Multisector Approach to Improve Healthy Eating and Physical Activity Policies and Practices in Early Care and Education Programs: The National Early Care and Education Learning Collaboratives Project, 2013–2017

Multisector Approach to Improve Healthy Eating and Physical Activity Policies and Practices in Early Care and Education Programs: The National Early Care and Education Learning Collaboratives Project, 2013–2017

IMPLEMENTATION EVALUATION — Volume 16 — July 25, 2019

This article is part of the Health Care Systems, Public Health, and Communities: Population Health Improvements collection.

Teresa M. Garvin, PhD, MS1; Lisa Weissenburger-Moser Boyd, PhD, MPH1; Alethea Chiappone, MPH, MSW1; Casey Blaser, MSc1; Mary Story, PhD, RD2; Allison Gertel-Rosenberg, MS3; Julie Shuell, MPA3; Debbie Chang, MPH3; Dianne Ward, EdD4; Catherine Plumlee, MPH1; Michael Beets, MEd, MPH, PhD5; Amy L. Yaroch, PhD1 (View author affiliations)

Suggested citation for this article: Garvin TM, Weissenburger-Moser Boyd L, Chiappone A, Blaser C, Story M, Gertel-Rosenberg A, et al. Multisector Approach to Improve Healthy Eating and Physical Activity Policies and Practices in Early Care and Education Programs: The National Early Care and Education Learning Collaboratives Project, 2013–2017. Prev Chronic Dis 2019;16:180582. DOI: http://dx.doi.org/10.5888/pcd16.180582external icon.

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On This Page

• Abstract
• Introduction
• Purpose and Objectives
• Intervention Approach
• Evaluation Methods
• Results
• Implications for Public Health
• Acknowledgments
• Author Information
• References
• Tables

Summary

What is already known on this topic?

Incorporating healthy eating and physical activity best practices in early care and education settings is important for instilling healthy behaviors early in life.

What is added by this report?

A collaborative intervention among a health care system, state-level partners, and early care and education programs increased the number of best practices being met related to breastfeeding and infant feeding, child nutrition, infant and child physical activity, screen time, and outdoor play and learning in early care and education settings.

What are the implications for public health practice?

Development, implementation, and evaluation of policy and practice-based partnerships to promote healthy eating and physical activity among children attending early care and education programs may help prevent obesity in the United States.

Abstract

Purpose and Objectives

Embedding healthy eating and physical activity best practices in early care and education settings is important for instilling healthy behaviors early in life. A collaborative partnership between Nemours Children’s Health System and the Centers for Disease Control and Prevention was created to implement the National Early Care and Education Learning Collaboratives Project (ECELC) in childcare settings in 10 states. We measured improvement at the program level by the self-reported number of best practices implemented related to healthy eating and physical activity.

Intervention Approach

The ECELC implemented a collaborative model with state-level partners (eg, child care resource and referral networks) and early care and education programs. Intervention components received by program directors and lead teachers included 1) self-assessment, 2) in-person learning and training sessions, 3) action planning and implementation, 4) technical assistance, and 5) post-reassessment.

Evaluation Methods

A pre–post design assessed self-reported policies and practices related to breastfeeding and infant feeding, child nutrition, infant and child physical activity, screen time, and outdoor play and learning as measured by the validated Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) best practices instrument. The sample included 1,173 early care and education programs.

Results

The number of best practices met for each of the 5 NAP SACC areas increased from pre-assessment to post-assessment approximately 6 months later and ranged from 1.5 to 4.7 best practices (P < .001). Almost all increases occurred regardless of participation in the Child and Adult Care Food Program, Quality Rating Improvement System, Head Start/Early Head Start, and/or accreditation status.

Implications for Public Health

The innovative and collaborative partnerships led to broad implementation of healthy eating and physical activity–based practices in early care and education settings. Development, implementation, and evaluation of policy and practice-based partnerships to promote healthy eating and physical activity among children attending early care and education programs may contribute to obesity prevention in the United States.