Child, Youth, and Family Studies, Department of


Date of this Version



Published in Public Health Nutrition 24:11 (2020), pp 3460–3476.



Copyright © 2020 Virginia C. Stage, Lorelei Jones, Jocelyn Bayles, Archana V. Hegde, Dipti A. Dev, and L. Suzanne Goodell. Published by Cambridge University Press on behalf of The Nutrition Society. Used by permission.


Objective: Explore the interrelationship between teachers’ personal and professional socio-ecological structures while examining Head Start (HS) teachers’ experiences with (1) trying to eat healthy and engage in physical activity (PA) and (2) promote healthy eating and PA in their classrooms.

Design: In-depth semi-structured interviews were collected from March through June 2017. Researchers designed the data collection and analysis methods using a phenomenological approach. All interviews were recorded using digital audio and transcribed verbatim.

Setting: Seven HS centers in two rural eastern North Carolina counties.

Participants: Teachers (n 15) who had recently participated in a healthy eating and physical activity intervention. Participants were 100 % female, an average age of 43 years (SD 9.6) and primarily Black/African American (93.3 %).

Results: Eighteen primary themes were identified providing unique insight into individual, social and environmental determinants that may influence teachers’ personal health behaviors and professional health promotion practices. Findings indicated that teachers want to improve health behaviors personally (individual/family health) and professionally (children/families served); however, barriers exist at all levels impacting their ability to improve their own health and facilitate positive behaviors among the children/families they serve. Many teachers observed connections between their personal and professional experiences, but not beyond the individual level.

Conclusions: Study findings highlight the importance of considering and emphasizing the potential relationship between personal and professional determinants of health when working with early childhood teachers. Findings from this study may be useful for informing the development, implementation and evaluation of future health promotion interventions using teachers as implementers.