Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Authors

Dipti Dev, University of Nebraska-LincolnFollow
Aileen Garcia, South Dakota State UniversityFollow
David A. Dzewaltowski, University of Nebraska Medical CenterFollow
Susan B. Sisson, University of Oklahoma Health SciencesFollow
Lisa Franzen-Castle, University of Nebraska-LincolnFollow
Zainab Rida, Nebraska Department of EducationFollow
Natalie A. Williams, University of Nebraska-LincolnFollow
Carly Hillburn, University of Nebraska-LincolnFollow
Danae Dinkel, University of Nebraska at OmahaFollow
Deepa Srivastava, University of California Cooperative Extension, Tulare, CAFollow
Christina Burger, Nebraska Department of EducationFollow
Emily Hulse, Center for the Child & Community, Lincoln, NEFollow
Donnia Behrends, University of Nebraska−LincolnFollow
Natasha Frost, Public Health Law Center, USAFollow

Date of this Version

1-2020

Citation

Preventive Medicine Reports 17 (2020) 101021

DOI: 10.1016/j.pmedr.2019.101021

Comments

© 2019 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license

Abstract

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children’s dietary intake. Childcare settings vary in organizational structure – childcare centers (CCCs) vs. family childcare homes (FCCHs) – and in geographical location – urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p < .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations.