood Obesity in Head Start, 2008
RWJF Grant ID: 63042
Principal Investigator: Robert Whitaker, MD, MPH
Organization: Temple University
Results: This article describes obesity prevention activities directed at staff, parents and community partners in Head Start, the United States’ largest federally-funded early childhood education program. On the bases of survey data, researchers found that 60% of responding Head Start programs trained staff about feeding children, and 63% trained staff about children’s gross motor activity. Eighty-four percent of programs offered parent workshops on preparing or shopping for healthy foods, while 43% offered workshops to teach parents how to encourage gross motor activity at home. Finally, 97% of programs reported having at least one community partnership to encourage healthy eating, and 75% had at least one partnership to encourage gross motor activity.
Title: Preventing Obesity in the Child Care Setting: Evaluating State Regulations
RWJF Grant ID: 65067
Principal Investigator: Jonathan Finkelstein, MD, MPH, Sara E. Benjamin, PhD, MPH, RD (Co-Principal Investigator)
Organization: Harvard Pilgrim Health Care*
Results: This report evaluates states' healthy eating and physical activity regulations for two types of child care facilities: child-care centers and child-care homes. To determine states' performance, experts first compiled a list of top ten healthy eating and top ten physical activity regulations, then compared this list against existing child-care regulations for the 50 United States, the District of Columbia, the U.S. Virgin Islands, Puerto Rico, and the Department of Defense. The study found that most states had few regulations in place. Researchers also calculated a grade for each state on the basis of more general healthy eating and physical activity regulations.
* Work on this research began while Dr. Benjamin was at Harvard Pilgrim Health Care. She is now at Duke University.
Title: Nutrition and Physical Activity Environments in Licensed Child Care
RWJF Grant ID: 63053
Principal Investigator: Kenneth Hecht, LLB
Organization: California Food Policy Advocates
Results: This report summarizes the results of a survey assessing the nutrition and physical activity environments for 2- to 5-year old children in licensed child-care facilities in California, including child-care centers and homes, and state preschool and Head Start program sites. Researchers found that child-care sites that participated in the Child and Adult Care Food Program (CACFP) generally served more healthful foods and beverages than non-CACFP sites, and generally had better physical activity environments. Head Start generally provided higher quality nutrition than all other child-care settings. Researchers also found that meals brought from home were of lower quality than meals provided by child-care sites. To conclude, the researchers identified opportunities, including public policy recommendations, for improving meal quality and physical activity for all child-care sites. A number of the policy recommendations already have been enacted in state (California AB 2084) and federal law (Healthy, Hunger-Free Kids Act of 2010).
Source: Hecht K, Chandran K, Samuels S, Crawford P, Ritchie L, Spector P. Nutrition and physical activity environments in licensed child care. March 2009. Available at http://cfpa.net/child-care-nutrition
Title: Child Care as an Untapped Setting for Obesity Prevention: State Child Care Licensing Regulations Related to Nutrition, Physical Activity, and Media Use for Preschool-Aged Children in the United States
Authors: Karen Kaphingst, MPH, Mary Story, PhD, RD
Organization: RWJF Healthy Eating Research national program office, University of Minnesota
Results: There are 8.6 million preschool-aged children enrolled in child-care facilities in the United States. The licensing regulations for these facilities in the areas of nutrition, physical activity, and media use (e.g., television, videos, computers) show that there are many potential opportunities to prevent obesity among these children.
Title: A National Survey of Obesity Prevention Practices in Head Start
RWJF Grant ID: 63042
Principal Investigator: Robert C. Whitaker, MD, MPH
Organization: Temple University
Results: This article summarizes obesity prevention practices and environments within Head Start, the United States’ largest federally-funded early childhood education program. On the basis of survey data, researchers found that most Head Start programs report doing more to support healthy eating and gross motor activity than required by federal performance standards in these areas.
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