1 Department of Epidemiology, Rollins School of Public Health, Emory University , Atlanta, GA.
2 HealthMPowers, Inc. , Norcross, GA.
Child Obes. 2018 Aug/Sep;14(6):358-367. doi: 10.1089/chi.2018.0088.
This article describes the process and intermediate outcomes from a program implemented in 65 Early Care and Education (ECE) centers serving low-income families throughout Georgia during the 2014-2017 school years.
The HealthMPowers' Empowering Healthy Choices in Schools, Homes, and Communities ECE program was based on the organization's previously successful elementary school program and aligns with current early childhood nutrition and physical activity recommendations. Participating centers worked with HealthMPowers for up to 3 years. A team from each center led changes by conducting annual self-assessments, creating and implementing improvement plans, and implementing nutrition and physical activity programs using educational resources and environmental cues. A monitoring and evaluation plan provided ongoing feedback to HealthMPowers and centers. Family and staff surveys provided insights into behaviors of children, families, and staff. Process measures included specific benchmarks (e.g., center leadership team formation, improvement plan implementation). Annual self-assessment results served as intermediate outcome measures.
As of 2017, 65 centers had enrolled in the program. All centers formed a health team and completed the baseline self-assessment and most implemented an improvement plan (88%). At the 1-year follow-up self-assessment, centers reported improvements from baseline including never offering food incentives for good behavior (75%-86%), conducting taste testing at least once a month (61%-79%), and rarely/never serving sugar-sweetened beverages (93%-96%).
Initial process measures from a multicomponent health promotion program in ECE were promising. An integrated continuous improvement approach to working with child care settings is feasible and likely effective.
本文描述了一项在 2014-2017 学年期间在佐治亚州为低收入家庭服务的 65 个早期护理和教育 (ECE) 中心实施的计划的过程和中期结果。
HealthMPowers' Empowering Healthy Choices in Schools, Homes, and Communities ECE 计划基于该组织之前在小学项目的成功经验，并与当前的幼儿营养和体育活动建议相一致。参与中心与 HealthMPowers 合作长达 3 年。每个中心的一个团队通过进行年度自我评估、创建和实施改进计划以及使用教育资源和环境提示实施营养和体育活动计划来引领变革。监测和评估计划为 HealthMPowers 和中心提供了持续的反馈。家庭和工作人员调查提供了儿童、家庭和工作人员行为的见解。过程措施包括具体的基准（例如，中心领导团队的形成，改进计划的实施）。年度自我评估结果作为中期结果衡量标准。
截至 2017 年，已有 65 个中心参加了该计划。所有中心都组建了健康团队，完成了基线自我评估，并且大多数都实施了改进计划（88%）。在 1 年的后续自我评估中，中心报告了从基线开始的改进，包括从不为良好行为提供食物奖励（75%-86%）、每月至少进行一次品尝测试（61%-79%）以及很少/从不提供含糖饮料（93%-96%）。
ECE 中多组分健康促进计划的初始过程措施很有希望。与儿童保育环境合作的综合持续改进方法是可行的，并且可能是有效的。
