Division of Critical Care, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH; Prevention Research Center for Health Neighborhoods, Case Western Reserve University, Cleveland, OH.
J Nutr Educ Behav. 2019 Apr;51(4):465-477. doi: 10.1016/j.jneb.2018.09.004. Epub 2018 Nov 8.
Identify factors perceived to influence implementation of healthy eating policy, systems, and environmental strategies (PSEs) in child care settings serving low-income children.
This mixed-methods study, conducted in 2015-2016, used semi-structured interviews (n = 18), focus groups (n = 23), and an expert panel.
Public health (n = 11) and Supplemental Nutrition Assistance Program-Education practitioners (n = 9) and community residents (n = 174) from 9 counties in Ohio. Expert panelists (n = 10) had experience implementing PSEs in child care settings.
Implementation factors influencing healthy eating PSEs in child care settings.
Qualitative thematic analysis of 41 transcripts using a grounded theory approach. Indicators for each theme were operationalized. Consensus feedback from an expert panel weighted themes and indicators based on perceived importance for implementation.
Identified themes relevant to implementation of PSEs included (1) organizational and practitioner capacity, (2) child care capacity, (3) networks and relationships, and (4) community resources and motivations. Nineteen indicators related to the 4 themes were identified and weighted.
Findings highlighted key factors within domains of influence and informed the operationalization of the indicators and the development of an assessment tool. The assessment tool is designed to tailor PSE implementation to the realities of different child care settings.
确定影响儿童保育环境中健康饮食政策、系统和环境策略（PSE）实施的因素，这些儿童保育环境服务于低收入儿童。
这项混合方法研究于 2015-2016 年进行，使用半结构化访谈（n=18）、焦点小组（n=23）和专家小组。
来自俄亥俄州 9 个县的公共卫生（n=11）和补充营养援助计划教育从业者（n=9）和社区居民（n=174）。专家小组成员（n=10）在儿童保育环境中实施 PSE 方面有经验。
影响儿童保育环境中健康饮食 PSE 实施的实施因素。
使用扎根理论方法对 41 份转录本进行定性主题分析。为每个主题制定了操作性指标。根据实施的重要性，一个专家小组对主题和指标进行了共识反馈。
确定与 PSE 实施相关的主题包括（1）组织和从业者能力，（2）儿童保育能力，（3）网络和关系，以及（4）社区资源和动机。确定了与 4 个主题相关的 19 个指标，并对其进行了加权。
研究结果突出了影响领域内的关键因素，并为指标的实施和评估工具的开发提供了信息。评估工具旨在根据不同儿童保育环境的实际情况调整 PSE 的实施。
