domingo, 7 de junio de 2015

An Assessment of Nutrition Practices and Attitudes in Family Child-Care Homes: Implications for Policy Implementation

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An Assessment of Nutrition Practices and Attitudes in Family Child-Care Homes: Implications for Policy Implementation

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An Assessment of Nutrition Practices and Attitudes in Family Child-Care Homes: Implications for Policy Implementation

Alison Tovar, PhD, MPH; Patricia Risica, DrPH; Noereem Mena, MS, RD; Eliza Lawson, MPH; Angela Ankoma, MSW; Kim M. Gans, PhD

Suggested citation for this article: Tovar A, Risica P, Mena N, Lawson E, Ankoma A, Gans KM. An Assessment of Nutrition Practices and Attitudes in Family Child-Care Homes: Implications for Policy Implementation. Prev Chronic Dis 2015;12:140587. DOI:


Family child-care homes (FCCHs) provide care and nutrition for millions of US children, including 28% in Rhode Island. New proposed regulations for FCCHs in Rhode Island require competencies and knowledge in nutrition. We explored nutrition-related practices and attitudes of FCCH providers in Rhode Island and assessed whether these differed by provider ethnicity or socioeconomic status of the enrolled children.
Of 536 licensed FCCHs in Rhode Island, 105 randomly selected FCCH providers completed a survey about provider nutrition attitudes and practices, demographics of providers, and characteristics of the FCCH, including participation in the federal Child and Adult Care Food Program (CACFP). No differences between CACFP and non-CACFP participants were found; responses were compared by provider ethnicity using χ2 tests and multivariate models.
Nearly 70% of FCCHs reported receiving nutrition training only 0 to 3 times during the past 3 years; however, more than 60% found these trainings to be very helpful. More Hispanic than non-Hispanic providers strongly agreed to sitting with children during meals, encouraging children to finish their plate, and being involved with parents on the topics of healthy eating and weight. These differences persisted in multivariate models.
Although some positive practices are in place in Rhode Island FCCHs, there is room for improvement. State licensing requirements provide a foundation for achieving better nutrition environments in FCCHs, but successful implementation is key to translating policies into real changes. FCCH providers need culturally and linguistically appropriate nutrition-related training.


We thank Heather Butler Feliz and Emma Lamothe who collected the data and initiated the data analysis. This study was funded by cooperative agreement no. 5U58DP001385 from Centers for Disease Control and Prevention, awarded to the Rhode Island Department of Health.

Author Information

Corresponding Author: Alison Tovar, PhD, MPH, Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island 02881. Telephone: 401-874-9855.
Author Affiliations: Patricia Risica, Kim M. Gans, Institute for Community Health Promotion, Brown University School of Public Health, Providence, Rhode Island, and Human Development and Family Studies Department and Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut; Noereem Mena, Department of Nutrition and Food Sciences, University of Rhode Island, Kingston, Rhode Island; Eliza Lawson, Chronic Disease Prevention and Control Initiative, Rhode Island Department of Health, Providence, Rhode Island; Angela Ankoma, Office of Minority Health, Rhode Island Department of Health, Providence, Rhode Island.


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