1 University of Minnesota, Minneapolis, MN, USA.
2 Center for Prevention at Blue Cross and Blue Shield of Minnesota, Eagan, MN, USA.
Health Educ Behav. 2019 Apr;46(2):213-223. doi: 10.1177/1090198118780458. Epub 2018 Jul 13.
Licensed child care providers, and the early care and education settings in which they operate, are uniquely situated to influence children's healthy eating and physical activity through practices, attitudes, and supportive physical and social environments. However, preliminary research indicates that child-, family-, and provider-level characteristics affect adherence to best practices across early care and education settings. The current article used survey data ( n = 618) to characterize differences in child care providers' adherence to nutrition, physical activity, and mealtime best practices, based on child-, family- and provider-level characteristics, and to describe secular trends in adherence to nutrition and physical activity best practices between 2010 and 2016. Results indicate that differences exist across certain characteristics, including child race/ethnicity, family's use of child care assistance, language spoken at home, and provider educational attainment; however, it is notable that in most cases providers serving children of minority race and children in low-income families have a higher rate of compliance with the nutrition and physical activity best practices studied. Additionally, the comparison of adherence to best practices from 2010 to 2016 suggests that, while there was an increase in mean adherence from 2010 to 2016, overall trends in adherence across child-, family- and provider-level characteristics have been consistent across time. Public health professionals should continue to advocate for opportunities for providers to learn how to best incorporate best practices within their setting (e.g., education and training opportunities) as well as for the development and adoption of systems-level changes (e.g., expansion of food assistance programs) to reduce barriers to adherence to best practices.
持照儿童保育提供者，以及他们所经营的早期护理和教育环境，通过实践、态度以及支持性的身体和社会环境，在影响儿童健康饮食和身体活动方面具有独特的地位。然而，初步研究表明，儿童、家庭和提供者层面的特征会影响整个早期护理和教育环境中最佳实践的遵循。本文使用调查数据（n=618），根据儿童、家庭和提供者层面的特征，描述儿童保育提供者在营养、身体活动和用餐时间最佳实践方面的遵循情况，并描述 2010 年至 2016 年期间营养和身体活动最佳实践遵循情况的季节性趋势。结果表明，在某些特征方面存在差异，包括儿童的种族/族裔、家庭对儿童保育援助的使用、家庭中使用的语言以及提供者的教育程度；然而，值得注意的是，在大多数情况下，为少数族裔儿童和低收入家庭儿童提供服务的提供者遵守营养和身体活动最佳实践的比例更高。此外，对 2010 年至 2016 年最佳实践遵循情况的比较表明，尽管从 2010 年到 2016 年，遵循的平均值有所增加，但从儿童、家庭和提供者层面特征来看，遵循的总体趋势一直保持一致。公共卫生专业人员应继续倡导为提供者提供学习机会，以便在其环境中最好地实施最佳实践（例如，教育和培训机会），并倡导制定和采用系统层面的变化（例如，扩大食品援助计划），以减少遵守最佳实践的障碍。
