The relationship between practices and child care providers' beliefs related to child feeding and obesity prevention.

OBJECTIVE

To examine the association between child care practices and child care provider knowledge and beliefs about their role in supporting children's healthful eating.

DESIGN

Longitudinal design using survey and observation data from baseline and year 1 of the Encouraging Healthy Activity and Eating in Childcare Environments (ENHANCE) pilot project.

PARTICIPANTS

Seventy-two child care providers from 45 child care settings.

MAIN OUTCOME MEASURES

Child care setting variables included the feeding environment, nutrition education, and family communication. Child care provider variables were efficacy, knowledge, and misconceptions about child feeding; and the priority placed on supporting children's healthful eating.

DATA ANALYSIS

Correlation and multiple linear regression were used to examine the association between variables.

RESULTS

Models indicated that changes in efficacy and feeding knowledge accounted for a significant portion of the variance in nutrition education changes (R(2) = 0.59) and family communication changes (R(2) = 0.29). A reduction in misconceptions was significantly associated with improved feeding practices (β = .71; P < .01; R(2) = 0.40).

CONCLUSIONS AND IMPLICATIONS

Understanding child care providers' knowledge and beliefs regarding their role in children's healthful eating is an essential component of child care-based obesity prevention initiatives. Training should assess and address provider efficacy and misconceptions as well as educate providers about evidence-based practices related to child feeding, nutrition education, and family communication.