Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
Rudd Center for Food Policy & Obesity, University of Connecticut, Hartford, CT, USA.
Transl Behav Med. 2020 Aug 7;10(3):801-811. doi: 10.1093/tbm/ibz045.
Learning Care Group made a three-year commitment with the Partnership for a Healthier America to implement several evidence-based nutrition and physical activity policies in over 900 child care centers. New practices included serving more fruits and vegetables; eliminating sugary drinks and juice; family-style dining; healthier celebrations; limiting screen time; increasing outdoor play time; and supporting breastfeeding. A sequential convergent mixed-methods design was used to describe changes in center practices over time; organizational support for changes; and center director perceptions of the implementation process. Data were collected through an interview with organizational leadership; document review; and online center director surveys at 6, 18, and 36 months. The final center director survey included open-ended questions about policy implementation. Written responses were coded and overall themes were extracted by integrating the qualitative and quantitative data. The five overall themes were to: take a comprehensive approach; build the initiative over time; provide structural supports; replace old practices with new ones; and communicate thoroughly. Center leaders reported primarily positive reactions to healthier menus, juice removal, and increased physical activity. The most controversial policy concerned healthier celebrations. Center directors reported that the staff and children adapted quickly to changes, while some families required more assistance. The experience of this large child care organization can inform other efforts to implement early care and education wellness policies.
Learning Care Group 与“更健康美国伙伴关系”签署了为期三年的协议，将在 900 多家日托中心实施多项基于证据的营养和体育活动政策。新的实践包括提供更多的水果和蔬菜；消除含糖饮料和果汁；家庭式用餐；更健康的庆祝活动；限制屏幕时间；增加户外活动时间；以及支持母乳喂养。采用顺序收敛混合方法设计来描述中心实践随时间的变化；组织对变革的支持；以及中心主任对实施过程的看法。通过与组织领导进行访谈、文件审查以及在 6、18 和 36 个月进行在线中心主任调查来收集数据。最终的中心主任调查包括有关政策实施的开放式问题。对书面答复进行编码，并通过整合定性和定量数据提取总体主题。五个总体主题是：采取综合方法；随着时间的推移逐步开展倡议；提供结构支持；用新实践取代旧实践；以及进行全面沟通。中心领导报告称，对更健康的菜单、去除果汁和增加体育活动反应积极。最具争议的政策涉及更健康的庆祝活动。中心主任报告说，工作人员和孩子很快适应了变化，而一些家庭则需要更多的帮助。这家大型儿童保育组织的经验可以为其他实施早期保育和教育健康政策的努力提供信息。
