Assessment of Food, Nutrition, and Physical Activity Practices in Oklahoma Child-Care Centers

Behavioral Nutrition and Physical Activity Laboratory, Department of NutritionalSciences, University of Oklahoma Health Sciences Center, 1200 N Stonewall Ave, Oklahoma City, OK 73117-1215, USA.
Journal of the American Academy of Nutrition and Dietetics (Impact Factor: 3.47). 08/2012; 112(8):1230-40. DOI: 10.1016/j.jand.2012.05.009
Source: PubMed


The purpose of the current study was to determine the obesogenic practices in all-day child-care centers caring for preschool-aged children. This study used a cross-sectional, self-reported survey mailed to centers across Oklahoma (n=314). Frequency of responses and χ(2) were calculated comparing region and star rating. Items where the majority of centers frequently report best practices include: daily fruits served (76%), daily nonfried vegetables served (71%), rarely/never served sugary drinks (92%), rarely/never used food to encourage good behaviors (88%), staff join children at table most of the time (81%), staff rarely eat different foods in view of children (69%), visible self-serve or request availability of water (93%), regular informal communication about healthy eating (86%), opportunities for outdoor play (95%), not withholding activity for punishment (91%), accessible play equipment (59% to 80% for different types of equipment), and minimization of extended sitting time (78%). Practices where centers can improve include increasing variety of vegetables (18%), reducing frequency of high-fat meats served (74% serve more than once per week), increasing high-fiber and whole-grain foods (35% offer daily), serving style of "seconds" (28% help kids determine whether they are still hungry), nonfood holiday celebrations (44% use nonfood treats), having toys and books that encourage healthy eating (27%) and physical activity (25%) in all rooms in the center, a standard nutrition (21%) and physical education (50%) curriculum, and following a written physical activity policy (43%). Practitioners can use these data to develop benchmarks and interventions, as this was the first study to assess statewide obesogenic practices in child care.

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    • "With regard to specific policies and practices concerning screen-use in childcare, projects by Trost et al. (n = 294 facilities) [59] and Gunter et al. (n = 53 facilities) [54] reported that the majority of home-based facilities had the television turned on every day (for at least a portion of the day; 64.6% and 60.4%, respectively) and also permitted children to play video games and/or watch television at least once a day (55.1% and 58.5%, respectively); computer use was also permitted in a number of facilities across both studies. While Sisson et al. found approximately 60% of participating centers rarely/never permitted children to watch television [57], Natale and colleagues’ work indicated 474 center- and 113 home-based childcare facilities restricted television-viewing to 1-hour per day, and that 410 centre- and 186-home-based facilities limited their computer use to this same time restriction [56]. Over half the centers in Wolfenden and colleagues’ paper [61] and 45% of those in Finch et al.’s [52] paper had policies in place limiting screen-use during care hours (but did not provide specifics). "
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    ABSTRACT: Background Screen-viewing is one of the most common sedentary behaviors among preschoolers. Despite the high prevalence of sedentary behaviors in childcare, little research exists on the context and/or type of activities that account for these particular behaviors. Accordingly, if the amount of screen-viewing accumulated by preschoolers in childcare is not considered, researchers may be underestimating total screen time among this population, as only a portion of their day is being captured (i.e., the home environment). This systematic review provides a synthesis of research on the levels of screen-viewing among preschool-aged children (2.5-5 years) attending childcare (i.e., centre- and home-based childcare). This review also examined the correlates of screen-viewing among preschoolers in this setting. To provide additional contextual information, availability of screen activities was used to help ameliorate the understanding of preschoolers’ screen-viewing behaviors in childcare. Methods Twelve electronic databases were searched to retrieve relevant articles for inclusion (dating from 2000 onwards). Additional studies were identified via manual searching techniques (i.e., hand searching and citation tracking). Only English, published peer-reviewed articles that examined preschoolers’ screen-viewing behaviors in childcare (i.e., rates of screen-viewing and access to/opportunities for related activities) were included. No restrictions to study design were applied. Results Seventeen international studies (4 experimental; 12 cross-sectional; 1 mixed-methods) published between 2004 and 2014 were examined. Of those, eight studies reported rates of screen-viewing and found that preschoolers spent approximately 0.1 to 1.3 hrs/day and 1.8 to 2.4 hrs/day engaged in this behavior in center- and home-based childcare, respectively. High staff education (negative association) and type of childcare arrangement (notably, home-based childcare in comparison to center-based childcare; positive association) were identified as two correlates in relation to preschoolers’ screen-viewing in childcare. Nine studies spoke to the availability of screen-viewing activities in childcare, and found the childcare environment to be conducive to this behavior. Conclusions Despite some variability, preschoolers appear to engage in somewhat high levels of screen-viewing while in childcare, particularly within home-based facilities. This paper also highlighted the conduciveness of the childcare environment with regard to screen-viewing among preschoolers. Additional exploration into the correlates of screen-viewing in childcare is required. (PROSPORO registration: CRD42013005552).
    BMC Pediatrics 08/2014; 14(1):205. DOI:10.1186/1471-2431-14-205 · 1.93 Impact Factor
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    • "The food served in our study’s child care centers was similar to that reported in observational studies from North Carolina [11], Oklahoma [54], and New York City [14]. These studies reported daily offerings of healthy foods such as fruits, non-fried vegetables, whole grains, and reduced-fat milk. "
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    ABSTRACT: To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post- intervention. Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic.Trial registration: National Clinical Trials Number NCT01921842.
    BMC Public Health 03/2014; 14(1):215. DOI:10.1186/1471-2458-14-215 · 2.26 Impact Factor
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    • "Few centers in Australia have trained staff or policies in relation to physical activity [29]. Encouraging physical activity by training staff and following written policy are areas where centers can improve obesity prevention best practice [30]. LDC centers within the current study benefited from their prior intervention involvement as this encouraged the incorporation of childcare quality guidelines into center practice through staff training in fundamental movement skills and the design of structured active play programs tailored to each center [25]. "
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    ABSTRACT: Introduction: Interest has grown in how systems thinking could be used in obesity prevention. Relationships between key actors, represented by social networks, are an important focus for considering intervention in systems. Method: Two long day care centers were selected in which previous obesity prevention programs had been implemented. Measures showed ways in which physical activity and dietary policy are conversations and actions transacted through social networks (interrelationships) within centers, via an eight item closed-ended social network questionnaire. Questionnaire data were collected from (17/20; response rate 85%) long day care center staff. Social network density and centrality statistics were calculated, using UCINET social network software, to examine the role of networks in obesity prevention. Results: "Degree" (influence) and "betweeness" (gatekeeper) centrality measures of staff inter-relationships about physical activity, dietary, and policy information identified key players in each center. Network density was similar and high on some relationship networks in both centers but markedly different in others, suggesting that the network tool identified unique center social dynamics. These differences could potentially be the focus of future team capacity building. Conclusion: Social network analysis is a feasible and useful method to identify existing obesity prevention networks and key personnel in long day care centers.
    Journal of obesity 08/2013; 2013(3):919287. DOI:10.1155/2013/919287
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